- Centene Corporation (Sacramento, CA)
- …5:30am PT to as late as 8:30am PT. **Position Purpose:** Perform regulatory claims compliance audits to support health plan operations. Completes retrospective ... a monthly, quarterly and annual basis to ensure regulatory compliance . + Perform claims compliance ...professional and facility claims , managed care benefits, claims adjudication concepts, claims inventory management… more
- Providence (CA)
- …and procedures, system-wide claims and litigation processes, and appropriate System risk management issues + Provide input for quality and patient safety ... with potential excess exposure to excess insurers + Ensure compliance with relevant claims reporting procedures and...from approved counsel list + Coordinate and consult with risk management on disclosure conversations with patients… more
- ICW Group (Pleasanton, CA)
- …to enterprise risk reduction by ensuring timely resolution of high-cost claims and influencing best practices in litigation management . The Major ... medical management . **ESSENTIAL DUTIES AND RESPONSIBILITIES** **Strategic Claims Management ** + Manages all aspects of... risk transfer. + Partners with Underwriting and Risk Management to inform account level-strategies and… more
- Providence (CA)
- …and procedures, system-wide claims and litigation processes, and appropriate System risk management issues. The Claims Manager will foster teamwork, ... data management software; coordinating with facility leadership, risk managers, defense counsel, and others; ensuring compliance...as a litigator or paralegal), health care or general risk management , and insurance claims … more
- Adecco US, Inc. (Fountain Valley, CA)
- Adecco is assisting a local client recruiting for **a Sr. Associate Risk Management Compliance ** opportunity in Fountain Valley, CA! If the **Sr. Associate ... Risk Management Compliance ** sounds like...Risk Management Compliance ** sounds like something you would...graduate and Bachelor's degree required - 4-5 years of claims or risk management experience… more
- Sedgwick (Sacramento, CA)
- …as applicable to line of business preferred. **Experience** Six (6) years of claims management experience related to general liability claims or ... and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service...motivation to promote maximum performance. + Thorough knowledge of claims management processes and procedures for multiple… more
- Sedgwick (Sacramento, CA)
- … claims supervisor experience. **Skills & Knowledge** + Thorough knowledge of claims management processes and procedures for multiple product lines + ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles reviews and analyzes management reports and… more
- Sedgwick (San Diego, CA)
- …dental vision, 401K on day one. **Skills & Knowledge** + Thorough knowledge of claims management processes and procedures for multiple product lines + Excellent ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles reviews and analyzes management reports and… more
- Zurich NA (Sacramento, CA)
- …+ Ensure regular communication with clients, brokers, business units, and senior claims management . + Proactively manage and resolve high-severity injury ... Sr. Claims Specialist - Complex Construction 126105 Zurich North...commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses… more
- Sedgwick (Sacramento, CA)
- …as applicable to line of business preferred. **Experience** Six (6) years of claims management experience or equivalent combination of education and experience ... provide resolution of highly complex nature and/or severe injury claims ; to coordinate case management within Company...this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps… more