- Molina Healthcare (Riverside, CA)
- …and JOCs. Entail heavy negotiations. Maintains critical Complex provider information on claims and provider databases. Synchronizes data among multiple claims ... through recontracting initiatives. Implements cost control initiatives to positively influence the Medical Care Ratio (MCR) in each contracted region. * Prepares the… more
- Robert Half Legal (Woodland Hills, CA)
- …handles a variety of cases related to workers' compensation and third-party liability claims , and are seeking a highly motivated litigation attorney to join the ... This position will involve representing injured workers in both workers' compensation claims and third-party liability cases. The ideal candidate will have a passion… more
- TP-Link North America, Inc. (Irvine, CA)
- …and complaints according to company policy. + File and track fraud and chargeback claims on Shopify and TikTok Shop. + Flag suspicious orders and escalate as needed. ... a plus. + Experience handling returns, disputes, and fraud claims . + Able to work independently in a fast-paced...drinks, and provided lunch on Fridays + Fully paid medical , dental, and vision insurance (partial coverage for dependents)… more
- CDM Smith (Rancho Cucamonga, CA)
- …expertise may be needed throughout the program delivery process. * Supports the claims process by reviewing and validating damage details, scopes of work, and costs ... in regular FEMA meetings by providing updates on work status and may evaluate claims and make recommendations to FEMA as to whether the claim is eligible. Assists… more
- Southern California Edison (Rosemead, CA)
- …job, you'll play a crucial role in accounting for legal reserves, claims , and settlements, collaborating with various stakeholders and leadership to ensure accurate ... properly accessing and managing private customer data, proprietary information, confidential medical records, and other types of highly sensitive information and… more
- ICW Group (San Diego, CA)
- …optimizing data models that support actuarial analysis, policy processing, claims processing, underwriting, compliance reporting, and overall business intelligence ... physical) tailored for Workers Compensation Insurance data such as claims , policies, premiums, exposures, and provider networks. + Builds...* We offer a competitive benefits package, with generous medical , dental, and vision plans as well as 401K… more
- LA Care Health Plan (Los Angeles, CA)
- …Initiatives team include analysis of housing data on enrollment, payment, or claims data to identify operational problems or issues. Make recommendations to resolve ... Health initiatives operate. This operational and policy infrastructure includes claims processing, provider network management, community engagement, data and… more
- Evolent (Sacramento, CA)
- …and member-centric products. This role plays a critical part in both ** Medical Cost Management** and **Product Management** , leveraging advanced analytics to solve ... + Lead in-depth analyses of healthcare data - including authorizations, claims , membership, and clinical outcomes to identify cost drivers, utilization patterns,… more
- UIC Government Services and the Bowhead Family of Companies (San Diego, CA)
- …and other protected characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual ... based on the provisions contained within The Alaska Native Claims Settlement Act. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities. All… more
- TYLin (Oakland, CA)
- …you will have extensive experience in design-build projects, contract negotiations, claims avoidance, and change order management. Availability to be on-location at ... infrastructure construction. + Expertise in design-build project delivery and claims avoidance. + Familiarity with progressive design-build and GMP contract… more