- Sedgwick (Sacramento, CA)
- …monthly reconciliations and various balance sheet account controls to safeguard quality assurance. + Prepares deposits, posts receipts, and reconciles billing. + ... the Finance Manager or Director. + Process account collections/receivables. + Reconcile claims activity between general ledger and claims system and investigate… more
- Oura (San Francisco, CA)
- …this role will be responsible for advising on regulatory risk, marketing claims , product labeling, corporate compliance initiatives, and will oversee the privacy ... tracking, AI-driven diagnostics, real-world data applications, and health and wellness claims . + Provide legal and regulatory oversight for clinical studies and… more
- LA Care Health Plan (Los Angeles, CA)
- …the right time. Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents ... and corrective action plans monitoring of financial solvency and claims processing compliance for specialty health plans and vendors....responsible for the Department of Managed Health Care (DMHC) claims data submissions for LA Care and its Plan… more
- Sedgwick (San Francisco, CA)
- …Adjuster - Pacific Region **PRIMARY PURPOSE** **:** To investigate losses or claims internationally on any size National Account (Maintaining a minimum of five ... be negotiated. + Attends litigation hearings. + Revises case reserves in assigned claims files to cover probably costs. + Prepares loss experience reports to help… more
- Sedgwick (Sacramento, CA)
- …role will be responsible for investigating and adjusting property and casualty claims , both residential and commercial, with little to no supervision. **ESSENTIAL ... be negotiated. + Attends litigation hearings. + Revises case reserves in assigned claims files to cover probable costs. + Assists in preparing loss experience report… more
- Evolent (Sacramento, CA)
- …cost and use trends, and estimate Evolent's ability to reduce costs and improve quality . + Develop models to quantify and articulate value of new and existing ... fostering trust, expertise and cooperation. + Extract, manage, and analyze claims and operational data using industry-standard metrics. + Process and validate… more
- J&J Family of Companies (Irvine, CA)
- …also have preclinical operations responsibility for the entire PFA Platform, including quality review and compliance to GLP guidelines. This role will provide strong ... of evidence generation and dissemination activities that support product approvals, claims development, and product adoption and lifecycle management, and work… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …and guidelines. - Confirms submission documents are accurate, compliant, and high- quality to allow for smooth and expeditious approvals from regulatory authorities. ... department to execute departmental initiatives to improve overall efficiency, quality , and/or output. - Assess and develop innovative ideas...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Guidehouse (El Segundo, CA)
- …**:** None **What You Will Do** **:** The **Team Lead - Hospital Claims ** is responsible for supervising and coordinating the daily operations and activities of ... This role ensures the efficient handling of patient accounts while maintaining quality assurance standards. The individual is to provide support in developing,… more
- Dignity Health (Bakersfield, CA)
- …deep familiarity with the complexities of delegated services, including claims , utilization management, provider data, and network operations. Essential Functions ... to PHSO managed care objectives, with focus areas including delegated operations, quality , analytics, and care coordination. - Program Execution: Lead the end-to-end… more