- Sedgwick (Sacramento, CA)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... operations of multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training, and monitor… more
- Ross Stores, Inc. (Dublin, CA)
- …resolve any conflicts\. * Tie out Landlord receivable balances by isolating overcharges, audit claims , misapplied checks, and unpaid charges\. * Contribute to ... the development and implementation of the proprietary lease audit /administration software \(PD Sitelink\) enhancements\. Lead user acceptance testing process\. * Act… more
- Actalent (Irvine, CA)
- …required health and safety documentation, such as OSHA 300 logs, workers compensation claims , and safety audit and inspection records; collaborate with Human ... programs. Manage safety records and ensure compliance with third-party client safety audit platforms (eg, Avetta). Training and Education Design and maintain a… more
- LA Care Health Plan (Los Angeles, CA)
- …Summary The Specialty Plans Auditor III is responsible for planning audits and audit work programs that address appropriate claims and financial compliance ... Senior Health Care Audit Analyst Job Category: Accounting/Finance Department: Financial Compliance...also LA Care contractual agreements. The position handles DMHC claims data submissions for LA Care and its Plan… more
- Guidehouse (El Segundo, CA)
- …is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims . Must work with other ... Billing Emphasis + Correcting and billing electronic and hardcopy claims + Submits Adjusted claims + Provides...or insurance information. + Works all rejection and payer audit reports within 48 hours of receipt taking whatever… more
- Horizon Services, Inc. (Pleasanton, CA)
- …necessary + Ensure Safety Information is being completed including; fire drills, workman's comp claims , program safety audit , etc. and sent to HR as required. + ... Ensure confidential information is protected + Perform daily/monthly/quarterly/ and annual data entry, auditing and reporting into multiple systems + Record, document, monitor data pertaining to census models + Responsible for inventory control; monitor… more
- Robert Half Accountemps (Los Angeles, CA)
- Description The Claims Auditor reports functionally to the Administrative Manager but takes most direction from the Claims Manager. The Claims Auditor is ... for accuracy of the payment release. Provide back-up support to audit Member Service Representatives, fielding incoming telephone calls from members and providers,… more
- PennyMac (Moorpark, CA)
- …of homeownership through the complete mortgage journey. A Typical Day The Claims Supervisor is responsible for providing structure and oversight to the post-sale ... for the claim process including, filing all MI, investor, and insurer claims timely and accurately, providing all back-up as requested, and the reconciliation… 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
- Trustmark (Sacramento, CA)
- …communities. **About the role** This role is a dedicated training position for Claims that resides in the Knowledge Management & Customer Experience group. The ... primary function of this role is to train and audit new and existing staff in all products including...claim handling process and procedures and experience in handling claims appropriately in accordance with the corporate claim philosophy,… more