- Prime Healthcare (Ontario, CA)
- …relocating to Ontario, California. TheVice President of Health Plan Operations and Claims is responsible for the development and execution of Claim Operations ... to improve the quality and minimize process cost of Claims for all Prime Healthcare's self-insured Employee Health Plans....Employee Health Plans. Through in-depth audit and review of Claims data, the VP will identify financial savings across… more
- City of Long Beach (Long Beach, CA)
- WORKERS COMPENSATION CLAIMS ASSISTANT Print (https://www.governmentjobs.com/careers/longbeach/jobs/newprint/5085519) Apply WORKERS COMPENSATION CLAIMS ... notices, and other correspondence; + Processes benefit payments, invoices, and claims payments as requested; + Assists in obtaining disability status, medical… more
- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** The Claims Examiner III is an advanced-level role responsible for the detailed and accurate processing, review, and adjudication ... of complex healthcare claims . This position requires expert knowledge of claims processing, coding, and regulatory compliance. The Claims Examiner III will… more
- Sedgwick (Concord, CA)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Liability Claims Manager - Dedicated Are you looking for an opportunity to join a ... Establishes policy and procedure to ensure compliance to best practices, claims management services standards, state regulations and client service requirements;… more
- US Tech Solutions (Whittier, CA)
- …3+ months contract** **Responsibilities:** + Review, adjudicate, and process medical claims for HMO patients + Work closely with affiliated medical groups ... Evaluate provider reimbursement terms and flag non-contracted providers + Ensure claims are processed accurately and timely per policy guidelines **Experience:** 2+… more
- Fluor (Fresno, CA)
- …direction of the Director and Deputy Director of the PMO/forensics & Claims , this role is responsible for developing forensic analyses and providing oversight ... also responsible for reviewing and analyzing Contractors' Time Impact Analyses and claims and assisting with the rebuttal responses. In addition to forensic analysis… more
- HUB International (Sacramento, CA)
- …carrier selections. + Ensures client questions / concerns are addressed by claims department or Third Party Administrator. + Interact with clients by telephone ... producers. Attend sales presentations or renewal visits to present claims , programs for the reduction of risk, or loss...policy coverage in its application to property & casualty claims . + Maintains accurate and organized claim files by… more
- UCLA Health (Los Angeles, CA)
- …to the next level. You can do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned to the ... auditor. You will review claims (paid, pending, and denied) for accuracy, appropriate application...or equivalent + Four or more years of medical claims payment experience in an HMO environment + Experience… more
- Prime Healthcare (Victorville, CA)
- …Many more Voluntary Benefit Options! (https://www.primehealthcare.com/careers/benefits/) Responsibilities Claims Examiner processes routine and non-routine claims ... departmental policies and procedures. To accurately evaluate and adjudicate claims in a timely manner and according to set...Experience + 2-3 years relevant experience in health care claims and customer service. + Knowledge of Medical Terminology,… more
- Philadelphia Insurance Companies (Roseville, CA)
- …of Ward's Top 50 and rated A++ by AM Best. We are looking for a Claims Assistant - to join our team. Summary: Provides administrative support to claims unit(s) ... handles routine document tracking, internal/external customer/vendor communication and other basic claims functions. A typical day will include the following: *… more