- Providence (Anaheim, CA)
- **Description** Manage the claims internal audit functions, which includes audit process for adjudicated claims and encounters. Monitor check run process for ... accuracy. Develop policies and procedures for periodic claims audits and ensure compliance with affiliated health plans, client groups, and administrative… more
- Carrington (Anaheim, CA)
- **Come join our amazing team and work remote from home!** The Default Claims Specialist is responsible for preparing, filing, and following up on all FHA, VA, ... USDA, PMI, and investor claims timely and accurately according to insurer/investor guidelines. Perform...phone conversations in the system notes. + Keep Team Lead and Supervisor informed of all trends and problems… more
- Elevance Health (Costa Mesa, CA)
- **Anticipated End Date:** 2024-09-20 **Position Title:** eCOB Specialist II **Job Description:** **eCOB Specialist II** **Location:** Hybrid, within 50 miles of ... Monday - Friday, 6am - 6pm EST The **eCOB Specialist II** is responsible for researching and investigating other...enrolling in Medicare. + Reviews claim history to identify claims requiring reconciliation, whether processed or pended, as well… more
- CROSSMARK (La Habra, CA)
- …to perform the essential duties. _Responsibilities With Regard to Workers' Compensation Claims :_ You are responsible for reporting all employment related injury you ... incur to your direct supervisor as soon as possible following an incident resulting in an injury. **Qualifications** _Education/Experience:_ High school diploma or general education degree (GED); or one to three months' related experience and/or training; or… more
- Elevance Health (Costa Mesa, CA)
- **Anticipated End Date:** 2024-09-13 **Position Title:** eCOB Specialist I **Job Description:** **eCOB Specialist I** **Location** : Remote, within 50 miles of ... hours of 8 am - 4:30 pm The **eCOB Specialist I** is responsible for researching and investigating other...identify the correct formulas in order to adjudicates impacted claims , using multiple COB Formulas for the various product… more
- Deloitte (Costa Mesa, CA)
- Operations & Technology Transformation Specialist Master, Guidewire Data Migration - ETL Developer What we do Operations and Technology Transformation delivers ... on July 31, 2024 Work you'll do As an OTT Insurance Transformation Specialist Master, you will bring considerable technical expertise to deliver effective solutions… more
- Walgreens (Van Nuys, CA)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more
- Elevance Health (Costa Mesa, CA)
- **Anticipated End Date:** 2024-09-09 **Position Title:** Pharmacy Quality Assurance Specialist **Job Description:** **Pharmacy Quality Assurance Specialist ** ... office 1-2 days per week. The **Pharmacy Quality Assurance Specialist ** will be responsible for evaluating the quality of...Included are processes related to enrollment and billing and claims processing, as well as customer service written and… more
- Elevance Health (Woodland Hills, CA)
- **Anticipated End Date:** 2024-09-30 **Position Title:** Legal Specialist II **Job Description:** **Location:** This position will take part in Elevance Health's ... with PulsePoint sites used for collaboration, community, and connection. The **Legal Specialist II** is responsible for providing legal support services for multiple… more
- Mondelez International (Ontario, CA)
- …You Ready to Make It Happen at Mondelēz International?** **Join our Mission to Lead the Future of Snacking. Make It Possible.** You will execute warehouse operations ... (iDoc management, stock reconciliation), interfaces monitoring, track and trace, claims management, invoice management, compliance execution (HSE, quality, risk… more
- Elevance Health (Costa Mesa, CA)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... HS diploma or equivalent and a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more