- Humana (Sacramento, CA)
- …data mining, detects anomalies in data to identify and collect overpayment of claims . Contributes to the investigations of fraud waste and our financial recovery. ... provider contract payments in our payer systems, and by ensuring correct claims payment. Begins to influence department's strategy. Makes decisions on moderately… more
- Sedgwick (Sacramento, CA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance (Remote) EDI Support Specialist - Casualty **PRIMARY PURPOSE** **:** To identify, ... to include two (2) years of workers' compensation or claims related experience and three (3) years of EDI...package is offered including but not limited to, medical, dental , vision, 401k and matching, PTO, disability and life… more
- LA Care Health Plan (Los Angeles, CA)
- …management for identified and assigned member population according to Health Insurance Portability and Accountability Act (HIPAA) guidelines. Manages a specified ... additional service needs according to specific program guidelines. Uses claims processing and care management software to look up...group or managed care setting, such as a health insurance environment and/or experience as care manager in home… more
- Elevance Health (Cerritos, 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
- Elevance Health (Los Angeles, CA)
- …as single point of service support (eg, phone and e-mail inquiries, claims , enrollment, billing) to Elite Broker contacts (Brokers, General Agents, Agencies, etc.) ... plan offerings, have issues that are impacting multiple service areas such as claims , eligibility, etc. and provide onsite support as needed) with timely and… more
- Robert Half Accountemps (Lynwood, CA)
- …Benefits are available to contract/temporary professionals, including medical, vision, dental , and life and disability insurance . Hired contract/temporary ... play a crucial role in managing billing operations, ensuring accuracy in claims processing, and maintaining compliance with organizational standards. This is a fully… more
- Walmart (Manteca, CA)
- …facility level training and execution of asset protection safety functions and claims and receiving procedures by reviewing the application of policies procedures ... training needs and developing and delivering the training where needed Manages claims and receiving operations by ensuring proper policies and procedures are… more
- Robert Half Legal (Oakland, CA)
- …Benefits are available to contract/temporary professionals, including medical, vision, dental , and life and disability insurance . Hired contract/temporary ... cases, with a focus on plaintiff-side matters and disability claims . * Conduct thorough legal research and draft compelling...and trials. * Collaborate with clients to assess their claims and provide strategic legal guidance. * Utilize case… more
- The Hartford (Carlsbad, CA)
- …- LM07EE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every ... efficiency. * Collaborative Environment: Work alongside experienced Attorneys and Claims professionals in a matrixed business setting that encourages… more
- Robert Half Legal (Long Beach, CA)
- …Benefits are available to contract/temporary professionals, including medical, vision, dental , and life and disability insurance . Hired contract/temporary ... long-standing reputation in maritime and federal workers' compensation (Longshore & DBA claims ). The firm is actively seeking a Workers' Compensation Attorney with… more