• Claims Adjudication Specialist - Remote

    Cognizant (Sacramento, CA)
    …Monday to Friday 8am - 4:30pm ET **Experience:** A minimum of 2 years of claim processing is required. **Travel:** None required **About the role:** As Claims ... * Be Responsible for reviewing the data in the claim processing system and comparing with corresponding...of Facets experience. * Experience in the analysis and processing of claims for payments, utilization review/quality… more
    Cognizant (08/15/25)
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  • Pharmacy Claims Auditor - Remote

    Prime Therapeutics (San Diego, CA)
    …skill and understanding of the point of sale and on-line pharmacy claims processing environment + Excellent oral, written and interpersonal communication ... pharmacies to drive timely and accurate documentation receipt and review + Analyze pharmacy claims to identify those at the highest risk for error; utilize… more
    Prime Therapeutics (08/15/25)
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  • Claims Examiner

    Kelly Services (Brea, CA)
    … Examiner? You'll be:** **Essential Duties and Responsibilities** + Analyzing and processing complex or litigated **California workers' compensation claims ** + ... isn't always easy. That's where we come in.** We're seeking a ** Claims Examiner - Workers' Compensation** to support a leading provider of technology-enabled… more
    Kelly Services (08/08/25)
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  • Claims and Denials Specialist

    Robert Half Office Team (Oakland, CA)
    …in a fast-paced environment. * Proficiency in relevant software and tools for claims processing and administrative tasks. TalentMatch(R) Robert Half is the ... Description We are looking for an experienced Claims and Denials Specialist to join our team...claim denials, and ensuring smooth administrative operations for home health services. If you have a strong background… more
    Robert Half Office Team (08/15/25)
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  • Claims and Denials Specialist

    Robert Half Office Team (Oakland, CA)
    …processes. Responsibilities: * Handle insurance authorization requests and ensure timely processing . * Manage claim denials and appeals, working closely ... or a related field. * Proficiency in handling medical insurance verifications and claims processes. * Strong knowledge of claim denials and appeals procedures.… more
    Robert Half Office Team (08/08/25)
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  • Work at Home Contact Center Agent

    Mass Markets (CA)
    POSITION OVERVIEW WE'RE HIRING 1,000 WORK AT HOME STAFF TO SUPPORT FEDERAL, STATE, AND COMMERCIAL CLIENTS MCI is looking for nationwide work at home ... a home broadband connection. POSITION RESPONSIBILITIES WHAT DOES A WORK AT HOME CONTACT CENTER REPRESENTATIVE DO? This position supports customer service,… more
    Mass Markets (07/16/25)
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  • Onsite Pharmacy Auditor (based in California)

    Prime Therapeutics (San Diego, CA)
    …skill and understanding of the point of sale and on-line pharmacy claims processing environment + Excellent oral, written and interpersonal communication ... and schedule trips in accordance to Prime's travel and expense policy + Analyze pharmacy claims to identify those at the highest risk for error; leverage audit… more
    Prime Therapeutics (06/28/25)
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  • Bi-lingual Pharmacy Tech Support Call Center Rep…

    IQVIA (San Francisco, CA)
    …+ Call center experience required (3+ years preferred) + Experience in medical claim processing is a plus + Bi-lingual (English/Spanish) **The pay range ... we are looking for a 100% remote (work from home -WFH) contract **Pharmacy Support Call Center Representative** to join...improve patient outcomes and population health worldwide. Learn more at https://jobs.iqvia.com IQVIA is proud to be an equal… more
    IQVIA (06/19/25)
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  • Code Edit Professional 2

    Humana (Sacramento, CA)
    …(CCM)_ + Prior experience analyzing medical claims data **Additional Information** **Work at Home Requirements** * At minimum, a download speed of ... available. The Payment Integrity Professional 2 utilizes vendor platforms, claims processing platforms, and data to collaborate...to make an impact** **WORK STYLE** : Remote, work at home . Minimal travel possible: Approximately 1-2x/year… more
    Humana (08/14/25)
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  • Accountant I/II/Senior

    Ventura County (Ventura, CA)
    …I) or calculates and analyzes (Accountant II) Incurred but not Reported medical claims based on system generated claim lag reports to provide realistic ... merit increase within the pay range upon completion of at least 1,040 hours (approximately 6 months) assuming work...The County includes 42 miles of coastline which is home to the fol-lowing cities and points of interest:… more
    Ventura County (06/02/25)
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