- Sedgwick (Sacramento, CA)
- …the Associate's skills and knowledge, the Associate will review documents and other third - party administrator 's claims system to make recommendations when ... needed to staff that will move workers' compensation claims toward resolution. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Provides initial research/data collection on claims file. + Performs file audits according to jurisdictional standards as directed by… more
- CVS Health (Sacramento, CA)
- …national carrier coupled with the unique flexibility and devoted service of a third - party administrator (TPA). The Meritain Health underwriting department ... of relevant medical insurance experience: brokers (producers), carriers, (TPA) third - party administrators, benefit analysis, underwriting, rating methodologies,… more
- Dignity Health (San Bernardino, CA)
- …serve as the central liaison between employees, management, healthcare providers, and our third - party administrator . You will guide the claims process from ... injured employees, management, healthcare providers, and the Workers' Compensation administrator . + Initiate and oversee timely investigations for all work-related… more
- CVS Health (Sacramento, CA)
- …medical malpractice claims with either a healthcare company, insurance carrier, third party claims administrator or self-administered corporation. ... malpractice claims with either a healthcare company, insurance carrier, third party claims administrator or self-administered corporation. . Proficient… more
- Evolent (Sacramento, CA)
- …+ 3 years of experience within a health plan, managed care organization or third - party administrator is preferred. + Understanding of appeals process and ... utilization management. + Working knowledge of regulatory and accreditation requirements. + Excellent verbal and written communication skills. **To comply with HIPAA security standards (45 CFR sec. 164.308 (a) (3)), identity verification may be required as… more
- Dignity Health (Oxnard, CA)
- …provide the capabilities needed to perform the job duties. + Familiarity with third party administrator operations such as eligibility, prior authorization, ... claims administration and provider network administration. Familiarity with managed care and self-insurance products and benefits. **Preferred Qualifications:** + Experience working as an account manager in a direct to employer health plan preferred. This is a… more
- Kelly Services (Brea, CA)
- …Examiner - Workers' Compensation:** + Opportunity to work with a highly regarded Third - Party Administrator (TPA) + Fully **remote** position-must reside in ... **California** + Work-life balance with a **Monday-Friday** schedule + Competitive **pay rate: $50.00/hr** + **Contract assignment:** August 5, 2025 - February 7, 2026 **What's a typical day as a Claims Examiner? You'll be:** **Essential Duties and… more
- CVS Health (Sacramento, CA)
- …**Required Qualifications** + A minimum of 7 years of relevant experience in a TPA ( Third Party Administrator ) environment or fully insured carrier. + A ... minimum of 5 years of leadership experience. + Experience managing large teams (20+ colleagues). + Strong execution and delivery skills, including planning, delivering, and supporting initiatives + Knowledge of ERISA, HIPAA, ACA, and other relevant regulatory… more
- Public Consulting Group (Sacramento, CA)
- …maximize program revenue, improve business processes, and achieve regulatory compliance. Services: + Third Party Administrator Services + Enhance Health and ... Public Safety Services + Claims Processing Services and Solutions + Consulting and Advisory Services + Cost Allocation Plans and Time Studies + Cost Settlement and Supplemental Payment Strategies + Healthcare Access and Markets **Duties and Responsibilities**… more
- Lincoln Financial (Sacramento, CA)
- …with applicable regulations such as IRC 409A and coordinate with legal, tax advisors and third - party administrator as needed. * Serve as a member of the ... fiduciary investment committee that monitors the investment funds used to track deferred compensation liabilities, providing insights and recommendations. * Working with the finance team, coordinate with the hedging programs for the deferred compensation… more