- USAA (Los Angeles, CA)
- … claim damages including communicating with the insured, internal claims adjusters, and third parties/vendors. May require face-to-face interactions with members ... for handling, if applicable. + Maintain accurate and current claim file documentation throughout the claims process...high standards of productivity through effective desk management, timely follow ups, and accurate mapping of repair plan and… more
- University of Southern California (Alhambra, CA)
- … rejections and denials which might prevent or delay payment of a particular claim or group of claims . Prepares appeals and rebuttals letters/packages in ... responses to payer's reason for coding-related ' claims denials' and ' claims rejections'-including documentation and an argument and follow up with the PFS… more
- Cognizant (Sacramento, CA)
- …stakeholders and other teams. **In this role, you will:** . Perform comprehensive follow -up on hospital claims to resolve outstanding accounts receivable. . ... Time **About the role:** Asan AR Physician Hospital Billing Follow Up, you will be responsible for resolving aged...management using advanced Excel skills. . Recommend updates to claim edits and work queues to improve efficiency and… more
- Sedgwick (Sacramento, CA)
- …to support the claim request and documents decision rationale. + Completes medical review of all claims by reviewing medical documentation received ... status. + Provides clear and appropriate follow -up recommendations for ongoing medical management of claims ; ensures appropriate recommendations are made on … more
- Rady Children's Hospital San Diego (San Diego, CA)
- …accurate adjudication of claim for reimbursement. They will process claims correctly following contractual arrangements the Medical Practice Foundation (MPF) ... to ensure claim will be adjudicated. Incumbent is expected to follow federal, state, and local regulatory collection guidelines as well as department and… more
- TevisHR (CA)
- …This position is NOT remote. Job Summary: A Loss Consultant for insurance claims is responsible for evaluating the extent of damage to residential properties caused ... with policyholders, contractors, and other relevant parties to ensure fair and timely claim settlements. Overall, an estimator for a claim plays a critical… more
- GE Aerospace (San Francisco, CA)
- …eligibility requirements, and limitations + Strong preference for long term care insurance claim experience + Working knowledge of medical terminology and ... In this high-impact role, you'll deliver sharp insights, adjudicate complex claims , and collaborate across teams using advanced analytics and emerging technology.… more
- City and County of San Francisco (San Francisco, CA)
- …Nurse Consultant, Nurse Manager, and/or Nurse Case Managers to review complex claims and establish medical protocols. 13. Advises the Occupational Nurse ... penalties to determine liability and authorizes payment. 10. Authorizes medical treatment for complex medical cases. 11.... clinic operations. 14. Provides ongoing system support to claims staff. 15. Accurately estimates the potential claim… more
- UNUM (Sacramento, CA)
- …Physical Medicine and Rehabilitation. This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across ... and efficient medical consultative services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal… more
- The County of Los Angeles (Los Angeles, CA)
- …Opening Date 09/03/2025 + Description + Benefits + Questions Position/Program Information Follow us on Social Media! EXAM NUMBER: R0647I-R TYPE OF RECRUITMENT: This ... needs of the service are met and is subject to closure without notice. Follow us on Social Media! Essential Job Functions Withhold Information: No withholds will be… more