- 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 ... Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and...in good faith believes is the range of possible compensation for this role at the time of this… more
- Robert Half Accountemps (Lynwood, CA)
- …may be available. Key Responsibilities: + Submit and process medical claims accurately to Medi-Cal, commercial insurance, government payers, and other third-party ... Manage denials and appeals, researching root causes, documenting issues, and resubmitting claims as needed. + Collaborate with payers and providers to resolve… more
- Ventura County (Ventura, CA)
- …general direction, the incumbent is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, ... the Service Employees' International Union (SEIU) and is eligible for overtime compensation . TENTATIVE SCHEDULE OPENING DATE: May 28, 2025 CLOSING DATE: Continuous… more
- CDM Smith (San Diego, CA)
- …Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial data related ... to disaster-related claims , including property damage, business interruption, and other loss...**Pay Range Minimum:** $59.85 **Pay Range Maximum:** $126.00 **Additional Compensation :** All bonuses at CDM Smith are discretionary and… more
- Prime Therapeutics (San Diego, CA)
- …pharmacy audits and is responsible for the selection and auditing of claims , educating Prime's network pharmacies and driving contract compliance, and supporting ... schedule trips in accordance to Prime's travel and expense policy + Analyze pharmacy claims to identify those at the highest risk for error; leverage audit analytics… more
- Clark Construction Group, LLC (San Francisco, CA)
- …everyone. * Facilitate third-party safety reviews, including OSHA. * Understand workers' compensation and lead efforts in managing claims . * Utilize experience ... to proactively mitigate upcoming safety challenges. * Proactively identify and develop relationships with industry professionals to generate and win the right work. * Take an active role in recruiting top industry talent to join the Clark team. Identify, hire,… more
- Zurich NA (San Francisco, CA)
- …Diploma or Equivalent and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate ... and 8 or more years of experience in the Claims or Underwriting Support areaAND + Knowledge of Microsoft...communication skills + Strong relationship building skills At Zurich, compensation for roles is influenced by a variety of… 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 ... of insurance. + Estimates cost of repair, replacement, or compensation . + Prepares report of findings and negotiates settlement...Attends litigation hearings. + Revises case reserves in assigned claims files to cover probable costs. + Assists in… more
- Molina Healthcare (Long Beach, CA)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... that provider information is loaded accurately to allow for proper claims processing, outbound reporting and directory processes. **JOB QUALIFICATIONS** **Required… more
- Sedgwick (Sacramento, CA)
- …the Finance Manager or Director. + Process account collections/receivables. + Reconcile claims activity between general ledger and claims system and investigate ... required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more