• Claims Representative

    The Cigna Group (Sacramento, CA)
    ** Claims Representative - Remote ** **SUMMARY** The claims representative is responsible for manually reviewing and processing medical, supplemental, ... or dental claims . Claims are processed according to benefits, eligibility, and internal processes, policies, and procedures and may be completed, held for… more
    The Cigna Group (01/25/25)
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  • Liability Claims Representative

    Sedgwick (Sacramento, CA)
    …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Liability Claims Representative | Remote Are you looking for an ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...OF THE ROLE:** To analyze mid-level Commercial General Liability claims on behalf of our valued clients to determine… more
    Sedgwick (10/31/24)
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  • Claims Representative I…

    Ryder System (Sacramento, CA)
    …small to medium 3rd party property damage and cargo claims under Ryder's self-insured, self-administered liability program. **ESSENTIAL FUNCTIONS** Investigates, ... to medium exposure 3rd party property damage and cargo claims pursued against Ryder Ensures the most appropriate and...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
    Ryder System (01/15/25)
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  • Remote Customer Service…

    Mass Markets (CA)
    POSITION OVERVIEW REMOTE CUSTOMER SERVICE REPRESENTATIVE Looking for opportunities to work for a rapidly growing company? We are looking for call center ... - POSITION RESPONSIBILITIES WHAT DOES A WORK AT HOME CONTACT CENTER REPRESENTATIVE DO? This position supports customer service, technical support, and customer sales… more
    Mass Markets (01/22/25)
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  • Remote Call Center Representative

    Mass Markets (CA)
    …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service, ... any reason. ID2025-44492 Updated Date1/16/2025 DepartmentCanada Provincewide Work-at-Home Positions ( Remote ) ScheduleFlexible Day, Evening & Weekend Shifts | M-F, S,… more
    Mass Markets (01/11/25)
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  • Account Representative II, Employee…

    HUB International (San Diego, CA)
    **_This_** **_role_** **_can be Hybrid or Remote in Southern CA_** **THE OPPORTUNITY:** HUB's Customer Service professionals provide critical support to our ... customers through account management, claims management, day-to-day client oversight, and underwriting services that make us a leading sales and service organization… more
    HUB International (12/27/24)
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  • Senior Provider Relations Representative

    Molina Healthcare (Long Beach, CA)
    **_ Remote and must live in Los Angeles County _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network ... monthly site visit goals. A key responsibility of the Representative during these visits is to proactively engage with...3 - 5 years customer service, provider service, or claims experience in a managed care setting. * 3+… more
    Molina Healthcare (01/25/25)
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  • Provider Relations Representative

    Molina Healthcare (Sacramento, CA)
    **_ Remote and must live in the Sacramento Valley _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for ... monthly site visit goals. A key responsibility of the Representative during these visits is to proactively engage with...2 - 3 years customer service, provider service, or claims experience in a managed care setting. * Working… more
    Molina Healthcare (01/24/25)
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  • Project Manager V - Owners Representative

    AECOM (Sacramento, CA)
    …in **Sacramento, CA:** + Manage a complex courthouse project acting as an Owner's Representative for a state client. + Oversee all aspects of the project(s) and ... and construction schedules. + Review and respond to change orders, disputes and claims (cost/extension of time) submitted by the contractor. + Perform daily field… more
    AECOM (01/22/25)
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  • Director, Senior Counsel, Regulatory & Compliance…

    United Therapeutics (Sacramento, CA)
    …the pharmaceutical and biotech industry, including FDA advertising and promotion, False Claims Act, Anti-Kickback Statute, OIG Guidance, the PhRMA Code, the Sunshine ... to the Food Drug and Cosmetic Act, the False Claims Act, Anti-Kickback Statute, the Sunshine Act and other...healthcare related laws and regulations + Serve as Legal representative on the Company's promotional review committee, including review… more
    United Therapeutics (12/14/24)
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  • Productivity & Quality Operations Manager (Patient…

    Stanford Health Care (Palo Alto, CA)
    …productivity and quality reports to the Managers for each Patient Account Representative . **Locations** Stanford Health Care **What you will do** + Operations ... functional teams. + Knowledge of billing procedures and third-party payer claims processing requirements. + Knowledge of information system and software relating… more
    Stanford Health Care (01/23/25)
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  • Warehouse Quality Control Manager

    BD (Becton, Dickinson and Company) (San Diego, CA)
    …nonconforming products with a focus on minimizing Escape incidents. + Oversee intracompany claims and drive the resolution process. + Conduct and manage QMS Audits, ... Ensure the site's compliance with local wholesale drug licenses as the designated representative . + Mentor and train team members on QMS requirements and facilitate… more
    BD (Becton, Dickinson and Company) (12/31/24)
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  • Senior Payment Integrity Analyst

    HealthEdge Software Inc (Sacramento, CA)
    …implementing proprietary healthcare edits that drive cost savings and accuracy in claims processing. The successful candidate will be responsible for taking a senior ... level role in analyzing claims data, as well as translating contract terms, policies,...permanent **Work Environment:** The physical demands described here are representative of those that must be met by an… more
    HealthEdge Software Inc (01/15/25)
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  • Senior Manager, Product Operations

    HealthEdge Software Inc (Sacramento, CA)
    …and QE. We have divided our product teams into Value Streams (ie, Claims , Billing & Financials, Enrollment, BlueCard, Integration, and Platform). Each Value Stream ... integrated solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration capabilities, a… more
    HealthEdge Software Inc (12/20/24)
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  • Business Consultant

    HealthEdge Software Inc (Sacramento, CA)
    …issues are identified and addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete suite ... of provider rate and/or claim editing provisions in a claims adjudication system and/or third-party vendor application. + Working...None **Work Environment:** The physical demands described here are representative of those that must be met by an… more
    HealthEdge Software Inc (12/18/24)
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  • Network Engineer

    HealthEdge Software Inc (Sacramento, CA)
    …root-cause issues areidentifiedand addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete ... and deliver excellent software and services to our customers._ **Geographic Responsibility:** Remote but ideal candidate would live within the driving distance to… more
    HealthEdge Software Inc (11/27/24)
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  • I&I Field Reimbursement Manager (FRM) Northern…

    Pfizer (Sacramento, CA)
    …financial assistance brochures. + Reactively assisting HCP offices with coding and claims -related issues by contacting payers to understand policy or procedures and ... achieve meaningful outcomes and create business impact. Work Location Assignment: Remote - Northern California, Northern Nevada Field Based **NON-STANDARD WORK… more
    Pfizer (01/24/25)
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  • Assistant Safety Director

    RailWorks (Los Angeles, CA)
    …vision coverage, 401(k) with company match, and additional performance incentives **This is a remote position that can sit anywhere in the US and will require travel ... the RailWorks Drug & Alcohol program as a Corporate Designated Employer Representative (DER). * Works closely with risk management and the company's insurance… more
    RailWorks (01/14/25)
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  • Project Manager V - Courthouse Project

    AECOM (Sacramento, CA)
    …CA.** The Project Manager will: + Manage a complex project acting as an Owner's Representative as part of a program management team for a state client. + Oversee all ... schedules. + Review and respond to change orders and claims (cost/extension of time) submitted by subcontractors. + Perform...work options. Whether you're working from an AECOM office, remote location or at a client site, you will… more
    AECOM (12/27/24)
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