- Prime Healthcare (Ontario, CA)
- …documents from internal or external entities, resolving claim rejections, packaging claims , including global billing with attachments of professional fee claims ... gender identity, religion, national origin, age (subject to applicable law), disability , military status, genetic information or any other basis protected by… more
- Evolent (Sacramento, CA)
- …You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, and population ... with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including prior authorization data… more
- Sharp HealthCare (San Diego, CA)
- …non-clinical appeals and grievances. **Required Qualifications** + 3 years' experience in claims , utilization review, appeals or member services in a managed care ... requests for assistance.Provides feedback to Customer Service, Enrollment, Provider Relations, Claims Research, and Health Services on issues and trends identified… more
- BeOne Medicines (San Carlos, CA)
- …progression probability, clinical trial outcomes, and market access feasibility. + Utilize claims data and real-world evidence (RWE) to develop Line of Therapy (LoT) ... access considerations. + Support strategic planning for market entry, lifecycle management , and geographic expansion, assessing unmet needs, pricing potential, and… more
- Sedgwick (San Diego, CA)
- …not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the ... but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account,… more
- The Hartford (San Francisco, CA)
- …intersection of underwriting, data science, risk finance, risk engineering, technology, and claims . We are seeking three exceptional individuals to lead the charge ... underwriting culture, and overseeing underwriting, sales leadership, and broker/agency management . The Managing Director will work closely with Y-Risk Innovation… more
- Financial Partners Credit Union (Downey, CA)
- …extensions, legal actions, or charge-offs. Essential Responsibilities: + Delinquency Management : + Collect past-due consumer loans and credit cards that ... for approval. + Assign accounts for field chase when necessary. + Documentation and Claims : + Review and follow up on letters of guarantee with insurance companies.… more
- Kemper (Bakersfield, CA)
- …collaborating with peers in the sales organization, State Product Managers, Claims , Agency Support and Licensing, Marketing, and Customer Service/Underwriting. + The ... + Bilingual a plus. + Working knowledge of insurance operations: underwriting, claims , marketing, and product. + Must have and maintain an acceptable driving… more
- TevisHR (CA)
- …home office in Sacramento, CA. Job Summary: A Loss Consultant for insurance claims is responsible for evaluating the extent of damage to residential properties ... informed about relevant laws, regulations, and industry standards governing insurance claims and property damage assessment, ensuring compliance with legal and… more
- Walgreens (San Bruno, CA)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... as assigned by the Pharmacy Manager. + Leads Pharmacy Department inventory management activities, such as, ordering, unpacking, checking and storing shipment of… more