- Molina Healthcare (Long Beach, CA)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems ... **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : 2 - 4 years provider contract support or negotiation experience in the health care field including, but not… more
- Naval Facilities Engineering Command (Port Hueneme, CA)
- …and achieve mission success. You will oversee the performance of contract support staff as a quality evaluator. Requirements Conditions of Employment Qualifications ... when selecting individuals under this specific hiring authority. However, if you claim veteran's preference, you will be required to submit supporting documentation… more
- Travelers Insurance Company (Diamond Bar, CA)
- …designation. **What is a Must Have?** + Two years of underwriting, claim , operations, risk assessment, actuarial, sales, product, or finance experience. **What Is ... access to free professional counseling services, health coaching and other resources to support your daily life needs. + **Volunteer Encouragement:** We have a deep… more
- Banc of California (Santa Ana, CA)
- …supporting organizations that provide financial literacy and job training, small business support , affordable housing, and more. At Banc of California, our success ... or credit card operations management Performs a variety of Operations Support functions; such as reviewing reports, preparing correspondence and participating in… more
- AIG (Los Angeles, CA)
- …also provide guidance, mentoring and training to less-experienced underwriters - and support them in building their broker network. + Your relationships with brokers ... meets clients' needs. + Working collaboratively with home office, distribution, actuary, claims , loss control, premium audit, credit and legal to develop and… more
- Centene Corporation (Sacramento, CA)
- …Services, Provider Network Management, Medical Management, Medical Review Unit, Pharmacy and Claims to resolve member issues. + Serves as Health Net's liaison to ... available services. + Researches and prepares conflict resolution documentation to support Appeals and Grievances. + Prepares and submits monthly and quarterly… more
- Sutter Health (Sacramento, CA)
- …quotes, reviewing policy language, budgeting, evaluating adequate limits & retentions, claims coordination & support , participating in underwriter meetings, and ... other duties as required to ensure insurance policies are renewed timely and effectively. Identifies risk, develops pro-active risk management programs and offers recommendations to mitigate risk or loss throughout the organization. Reviews & negotiates… more
- LA Care Health Plan (Los Angeles, CA)
- …members/ providers, with other duties as assigned. Duties Functional Elements: Technical Support to UM Specialist : Processing of time sensitive authorization and ... Specialist .; submit all Grievances and Appeals response letters to Grievances Specialist on daily basis. (20%) Support UM Committee and Audit activity… more
- CDM Smith (San Diego, CA)
- …and Evidence Gathering: Collect and organize all necessary documentation to support claim amounts. This includes gathering invoices, receipts, contracts, ... **Business Unit:** FSU **Job Description:** CDM Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical… more
- Molina Healthcare (San Diego, CA)
- …and financial outcomes for all PI solutions. + Leads efforts to improve claim payment accuracy, claim referrals, adjustment analysis and financial performance ... thought partner to health plan leadership and provide well-reasoned recommendations that support short- and long-term business goals. + Partners with Network to… more