- Insight Global (Irvine, CA)
- …working with excel In the job experience of EHR systems and medical insurance claims management softwares Knowledge of state, federal, and applicable regulations ... with strong understanding of medical terminology. Previous experience as a medical claims examiner or auditor preferred. Experience with claim investigation,… more
- Dignity Health (Bakersfield, CA)
- …for all claim types - Perform an analysis of the claims processing by reviewing contract, system configuration, benefits, financial risk (DOFRs), and manual ... **Responsibilities** The Claims Research Specialist will oversee and manage research...adjudication to identify the cause of the erroneous claim payment - Responsible to ask clarifying questions from… more
- ICW Group (San Diego, CA)
- …best interest of all parties and providing benefits as prescribed by law. + Ensures claim files are properly documented and claims coding is correct. + Refers ... degree from four-year college or university preferred. Minimum 1 year of insurance or claims related experience; or equivalent combination of education… more
- Cognizant (Sacramento, CA)
- …Monday to Friday 8am - 4:30pm ET **Experience:** A minimum of 2 years of claim processing is required. **Travel:** None required **About the role:** As Claims ... be responsible for timely and accurate adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to … more
- Sedgwick (Riverside, CA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead (Supervisor) Workers Compensation **PRIMARY PURPOSE:** To ... as suggested by the claim status; and provides written resumes of specific claims as requested by client. + Assures that direct reports are properly licensed in… more
- Sedgwick (West Hills, CA)
- …Certified as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Team Lead | West Hills, CA Are you ... as suggested by the claim status; and provides written resumes of specific claims as requested by client. + Assures that direct reports are properly licensed in… more
- Sedgwick (Long Beach, CA)
- …Certified as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation | Claims Examiner | Hybrid - Long Beach, CA ... resolution by investigating and gathering information to determine the exposure on the claim . + Negotiating settlement of claims within designated authority. +… more
- Cognizant (Sacramento, CA)
- …a variety of business operations. We are seeking **Fully Remote US Based** Claims Processors to join our growing team. The **Medical** ** Claims Processor** ... responsible for the timely and accurate adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to … more
- Centene Corporation (Sacramento, CA)
- …PT to as late as 8:30am PT. **Position Purpose:** Perform regulatory claims compliance audits to support health plan operations. Completes retrospective claims ... a monthly, quarterly and annual basis to ensure regulatory compliance. + Perform claims compliance audits for either federal or state programs. + Evaluate processes… more
- Sedgwick (Sacramento, CA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner, Auto Bodily Injury (Litigation Required) **PRIMARY PURPOSE** ... FUNCTIONS and RESPONSIBILITIES** + Processes complex auto commercial and personal line claims , including bodily injury and ensures claim files are properly… more