- Affordable Care (Sacramento, CA)
- …with Dentrix, handling dental office finances, full insurance billing process (including claims submission, appeals, and denial management ) and being able to ... treatment and financial arrangements, handling the insurance billing process ensuring all claims are processed in a timely manner according to a variety of… more
- CDM Smith (Carlsbad, CA)
- …Assist the project team in developing and maintaining a project risk register. Claim management : Early support for claims and disputes on the project. Identify ... Manager - Pacific will be responsible supporting the project management teams in CDM Constructors' Pacific region, primarily projects...contractual requirements to maintain and prosecute claims , and assist project team in managing to those… more
- WTW (San Francisco, CA)
- …clinical/health management program design, pharmacy solutions, disability/absence management strategies and claims audit services. Product-based solutions ... We provide solutions encompassing creative plan design, vendor evaluation and management , pricing and funding strategies, data analytics, valuation support, and… more
- CVS Health (Sacramento, CA)
- …compliance impacting plan sponsors. + Collaborate with internal departments-including claims , customer service, and client management -to ensure effective ... And we do it all with heart, each and every day. Oversees the day-to-day management and leadership of the plan document drafting team. Develops and coaches the team… more
- BrightSpring Health Services (San Diego, CA)
- …knowledge of Medicaid claim regulations and processes + May produce reports and keep management informed of unpaid claims and claims pending follow-up + ... resolve issues of denials identified through adjudication, and follow-up claims in Point of Sale (POS) + Maintains current...in any area of the pharmacy as directed by management Qualifications + High school diploma or equivalent +… more
- CDM Smith (San Diego, CA)
- …Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial data related ... to disaster-related claims , including property damage, business interruption, and other loss...other duties as assigned. \#LI-LP2 **Job Title:** FEMA Disaster Management Accountant **Group:** WAF Field Mod Fringe **Employment Type:**… more
- Zurich NA (San Francisco, CA)
- Senior Management Liability Underwriter 125890 Zurich is currently looking for a Management Liability Underwriter, D&O (Senior or AVP). As we are expanding we ... Pittsburgh, San Francisco, or South Carolina Virtual! As a Management Liability Underwriter, you will be responsible for utilizing...and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more
- Humana (Sacramento, CA)
- …and processes + Solid understanding of healthcare operations, particularly around claims processing, enrollment, provider data management and clinical ... + Experience with Jira Align, ADO, SNOW, and SmartSheets + Project Management Professional (PMP), Lean Six Sigma, or other relevant certifications are advantageous… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- **Job Summary** The Associate Director (AD), Commercial Data Management (CDM) within Data Enablement (DE) for Business Analysis (BA) is accountable for strategically ... responsible for providing strategic insight and ensuring smooth day-to-day data lifecycle management processes and activities for data assets as follows: + Providing… more
- Travelers Insurance Company (Irvine, CA)
- …creates Claim File Analysis (CFA) by adhering to quality standards. + Utilizes diary management system to ensure that all claims are handled timely. + At ... results of others. + Applies the Company's claim quality management protocols and Best Practices to all claims... management protocols and Best Practices to all claims ; documents the rationale for any departure from applicable… more