- CDM Smith (Carlsbad, CA)
- …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...Ensure that proper documentation is developed and maintained for claims . **Job Title:** Commercial Manager - Pacific **Group:** CCI… more
- Elevance Health (Los Angeles, CA)
- …in order to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health insurance policies, ... health insurance claims handling and provider network contracting. **How will you...claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying and developing enterprise-wide… more
- Amazon (CA)
- …needs via 1Life's tasking system to provide the best customer service. Investigating claims through insurance to ensure they were processed according to the patient ... from One Medical patients (customers) regarding their medical bills, insurance claims , and payment inquiries. Daily activities include reviewing patient accounts,… more
- Dignity Health (Bakersfield, CA)
- …deep familiarity with the complexities of delegated services, including claims , utilization management, provider data, and network operations. Essential Functions ... Optimization: Identify high-impact manual processes across departments such as Claims , UM, Credentialing, and Provider Data. Facilitate automation readiness… more
- Zurich NA (Irvine, CA)
- …+ Work to have a timely resolution to matters by collaborating with the claims adjuster, developing a case strategy and escalating issues as appropriate + Ensure ... state and federal laws and regulations + Protect Zurich's reputation by keeping claims information confidential Basic Qualifications: + Juris Doctor and 5 or more… more
- Wounded Warrior Project (San Diego, CA)
- …(NSO) educates and advocates for warriors and their families as they pursue claims for injuries sustained during active duty military service. The NSO guides and ... manages the preparation and processing of all claims and subsequent appeals through the Department of Defense...laws and regulations when researching, filing, and closing benefits claims . + Working knowledge of all VBA electronic systems,… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive ... legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,...will not be held liable or responsible for any claims , losses, damages or expenses resulting from job recruiting… more
- Sedgwick (Los Angeles, CA)
- …IDEAL CANDIDATE?** If you have a strong background in handling cargo claims , hull and machinery, yacht damage assessments, or investigating marine equipment ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- CVS Health (Sacramento, CA)
- …day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject ... customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority… more
- Sharp HealthCare (San Diego, CA)
- …with medical management such as provider relations, member services, benefits and claims management, IT management, etc. + Plans, organizes, and directs the ... analysis of Plan performance from summary data of paid claims , encounters, authorization logs, complaint and grievance logs and...POS/PPO Case Management and high-cost review with CMO and Claims management teams. + Co-Chairs with the CMO CPTAC… more