- Sedgwick (Rancho Cucamonga, CA)
- …+ This role will be primarily responsible for **_Large Complex Property_** claims . **PRIMARY PURPOSE** **:** To investigate losses or claims internationally ... Attends litigation hearings. + Revises case reserves in assigned claims files to cover probably costs. + Prepares loss...+ Attention to detail and accuracy + Good time management and organizational skills + Ability to work independently… more
- Robert Half Accountemps (San Diego, CA)
- …state and federal guidelines for Medicaid/Medicare billing and reporting. + Denial Management : Research and resolve denied claims , identify trends, and implement ... to lead their billing team and ensure the accuracy and compliance of claims submissions. This role is ideal for someone with in-depth experience in healthcare… more
- NTT DATA North America (San Francisco, CA)
- …benefits, provider contracts, pricing, accumulators, authorization rules, and claims processing. -Collaborate with configuration analysts, business analysts, and ... test scripts for functional, regression, and integration testing. -Create test data using Claims test Pro, testing tool created by Cognizant. -Identify test data and… more
- Molina Healthcare (San Diego, CA)
- …Analysis** + Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. + Applies understanding of ... healthcare regulations, managed care claims workflows, and provider reimbursement models to shape recommendations and action plans. + Translates strategic needs into… more
- Travelers Insurance Company (San Francisco, CA)
- …is intended to develop skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. Provides quality claim ... and execution of the following core assignments: + Handles 1st party property claims of moderate severity and complexity as assigned. + Establishes accurate scope of… more
- Sedgwick (West Hills, CA)
- …on client plans, state and federal regulations. Ensures that on-going claim management is within company service standards and industry best practices. **ESSENTIAL ... Establishes FMLA and other unpaid state, military, and/or company-specific leave claims ; tracks and codes documentation in accordance with internal workflow… more
- Evolent (Sacramento, CA)
- …will partner with stakeholders of various levels across analytics, finance, and account management . **What You Will Be Doing:** + Develop and deploy models and ... into succinct presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based on relevant… more
- Renewable Properties (San Francisco, CA)
- …divestitures, joint ventures, and partnership arrangements. + Identify and counsel management about potential risks, claims and disputes potentially arising ... connection with potential transactions. + Provide legal assistance and advice to management . + Remain current on constant changes within legal and regulatory… more
- Zurich NA (Los Angeles, CA)
- …work collaboratively across business units including but not limited to; claims , finance, risk engineering, actuary, and technical underwriting while gaining ... and 6 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance...property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We… more
- Highmark Health (Sacramento, CA)
- … management skills + Knowledgeable in enrollment and billing, claims , and telephone customer service and written correspondence processes and applications ... supervisory direction and oversight for all enrollment, premium billing, claims and/or customer service telephone and written correspondence inquiries (routine,… more