- Sedgwick (Sacramento, CA)
- …+ Receives and reviews new claims and maintains data integrity in the claims system. + Reviews survey reports and insurance policies to determine ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Marine Adjuster **PRIMARY PURPOSE** **:** To investigate and process marine … more
- Centene Corporation (Sacramento, CA)
- …fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare ... mining and analysis to detect aberrancies and outliers in claims + Develop new queries and reports to detect...related field or equivalent experience. 1+ years of medical claim investigation, medical claim audit, medical … more
- Humana (Sacramento, CA)
- … claims , and customer service). + Collaborate with each Insurance Operations function to identify, understand, and align Stars-related business strategies, ... + 8-9 + years of quality improvement, developing & advancing enterprise strategy, insurance operations experience, ie: claims , UM, CM, call center, enrollment,… more
- Robert Half Legal (Novato, CA)
- …legal industry by representing injured workers in their workers' compensation claims . The firm offers remote flexibility throughout California. Responsibilities: * ... Advocate for injured workers in their compensation claims * Manage a full caseload of ...Adobe Acrobat for document management and organization * Handle claim administration and complaint handling with detail-oriented and empathetic… more
- City and County of San Francisco (San Francisco, CA)
- …to charge errors, claims submission volume, denials and trends based on claim type and/or payer, including unbilled inventory to ensure the team is prioritizing ... claims processing, and/or collecting healthcare service reimbursements or medical claims from Medi-Cal (Medicaid), Medicare, insurance , third party payors,… more
- Gerber Collision & Glass (Hawthorne, CA)
- …in person and over the phone. + Have a sense of urgency when filing insurance claims with and/or without customers on the line. + Maintain regular communication ... respected leader in the auto glass industry. As a Claim Specialist, you are a key member of Glass...+ Follow our step by step process to File Insurance claims , order OEM glass, and receive… more
- BrightSpring Health Services (Union City, CA)
- …of the pharmacy. + Identifies and resolves issues of denials or follow-up of claims . + Maintains current knowledge of Medicaid claim regulations and processes. + ... Prior supervisory experience. Skills/Knowledge: + Required: Knowledge of Medicaid claims regulations and processes. Basic understanding of drugs, medication… more
- Robert Half Legal (San Francisco, CA)
- …to their insureds. This is a NON-LITIGATION position. If you are currently litigating insurance claims and want to shift away from litigation to a hybrid ... * Investigate and research complex matters involving detail-oriented liability claims * Analyze complex insurance contracts and...and policy forms and apply these terms to various claim scenarios * Stay updated on legislative trends and… more
- Humana (Sacramento, CA)
- …community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and readiness to ... data transformations, automation, and enhancements. Conduct in-depth analysis of healthcare claims to identify data issues and optimization opportunities. Work with… more
- Sedgwick (West Hills, CA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Leave of Absence Coordinator **Our teams connect! We collaborate onsite and have ... payments and/or adjustments for client paid leave plans ensuring that on-going claim management is within company service standards and industry best practices.… more