- CVS Health (Sacramento, CA)
- …with heart, each and every day. **Position Summary** Our **Customer Service Representative ** is the face of Aetna/Mercy Care and impacts members' service experience ... appeals and pre-authorizations, specifically those not handled by Clinical Claim Management. + Perform review of member claim...and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting,… more
- Humana (Sacramento, CA)
- …community and help us put health first** The Grievances & Appeals Representative 4 Investigates and resolves member and practitioner issues. manages client denials ... an a grievance, appeal or further request is warranted. The Grievances & Appeals Representative 4 + Review documents + Building cases + Inventory Management + Data… more
- Black & Veatch (San Jose, CA)
- **Subcontracts Representative ** Date: Aug 18, 2025 Location: Overland Park, KS, US Murrieta, CA, US San Jose, CA, US Phoenix, AZ, US Houston, TX, US Nashville, TN, ... subcontracts + Participates in the resolution/processing of backcharges and claims , as needed **Management Responsibilities** Individual Contributor **Minimum Qualifications**… more
- Insight Global (Burbank, CA)
- …role is customer facing and is considered a key customer service representative for the Health Fund. The Senior Participant Service Specialist/Analyst will process ... health insurance claims and answers calls from the customer (participant, providers,... and call policies and procedures while making sound claim /call decisions. Foster strong relationships through the resolution of… more
- CDM Smith (Carlsbad, CA)
- …Assist the project team in developing and maintaining a project risk register. Claim management: Early support for claims and disputes on the project. ... Identify contractual requirements to maintain and prosecute claims , and assist project team in managing to those requirements. Ensure that proper documentation is… more
- CDM Smith (Carlsbad, CA)
- …applicant-provided cost claims for reasonableness to report to FEMA regarding claim eligibility. Participates in and assists with the development of the final ... specialists when appropriate throughout the process. * Obtains the applicant representative 's agreement that all disaster-related damage was described and quantified… more
- Sysco (Union City, CA)
- …delivery impacts. + Communicate daily with Director of Transportation, Claims Coordinator, and Transportation Supervisors, Transportation Leads, and Transportation ... each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations… more
- Dignity Health (Oxnard, CA)
- **Responsibilities** The Provider Relations Representative is responsible for establishing and maintaining positive relationships with various clients building ... third party administrator operations such as eligibility, prior authorization, claims administration and provider network administration. Familiarity with managed… more
- CVS Health (Sacramento, CA)
- …Monitor service performance and implement improvements, as necessary. Gain in-depth knowledge of claims system and Call Tracking System to be able to lookup and ... members * May act as a backup or business representative in place of supervisor **Preferred Qualifications** + Strong...and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting,… more
- Cushman & Wakefield (Sunnyvale, CA)
- …that tenants and vendors comply with insurance requirements and coordinate all claims , as required KEY COMPETENCIES 1. Communication Proficiency (oral and written) ... conditions. PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an...by state, federal, or local law. Further, C&W takes affirmative action to ensure that applicants are employed and… more