- Prime Healthcare (Ontario, CA)
- … and Claims is responsible for the development and execution of Claim Operations strategies, end-to-end Claim process automation, optimization and ... and Operating Models, Long Term Business Objectives, Healthcare Payers, Claim Operations Strategies, Claim Process...(7) to ten (10) years prior work experience in Claims Operations and Health Plan Strategy, in… more
- CTG (CA)
- …on Behavioral Health and Ambulatory services. + Design, build, and maintain Epic HB Claims configuration, including claim edit rules, claim definition rules, ... **CTG is seeking to fill an Epic Hospital Billing Claims Analyst opening for our client in California.** **Location:** Remote **Duration:** 18 months **Duties:** +… more
- The Walt Disney Company (Anaheim, CA)
- …+ 3 + years of experience in property and casualty insurance, including claims handling, scene investigations, claim evaluation, and negotiation, preferably with ... software and reporting tools. + Experience driving process improvements in claims or guest service operations . **Required Education:** + Bachelor's… more
- Elevance Health (Los Angeles, CA)
- **Director II, Digital Claims Operations (Dir II Digital Ops)** Location: This role requires associates to be in-office **3 days per week** , fostering ... within a commutable distance from an office._ The **Director II, Digital Claims Operations ** oversees a combined digital and operations unit(s); executes… more
- Sedgwick (Sacramento, CA)
- …as suggested by the claim status; and provides written resumes of specific claims as requested by client. + Assures that direct reports are properly licensed in ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Leader - Liability **PRIMARY PURPOSE** : To supervise the operation of… more
- Sedgwick (Riverside, CA)
- …as suggested by the claim status; and provides written resumes of specific claims as requested by client. + Assures that direct reports are properly licensed in ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Team Lead (Supervisor) | Riverside, CA | SIP Required Are you… more
- CTG (CA)
- …include: + **System Configuration & Build:** Configure and maintain Epic PB Claims functionality, including claim edit rules, charge review workqueues, and ... Behavioral Health and Ambulatory billing requirements across multiple states. + ** Claims Management & Troubleshooting:** Monitor claim generation for accuracy… more
- Providence (CA)
- …statements for services and take proper steps to pay vendors + Inform Senior Manager Operations of large or complex claims and claims with potential for ... **Description** **Senior Professional Liability Medical Claims Manager This position works R** **_emote._** **Many...for each matter:** + Develop and document for each claim or lawsuit a plan of action for resolution… more
- Zurich NA (Gold River, CA)
- …within our General Liability Specialty Team. In this pivotal role, you'll oversee claim operations across Captives, Excess & Surplus, and Direct Markets. This ... Zurich is currently seeking an AVP to direct and oversee the operations of our Claims General Liability leadership team. We're seeking an inspiring and dynamic… more
- UCLA Health (Los Angeles, CA)
- …You will be responsible for monthly random and focus audits of all claim processing activities to identify inaccurate claims adjudication. This will involve ... reviewing UB04 and CMS 1500 healthcare claims and adjustments for accuracy, and appropriate application claims adjudication, including CMS regulations,… more