• Medicaid Provider Hospital Reimbursement…

    Humana (Sacramento, CA)
    …They will work closely with IT, the pricing software vendor, CIS BSS, Medicaid operations , claims operations , and other business teams involved in the ... APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg performing basic… more
    Humana (08/14/25)
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  • Senior Sales Executive-National Accounts

    Kemper (San Diego, CA)
    …company and state requirements. + Works directly with strategic partners like Product, Claims , and Operations on issues impacting the account. + Performs other ... or comparable sales/marketing management experience + Extensive knowledge of insurance operations : claims , coverages, products and underwriting is preferable to… more
    Kemper (08/07/25)
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  • Manager, Customer Solution Center Appeals…

    LA Care Health Plan (Los Angeles, CA)
    …etc. Collaborates with internal departments (Member Services, Provider Network Operations , Claims , Utilization Management, Pharmacy, and Quality Management) ... quality of care issues and work collaboratively with multiple departments ( Claims , Provider Network Operations , Utilization Management, Quality Management,… more
    LA Care Health Plan (07/08/25)
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  • Financial Business Systems Analyst

    Cedars-Sinai (Los Angeles, CA)
    …and payments for partners. + Address inquiries and provide support regarding claims processing and clearinghouse operations . + Implement corrective actions for ... definition, applications development and maintenance and enhancements for finance, claims processing, revenue management, and billing systems. Primary duties… more
    Cedars-Sinai (06/07/25)
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  • Manager, Provider Contracting Network Management…

    The Cigna Group (Los Angeles, CA)
    …of communication with matrix partners including but not limited to, Claims Operations , Medical Management. Credentialing, Legal, Medical Economics, Compliance, ... Sales and Marketing and Service. + Contributes to the development of alternative network initiatives. Supports and provides direction to develop network analytics required for the network solution. + Works to meet unit cost targets, while preserving an… more
    The Cigna Group (07/26/25)
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  • Manager, Risk and Insurance

    DoorDash (San Francisco, CA)
    …our business by managing corporate insurance programs and mitigating risk across Actuarial, Claims Operations , and Risk Management & Mitigation. We operate at ... the intersection of risk, safety, and innovation to support business growth. About the Role As a Manager, Risk and Insurance, you'll lead risk management initiatives, ensuring our insurance programs align with business growth. You'll assess and mitigate risks,… more
    DoorDash (06/06/25)
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  • Customer Experience Specialist

    Adecco US, Inc. (Los Angeles, CA)
    …experience for our customers. This role will focus on customer service operations , claims handling, feedback analysis, and experience optimization across various ... and loyalty. **What You'll Do** + Oversee and manage customer service operations across online and offline retail channels + Handle customer inquiries, complaints,… more
    Adecco US, Inc. (07/25/25)
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  • Claims Team Lead I Workers Comp (Calif Exp)

    Sedgwick (Sacramento, CA)
    …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead I Workers Comp (Calif Exp) **PRIMARY PURPOSE:** To supervise the ... individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in… more
    Sedgwick (08/23/25)
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  • Claims Examiner - Remote Within 90 Miles Of

    TEKsystems (Fresno, CA)
    MUST LIVE WITHIN A 90 MILE RADIUS OF FRESNO, CA. Description The Claims Examiner I reports to the Supervisor of Claims . Claims Examiner I is responsible for ... reviewing and processing medical, dental, vision and electronic claims in accordance with state, federal and health plan regulatory requirements, department… more
    TEKsystems (08/16/25)
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  • Workers Compensation Claims Team Lead…

    Sedgwick (Riverside, CA)
    …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Team Lead (Supervisor) | Riverside, CA | SIP Required Are you ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...multiple product line examiners and/or several (minimum seven) technical operations colleagues for a wide span of control; may… more
    Sedgwick (08/13/25)
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