• Field Adjuster | Property | Remote Central…

    Sedgwick (Sacramento, CA)
    …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Property Field Adjuster (Remote in Central California) As an adjuster at Sedgwick, ... role will be responsible for investigating and adjusting property and casualty claims , both residential and commercial, with little to no supervision. **ESSENTIAL… more
    Sedgwick (06/28/25)
    - Related Jobs
  • Associate General Counsel, Senior Director…

    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 ... health products, including wearable devices and related software, including Software as a Medical Device (SaMD), Software in a Medical Device (SiMD), and… more
    Oura (08/17/25)
    - Related Jobs
  • Grievance/Appeals Analyst I (California)

    Elevance Health (Los Angeles, CA)
    …to 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 ... + Demonstrated business writing proficiency, understanding of provider networks, the medical management process, claims process, the company's internal business… more
    Elevance Health (08/30/25)
    - Related Jobs
  • Benefit Administration Analyst - Sharp Health Plan…

    Sharp HealthCare (San Diego, CA)
    …investigating and responding to internal and external benefit inquiries, and supporting claims testing activities. **Required Qualifications** + 3 Years in HMO or ... Health Insurance Management. + Experience working collaboratively across multiple functional areas (eg, operations, configuration, clinical, IT, plan design) and… more
    Sharp HealthCare (08/09/25)
    - Related Jobs
  • Manager Benefit Administration - Sharp Health Plan…

    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
    Sharp HealthCare (08/09/25)
    - Related Jobs
  • Lead Prior Authorization Specialist

    Polaris Pharmacy Services, LLC (Covina, CA)
    …change as determined by the needs of the business. BENEFITS for full time Employees + Medical , Dental, and Vision insurance + 401 (k) (available for Part Time & ... for managing and identifying a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely billing...by working with national Medicare D plans, third party insurance companies, and all state Medicaid plans to ensure… more
    Polaris Pharmacy Services, LLC (08/23/25)
    - Related Jobs
  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Walnut Creek, CA)
    …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... claims . **How you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in… more
    Elevance Health (08/23/25)
    - Related Jobs
  • Accounting Associate - Pooling

    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 ... the Finance Manager or Director. + Process account collections/receivables. + Reconcile claims activity between general ledger and claims system and investigate… more
    Sedgwick (08/19/25)
    - Related Jobs
  • Telephonic Case Manager

    Sedgwick (Sacramento, CA)
    …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Telephonic Case Manager **PRIMARY PURPOSE OF THE ROLE:** While partnering with the ... injured worker, employer, and medical providers, create a case...systems. + Effectively communicates and builds relationships with the claims ' examiner, client, injured worker, attorney and supervisor. +… more
    Sedgwick (09/04/25)
    - Related Jobs
  • Investigator Senior

    Elevance Health (Los Angeles, CA)
    claims . Health insurance experience required with understanding of health insurance policies, health insurance claims handling and provider network ... Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Investigator Senior** is responsible for the independent… more
    Elevance Health (08/12/25)
    - Related Jobs