- Sedgwick (Sacramento, CA)
- …& Insurance (Remote) Manager Global Service Delivery Operations - Casualty Claims **PRIMARY PURPOSE** **:** Manages the global service delivery partnership, which ... operates as an extension of Sedgwick's services. Oversees service quality , performance, and transitions to ensure seamless execution, continuous improvement, and… more
- Kemper (Chatsworth, CA)
- …Adjuster, is responsible for the investigation, evaluation, and handling of complex to claims to conclusion. This role will have advanced claim handling skills and ... demonstrate high quality results. This position necessitates strong analytical abilities, attention...a cohesive team. **Position Responsibilities** : + Primarily handles claims with a high complexity and large injury severity.… more
- Insight Global (Irvine, CA)
- Job Description An employer in the Irvine area is seeking a Claims Examiner II. This is a hybrid position, working 1-2 days on site. The training for this role will ... will be responsible for the investigation, determination, and reporting of claims processing through auditing billing processes, including pre and post-billing… more
- Molina Healthcare (Long Beach, CA)
- **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage ... benefit interpretation. Monitors and controls backlog and workflow of claims . Ensures that claims are settled in...manner to ensure compliance to departmental turn-around time and quality standards. + Meets department quality and… more
- Humana (Sacramento, CA)
- …your opportunity to lead cross-functional initiatives, apply your expertise in healthcare claims , and shape the future of operational excellence in a dynamic, ... analyzing, and implementing strategies to improve operational efficiency, service quality , and overall performance across the enterprise shared service functions… more
- Sedgwick (West Hills, CA)
- …reviews, and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service ... multiple teams of examiners and technical staff for disability claims for clients; to monitor colleagues' workload, provide training,...contract requirements, and quality standards. + Acts as second level of appeal… more
- Centene Corporation (Sacramento, CA)
- …of recommendations to providers that would improve utilization and health care quality . + Reviews claims involving complex, controversial, or unusual or ... a leading provider of government-sponsored healthcare coverage, providing access to affordable, high- quality services to Medicaid and Medicare members, as well as to… more
- LA Care Health Plan (Los Angeles, CA)
- …etc. Collaborates with internal departments (Member Services, Provider Network Operations, Claims , Utilization Management, Pharmacy, and Quality Management) to ... of care issues and work collaboratively with multiple departments ( Claims , Provider Network Operations, Utilization Management, Quality Management, Pharmacy)… more
- Robert Half Legal (San Francisco, CA)
- …expert legal advice on risk exposure, policy interpretation, litigation strategy, and claims -handling protocols * Ensure high- quality work product within defined ... their insureds. This is a NON-LITIGATION position. If you are currently litigating insurance claims and want to shift away from litigation to a hybrid remote firm,… more
- Leonardo DRS, Inc. (Cypress, CA)
- …and maintain sound professional relationships with suppliers. Resolve issues (eg pricing, quality , timing, claims , contract disputes, etc.) associated with terms ... major subcontract items + Facilitate and manage any supplier issues (ie cost, quality , delivery, customer service) + Manage all aspects of supplier including A/P… more