• Senior Claim Benefit Specialist

    CVS Health (Sacramento, CA)
    …information for claim or reconsideration. **Required Qualifications** + 2+ years of medical claim processing experience. + Previous experience in a ... multiple assignments competently, accurately and efficiently. **Preferred Qualifications** + Self funded medical claim processing experience. + DG system… more
    CVS Health (08/15/25)
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  • Senior Claim Benefit Specialist

    CVS Health (Sacramento, CA)
    …competently, accurately and efficiently. **Preferred Qualifications** - 18+ months of medical claim processing experience - Self-Funding experience ... or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, completes… more
    CVS Health (08/01/25)
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  • Claims Examiner - Remote Within 90 Miles Of

    TEKsystems (Fresno, CA)
    …of Claims . Claims Examiner I is responsible for reviewing and processing medical , dental, vision and electronic claims in accordance with state, ... * A minimum of one (1)year experience as a Claims Examiner for medical , dental claims...of Employee Retirement Income Security Act of 1974 (ERISA) claims processing /adjudication guidelines.* Examine a problem, set… more
    TEKsystems (08/16/25)
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  • Claims Assistant

    Robert Half Office Team (Roseville, CA)
    claims into the claims management system. * Monitor and organize incoming medical bills for processing . * Record direct payments in claims software ... are met. * Collaborate with team members to streamline claims processing workflows. Requirements * Previous experience...Familiarity with administrative software and tools. * Experience with medical billing or claims systems is a… more
    Robert Half Office Team (08/19/25)
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  • Claim Representative - IAP (On-Site San…

    Sedgwick (San Diego, CA)
    …under close supervision. + Documenting claims files and properly coding claim activity. + Communicating claim action/ processing with claimant and ... + Performs on-the-job training activities including: + Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only … more
    Sedgwick (08/13/25)
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  • Claims Specialist Sr , Professional…

    Sedgwick (Sacramento, CA)
    …Liability (MEDMAL) **PRIMARY PURPOSE** : To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature ... and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to… more
    Sedgwick (08/14/25)
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  • Workers Compensation Claims Examiner | CA…

    Sedgwick (Roseville, CA)
    … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
    Sedgwick (08/08/25)
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  • Claims Examiner - Workers Comp (Hybird…

    Sedgwick (Roseville, CA)
    … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
    Sedgwick (06/29/25)
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  • Claims Examiner - Workers Compensation…

    Sedgwick (Roseville, CA)
    … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
    Sedgwick (06/29/25)
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  • Claims Adjudication Specialist

    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 reviewing the data in the claim processing system and comparing with corresponding...of Facets experience. * Experience in the analysis and processing of claims for payments, utilization review/quality… more
    Cognizant (08/20/25)
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