- 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 ... the Director. **Required Qualifications** + 5 Years in HMO or Health Insurance Management. + 2 Years leadership experience working collaboratively across multiple… more
- Zurich NA (Gold River, CA)
- …experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate Degree and 5 or more years of experience ... industry. + Administer and monitor underwriting rules and guidelines, insurance laws and regulations, and rating manuals. + Work...and 12 or more years of experience in the Claims or Underwriting Support areaAND + Experience with Microsoft… more
- Zurich NA (Irvine, CA)
- …performs a broad range of administrative and secretarial support for insurance defense attorneys, specializing in General Liability. This position combines remote ... candidate, and Zurich North America. At Zurich North America Claims we acknowledge that work life-balance and flexibility are...of experience in the Legal Secretary area within the Insurance industry OR + Zurich Certified Insurance … more
- Elevance Health (Los Angeles, CA)
- …with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable ... conduct extensive research and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize and route to nursing… more
- Elevance Health (Walnut Creek, CA)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- Highmark Health (Sacramento, CA)
- …supervisory direction and oversight for all enrollment, premium billing, claims and/or customer service telephone and written correspondence inquiries (routine, ... problems. Provides research and technical support need to address complex claims and inquiries and/or when systems problems occur. Provides direction for… more
- Oura (San Francisco, CA)
- …this role will be responsible for advising on regulatory risk, marketing claims , product labeling, corporate compliance initiatives, and will oversee the privacy ... tracking, AI-driven diagnostics, real-world data applications, and health and wellness claims . + Provide legal and regulatory oversight for clinical studies and… more
- Robert Half Legal (Oakland, CA)
- …in employment law cases, with a focus on plaintiff-side matters and disability claims . * Conduct thorough legal research and draft compelling briefs to support case ... hearings, motions, and trials. * Collaborate with clients to assess their claims and provide strategic legal guidance. * Utilize case management software to… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …third-party data assets, including Xponent Plantrak, DDD, HCOS, Claims Data, Specialty pharma, omnichannel data, SalesForce/Veeva (Call/Sample/Detail), etc. ... basic life, accidental death & dismemberment, short-term and long-term disability insurance , tuition reimbursement, student loan assistance, a generous 401(k) match,… more
- The Hartford (Brea, CA)
- …- LM07EE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every ... business environment where you will have direct interaction with Claims Partners and insureds, we want to speak with...support of defense strategies with autonomy.* Partner with our Claims Partners to achieve the best results for our… more