• Claims Compliance Lead

    UCLA Health (Los Angeles, CA)
    …you will play a critical role in in ensuring the timely, accurate, and compliant processing of health insurance claims . The ideal candidate will be ... will: + Coordinate and monitor the daily workflow of claims processing . + Distribute unprocessed claims...experience in an HMO environment (ie, MSO, IPA, or health plan) - Required + Comprehensive knowledge of industry-standard… more
    UCLA Health (05/21/25)
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  • Patient Accounts Assistant Supervisor - Dept.…

    City and County of San Francisco (San Francisco, CA)
    …of the eligible list. Under general supervision, supervises a unit involved in processing health care claims for reimbursement: monitors accounts, bills ... The Department of Public Health prioritizes equitable and inclusive access to quality...+ Provides immediate supervision to a staff involved in processing claims for reimbursement; reviews work of… more
    City and County of San Francisco (05/03/25)
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  • Financial Compliance Auditor III Claims

    LA Care Health Plan (Los Angeles, CA)
    …Preferred Master's Degree Experience Required: A minimum of 5 years of experience performing claims audits or claims processing related to Medi-Cal, Cal ... tasks within the Financial Compliance Unit, including audit of claims processed by medical groups and health ...capitated hospitals and the Plan Partners. This includes all claims processing sub-contracting functions of the delegates.… more
    LA Care Health Plan (04/05/25)
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  • Senior Stop Loss Claims Analyst/HNAS

    Highmark Health (Sacramento, CA)
    …**Required** + 5 years of relevant, progressive experience in health insurance claims + 3 years of prior experience processing 1st dollar health ... activities; disseminates necessary information to the management. Follows up on pended claims in accordance with department standards. HNAS ( Health Now… more
    Highmark Health (04/26/25)
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  • Sr Claims Systems Data Analyst - QNXT

    Molina Healthcare (Long Barn, CA)
    …functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received ... claims to identify billing issues that will impact claims processing and payment. Monitor new solutions...in the implementation and conversion of new and existing health plans. + Manage projects from requirements to deployment,… more
    Molina Healthcare (05/18/25)
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  • Bodily Injury Claims Examiner | Remote…

    Sedgwick (Sacramento, CA)
    …growth, and inclusion. **ESSENTIAL RESPONSIBILITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... Best Workplaces in Financial Services & Insurance Bodily Injury Claims Examiner | Remote | Dedicated Client | Complex... within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting… more
    Sedgwick (05/21/25)
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  • Industry Advancement Program | Workers…

    Sedgwick (San Diego, CA)
    …only claims . + Adjusting low and mid-level liability and/or physical damage claims under close supervision. + Processing disability claims of minimal ... + Communicating claim action/ processing with claimant and client. + Supporting other claims examiners and claims supervisors with larger or more complex … more
    Sedgwick (05/07/25)
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  • Claims Examiner | Workers Compensation…

    Sedgwick (Long Beach, CA)
    …client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner | Workers Compensation | Hybrid - Long... within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting… more
    Sedgwick (05/06/25)
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  • Industry Advancement Program | Workers…

    Sedgwick (Concord, CA)
    …only claims . + Adjusting low and mid-level liability and/or physical damage claims under close supervision. + Processing disability claims of minimal ... + Communicating claim action/ processing with claimant and client. + Supporting other claims examiners and claims supervisors with larger or more complex … more
    Sedgwick (05/02/25)
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  • Claims Rep - IAP (Trainee- must live local…

    Sedgwick (San Diego, CA)
    …only claims . + Adjusting low and mid-level liability and/or physical damage claims under close supervision. + Processing disability claims of minimal ... + Communicating claim action/ processing with claimant and client. + Supporting other claims examiners and claims supervisors with larger or more complex … more
    Sedgwick (05/02/25)
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