- Providence (CA)
- …must empower them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and manage professional, ... take proper steps to pay vendors + Inform Senior Manager Operations of large or complex claims ...Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various… more
- Sedgwick (Long Beach, CA)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Manager | Long Beach, CA | SIP Required Are you looking ... best brands? + Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing… more
- LA Care Health Plan (Los Angeles, CA)
- …is responsible for various tasks within the Financial Compliance Unit, including audit of claims processed by medical groups and health plans contracted with LA ... Manager of Financial Compliance. These assignments may include claims data reporting in the Online Monitor Tool (OMT),...and findings that would affect the audit results. Perform claims audits for all medical groups and health… more
- Elevance Health (Los Angeles, CA)
- **Business Consultant Senior - Commercial Claims Data Mining** **Hybrid 1:** This role requires associates to be in-office 1-2 days per week, fostering collaboration ... focus on the customer/provider must be considered for NPS scores. + WGS claims processing knowledge preferred. + Experience with multiple markets and lines of… more
- Guidehouse (San Marcos, CA)
- …healthcare provider or an outsourcing company. + Previous experience installing/utilizing Change Health , Waystar, SSI, and Epic claims scrubber would be ... You Will Do** **:** The **Billing Supervisor - Healthcare Claims ** is responsible for the daily operations of billing...processes. The Billing Supervisor reports directly to an Operations Manager or Director level position and may perform any… more
- Aston Carter (Corona, CA)
- Top manufacturing company looking for a Chain Claims Assistant to support their team! Great role to kick-start your accounting degree as no professional experience ... duplicate and problematic invoices. + Provide customer service and support to the Claims team, internal departments, and MEC sales staff as needed. + Provide… more
- Elevance Health (Walnut Creek, CA)
- **Title:** Behavioral Health Provider Quality Manager **Candidates must posses a licensure for the state of California.** **Location:** This role requires ... leaders passionate about transforming American healthcare delivery. The **Provider Quality Manager ** is responsible for leading Behavioral Health (BH) provider… more
- Sharp HealthCare (San Diego, CA)
- …and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit ... of the Director. **Required Qualifications** + 5 Years in HMO or Health Insurance Management. + 2 Years leadership experience working collaboratively across multiple… more
- Elevance Health (Cerritos, CA)
- **Account Service Manager Senior** **Location** : This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while ... work, promoting a dynamic and adaptable workplace. Alternate locations may be considered. Carelon Health is a proud member of the Elevance Health family of… more
- LA Care Health Plan (Los Angeles, CA)
- …Provider Groups (PPG), Specialty Health Plans (SHP) and Pharmacy Benefit Manager (PBM) including LA Care's Claims Department. This requires interaction with ... planning audits and audit work programs that address appropriate claims and financial compliance criteria for specialty health... claims and financial compliance criteria for specialty health plans. These audits are intended to ensure that… more
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