- 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 ... We may, at the sole discretion of the Hiring Manager , be open to hiring remote talent This role...industry. + Administer and monitor underwriting rules and guidelines, insurance laws and regulations, and rating manuals. + Work… more
- Sedgwick (Sacramento, CA)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Accounting Associate - Pooling Are you looking for an impactful job where you ... of accounting department or special projects as assigned by the Finance Manager or Director. + Process account collections/receivables. + Reconcile claims … more
- Elevance Health (Costa Mesa, 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
- Evolent (Sacramento, CA)
- …to find the most valuable defects. The IQA reports to a associate director or a manager . One or many IQAs may be engaged in any testing effort **What You Will Be ... risks and issues in coordination with the lead / manager for status reporting + Responsible to enforce department...Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1… more
- Empirical Systems Aerospace, Inc. (San Luis Obispo, CA)
- …project reports and make presentations at meetings + Support negotiations of claims , manage contractual changes and resolve disputes or conflict resolution with ... Contractors and Customers + Assess and prepare claims from suppliers + Manage contract closeout procedures + Confer with counsel and leadership on items out of the… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …is subject to renewal on 09/01/2025.** JOB SUMMARY: Under the direction of the Manager , Professional Billing & Coding, the Billing & Collections Rep I is responsible ... register new patients in the system, including patient demographics, verifying insurance , eligibility and claim information is accurate. Incumbent will verify… more
- Sedgwick (Sacramento, CA)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Return-to-Work Specialist **PRIMARY PURPOSE** : To negotiate, facilitate and monitor ... Determines objective, quantifiable, medically supported work restrictions for assigned claims . + Facilitates return-to-work (RTW) efforts through negotiation with… more
- HUB International (Encino, CA)
- …of benefits includes PPOs, HMO, HSA, FSA, vision coverage, dental coverage, pet insurance , paid time off, a generous 401k plan and more! **THE OPPORTUNITY:** Our ... play a vital role in supporting our clients with day-to-day account management, claims management, and underwriting services that ensure they have what they need to… more
- Walgreens (Los Angeles, CA)
- …systems to further promote productivity. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. ... efficient workflow of the pharmacy and assists the pharmacy manager in identifying ways to optimize pharmacy financials, inventory...Follows-up with insurance companies as well as medical providers and participates… more