• Vice President of Health Plan Operations…

    Prime Healthcare (Ontario, CA)
    …Responsibilities This position requires relocating to Ontario, California. TheVice President of Health Plan Operations and Claims is responsible for the ... to improve the quality and minimize process cost of Claims for all Prime Healthcare's self-insured Employee Health... Claims for all Prime Healthcare's self-insured Employee Health Plans. Through in-depth audit and review of … more
    Prime Healthcare (09/24/25)
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  • Claims Manager - Employment

    Stanford Health Care (Palo Alto, CA)
    Claims Manager is primarily responsible for handling Employment Practices Liability (EPL) claims for Stanford Health Care, Stanford Health Care ... Tri-Valley, and Stanford Children's Health . Claims include those involving allegations of discrimination, retaliation, hostile work environment, and wrongful… more
    Stanford Health Care (11/26/25)
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  • Claims Manager - Workers Compensation

    Stanford Health Care (Palo Alto, CA)
    … & Litigation Strategy, the Claims Manager oversees the workers' compensation claims program for Stanford Health Care, Stanford Health Care Tri-Valley, ... Hour (United States of America) **This is a Stanford Health Care job.** **A Brief Overview** Under the direction...and Stanford Children's Health . The Claims Manager acts as the primary liaison with the… more
    Stanford Health Care (11/26/25)
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  • Claims Quality Auditor

    UCLA Health (Los Angeles, CA)
    …Take your career to the next level. You can do all this and more at UCLA Health . The Claims Quality Auditor will be responsible for the daily audit of all ... + Knowledge of claims adjudication systems + Flexibility and adaptability UCLA Health is a world-renowned health system with four award-winning hospitals and… more
    UCLA Health (11/07/25)
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  • Claims Examiner - Claims

    Prime Healthcare (Victorville, CA)
    …- Qualifications Education and Work Experience + 2-3 years relevant experience in health care claims and customer service. + Knowledge of Medical Terminology, ... Reimbursement + Many more Voluntary Benefit Options! (https://www.primehealthcare.com/careers/benefits/) Responsibilities Claims Examiner processes routine and non-routine claims more
    Prime Healthcare (11/09/25)
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  • BILINGUAL Claims Research & Resolution Rep…

    Humana (Sacramento, CA)
    **Become a part of our caring community and help us put health first** The Bilingual Claims Research & Resolution Representative 2 manages claims operations ... that involve customer contact, investigation, and resolution of claims or claims -related financial issues. The position...us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and… more
    Humana (11/21/25)
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  • Financial Compliance Auditor III Claims

    LA Care Health Plan (Los Angeles, CA)
    …auditing procedures under minimal supervision during the audits of PPGs, hospitals and health plans. Conducts sub-delegation claims oversight audits of the PPGs, ... Financial Compliance Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location:...(Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by… more
    LA Care Health Plan (10/23/25)
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  • Specialist, Appeals & Grievances

    Molina Healthcare (CA)
    … environment, or equivalent combination of relevant education and experience. * Health claims processing experience, including coordination of benefits (COB), ... and requirements established by the CA Department of Managed Health Care (DMHC) and CA Department of Health...that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine… more
    Molina Healthcare (11/13/25)
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  • Director II, Digital Claims Operations

    Elevance Health (Los Angeles, CA)
    … operational setting strongly preferred. + Digital literacy strongly preferred. + Health insurance industry experience strongly preferred. + Claims operational ... **Director II, Digital Claims Operations (Dir II Digital Ops)** Location: This...Illinois; California; Minnesota In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package,… more
    Elevance Health (10/10/25)
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  • Reinsurance Auditor

    GE Aerospace (San Francisco, CA)
    …terminology and medical impairments related to long term care, disability, life and/or health insurance claims + Note: Position can be hybrid or remoteThe ... In this high-impact role, you'll deliver sharp insights, adjudicate complex claims , and collaborate across teams using advanced analytics and emerging technology.… more
    GE Aerospace (11/06/25)
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