- CVS Health (Sacramento, CA)
- …handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- Sedgwick (Sacramento, CA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist Sr - Commercial Coverage Specialist **PRIMARY PURPOSE** ... investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and timely… more
- Dignity Health (Bakersfield, CA)
- **Responsibilities** The Claims Research Specialist will oversee and manage research efforts related to claims overpayments, underpayments, and billing ... for all claim types - Perform an analysis of the claims processing by reviewing contract, system configuration, benefits, financial risk (DOFRs), and manual… more
- CVS Health (Sacramento, CA)
- …And we do it all with heart, each and every day. **Position Summary** The **Senior Claims Benefit Specialist ** will review and adjust SF ( _self-funded_ ), FI ( ... and/or RX claims . They will adjudicate complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. This person will also… more
- Zurich NA (Sacramento, CA)
- Sr. Claims Specialist - Complex Construction 126105 Zurich North America is seeking a skilled and experienced Senior Claims Specialist to join our ... team. This role is essential in managing complex, high-exposure construction, and litigation claims , while supporting the New York Labor team to ensure claims … more
- Golden State Foods (Irvine, CA)
- …to streamline claims processing and mitigate loss + Manage quarterly claim review with Third Party Administrators (TPA) through selection of claims ... can advance, innovate, and contribute to our ongoing success. TheSr. Corporate Claims Specialistanalyzes, coordinates, and manages all aspects of GSF's insurance … more
- Philadelphia Insurance Companies (Mission Viejo, CA)
- …of Ward's Top 50 and rated A++ by AM Best. We are looking for a Claims Specialist to join our team! Summary: Investigate, evaluate and settle more complex first ... and third party commercial auto insurance claims . A typical day will include the following: Thoroughly...communication as well as results of investigation. Evaluates each claim in light of facts; Affirm or deny coverage;… more
- Public Consulting Group (Chula Vista, CA)
- …+ Assessments and Feasibility Studies PCG is seeking highly motivated and dependable Claims Specialist payment processing clerk with an interest in public ... service who can work in our San Diego, CA Stage 1 Child Care Payment Services operation. The clerks will be responsible for accurately distributing child care payments to child care providers and working with CalWORKs families to access child care. These staff… more
- Guidehouse (San Marcos, CA)
- …Required** **:** None **What You Will Do** **:** The **Credit Balance Specialist ** will manage credit balance workloads and respond and follow-up on external ... service. + Working knowledge can be of the following: insurance claims , billing, coding, follow-up, finance, accounting or customer service related responsibilities.… more
- Adecco US, Inc. (Roseville, CA)
- … activity with claimants and clients, maintaining professional relationships and accurate claim documentation. Candidates for Claims Examiner must meet the ... Adecco is assisting a local client recruiting for Claims Examiner opportunities in Roseville, CA (ONSITE OR REMOTE) This is an excellent opportunity to join a… more