- Lincoln Financial (Sacramento, CA)
- …**Requisition #:** 74647 **The Role at a Glance** We are excited to bring on a Claims Customer Care Associate to join our claimant excellence team supporting ... coaching and development to perform in this fast-paced environment. As a Claims Customer Care Associate , you will be responsible for answering claimants… more
- Sedgwick (Rancho Cordova, CA)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Associate | Rancho Cordova, CA (Onsite) Are you looking ... general office experience or equivalent combination of education and experience required. Claims industry experience preferred. **TAKING CARE OF YOU** + Flexible… more
- Evolent (Sacramento, CA)
- …people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care ... system and ensure people get the same level of care and compassion we would want for our loved...our specialty programs and administrative platform. **Role Overview** The Associate Director role on Client Analytics will support both… more
- Travelers Insurance Company (Sacramento, CA)
- **Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our ... Claim Counsel team conducts thorough investigation, analysis, evaluation, and disposition of claims and claim litigation to achieve superior customer service and to… more
- Walgreens (Sacramento, CA)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Cherry Bekaert (Sacramento, CA)
- **Description** **Summary of Responsibilities:** The Senior Associate will work closely with the Cherry Bekaert FAO (Finance & Accounting Outsourcing) team, ... our clients in the insurance, service and related industries. The Sr. Associate will also assist in an administrative project management capacity, spearheading… more
- Walmart (Sacramento, CA)
- …Floor in accordance with Company policies and procedures by properly handling claims and returns, zoning the area, arranging and organizing merchandise, and ... digital tools to drive sales, improve the shopping experience, and elevate associate engagement; utilizing hand held technology to make immediate business decisions… more
- Highmark Health (Sacramento, CA)
- …opportunities aligned to the Quadruple Aim of Healthcare: lower per capita health care costs, improved outcomes and quality of care received, and optimal ... member/patient and provider experiences with care delivery. A key responsibility is developing methodologies to identify impactable cohorts for cost savings… more
- Walmart (Sacramento, CA)
- …thinking You will make an impact by: * Ensuring high-quality products are taken care of and available for our members * Ensuring shelves are clean, maintaining ... accordance with Company policies and procedures by properly handling claims and returns; zoning the area; receiving and stocking...Paid time off benefits include PTO, parental leave, family care leave, bereavement, jury duty, and voting. You will… more
- Humana (Sacramento, CA)
- …first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Humana (Sacramento, CA)
- …this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization, including offshore and vendor partners, with a focus ... and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …Specialty Medicine products at different stages of development for a global health- care market. The specific duties assigned to the Director, Global Clinical ... research experience (as a general guideline, 1-3 years for Associate Director level; 3-6 years for Director and 6-9...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (Sacramento, CA)
- …Specialty Medicine products at different stages of development for a global health- care market. The duties assigned to the Director, Global Clinical Development ... research experience (as a general guideline, 1-3 years for Associate Director level; 3-6 years for Director is typically...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Humana (Sacramento, CA)
- …to assignments. The Senior Encounter Data Management professional ensures data integrity for claims errors that result from the data exchange between Humana and its ... to make an impact** **Required Qualifications** **5 years of medical claims processing/auditing or encounter data management experience** **Demonstrated deep dive… more
- Travelers Insurance Company (Rancho Cordova, CA)
- **Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our ... CA Under general supervision, this position is responsible for assigning claims to appropriate claim professionals. Coordinating and monitoring claim professional… more
- Humana (Sacramento, CA)
- …and/or other end compliant inquiries. + Has 6-7 direct reports including Associate Directors, Managers, and Senior Professionals + Provides strategic direction and ... operational efficiencies + Collaborates with upstream business partners such as Claims , Clinical Guidance, and the Provider Network to identify opportunities and… more
- Evolent (Sacramento, CA)
- …people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care ... system and ensure people get the same level of care and compassion we would want for our loved...development efforts. **What You Will Be Doing:** + Analyze claims and authorization data to identify trends, calculate cost… more
- Humana (Sacramento, CA)
- …responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and expansion into new ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
- Humana (Sacramento, CA)
- …prospective programs and other strategic initiatives to inform the overall revenue forecast. Claims data as well as data from CMS are utilized to project revenue ... improving consumer experiences **Preferred Qualifications** + Experience working with Medical Claims or other healthcare data + Medicare Risk Adjustment Experience +… more
- Humana (Sacramento, CA)
- …health first** **Requires a strong foundation in COBOL mainframe development ** The Claims Adjudication System (CAS) team at Humana is essential in delivering core ... services through effective claims processing and management solutions. This position involves coding software applications based on business requirements and… more