- The County of Los Angeles (Los Angeles, CA)
- …SPECIAL INFORMATION: * A valid State of California Registration as a Professional Geologist (PG) holding the certification in Engineering Geology (EG) will also ... 60%, assessing: + Reading Comprehension + Deductive Reasoning + Professional Potential + Achievement + Coping with Uncertainty +...of MOST notices. Los Angeles County will not consider claims of not viewing or receiving notification to be… more
- Elevance Health (Walnut Creek, CA)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- Elevance Health (Costa Mesa, CA)
- …with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable ... conduct extensive research and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize and route to nursing… more
- Travelers Insurance Company (Walnut Creek, CA)
- …to work as soon as medically appropriate. As a Workers Compensation Claim Professional Trainee, you will handle all aspects of a workers compensation claims ... needed for quality claim handling including investigating, evaluating, negotiating, and resolving claims on losses of lesser value and complexity and provide claim… more
- Sedgwick (Sacramento, CA)
- …for its excellence and customer service. + Take advantage of a variety of professional development opportunities that help you perform your best work and grow your ... the Finance Manager or Director. + Process account collections/receivables. + Reconcile claims activity between general ledger and claims system and investigate… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …third-party data assets, including Xponent Plantrak, DDD, HCOS, Claims Data, Specialty pharma, omnichannel data, SalesForce/Veeva (Call/Sample/Detail), etc. ... through influence, persuasion and relationships. + Highest personal and professional integrity and strong work ethics. + Results orientation,...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Sharp HealthCare (San Diego, CA)
- …investigating and responding to internal and external benefit inquiries, and supporting claims testing activities. **Required Qualifications** + 3 Years in HMO or ... insurance product implementation, benefit/coverage policy development, benefit configuration, or claims role. **Other Qualification Requirements** + Bachelor's degree in… more
- Sharp HealthCare (San Diego, CA)
- …and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit ... insurance product implementation, benefit/coverage policy development, benefit configuration, or claims role. **Other Qualification Requirements** + Bachelor's degree in… more
- The Hartford (Brea, CA)
- …a matrixed business environment where you will have direct interaction with Claims Partners and insureds, we want to speak with you! RESPONSIBILITIES:* Analyze ... trial briefs in support of defense strategies with autonomy.* Partner with our Claims Partners to achieve the best results for our Hartford insured.* Provide… more
- The Hartford (CA)
- …within a matrixed business environment where you will have direct interaction with Claims Partners and insureds, we want to speak with you! RESPONSIBILITIES: * ... of defense strategies with autonomy. * Partner with our Claims Partners to achieve the best results for our...with the court, witnesses, opposing counsel and co-counsel with professional diplomacy and discretion. * Facilitate prompt, efficient and… more