- Sedgwick (Roseville, CA)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Future Medical Medical Only Claims Representative Workers Compensation Are you ... + May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims . + Maintains… more
- Ford Motor Company (Sacramento, CA)
- …the freedom to define and realize your dreams. With our incredible plans for the future of mobility, we have a wide variety of opportunities for you to accelerate ... you'll do ** The APD Auto Physical Damage Catastrophe Claims Adjuster/Field Service Manager is a field-based position representing...benefit of choice. You can choose what your Ford future will look like: will your story span the… more
- Kemper (Sacramento, CA)
- …negotiation skills? Kemper is looking for experienced Represented Bodily Injury Claims Adjusters for our growing teams! This specialized position focuses solely ... on the analysis & negotiation of bodily injury claims that are ordinarily assigned after the initial coverage...time limit demands + Obtain and thoroughly analyze complex medical records and data + Research and apply applicable… more
- Guardian Life (Sacramento, CA)
- …and assessment of medical information regarding disability by providing comprehensive medical reviews and analysis of long-term disability claims . The RN ... experience. **Candidate Responsibilities** The RN Clinical Consultant reviews long-term disability claims to determine the impact of claimants' medical condition… more
- Lincoln Financial Group (Sacramento, CA)
- …Role at a Glance** We are excited to bring on highly motivated STAT / PFL Claims Specialists to staff our ever-growing claims organization. As a STAT / PFL ... conducting initial and ongoing interviews with claimants, obtaining, and reviewing medical records and making timely and ethical claim determinations. You'll… more
- AECOM (Sacramento, CA)
- …with clients to solve the world's most complex challenges and build legacies for future generations. There has never been a better time to be at AECOM. With ... world. Join us. **Job Description** **AECOM** is seeking a **Senior Forensic Claims Analyst** to be based in **Sacramento, CA.** **JOB RESPONSIBILITIES:** + Perform… more
- Health Advocates Network (Folsom, CA)
- …a Library of Payer reference material regarding requirements for pre-authorization, medical necessity, and documentation requirements. Works with the Revenue Cycle ... etc.) to provide information related to denials and opportunities for future denials. **Denials Analyst** ** Qualification and Requirements:** + High school… more
- Zurich NA (Sacramento, CA)
- AVP, Medical Bill Review Litigation 119916 Zurich Insurance is seeking an. This is a fully remote position, offering the flexibility of a home-based office. In this ... role, you will be responsible for negotiating medical bill disputes, handling legal responses and filings, and representing Zurich at medical bill dispute… more
- Travelers Insurance Company (Sacramento, CA)
- …and complex Life Science medical products, clinical trial and pharmaceutical bodily injury claims , as well as General Liability Coverage B claims and E&O ... medical products, clinical trial and pharmaceutical bodily injury claims , as well as General Liability Coverage B ...with respect to accuracy and adequacy of, and potential future changes to, loss reserves on assigned claims… more
- Kemper (Sacramento, CA)
- …III is responsible for the investigation of complex, large loss, and multi-injury claims that may contain elements of fraud or claims otherwise deemed ... multi-feature and attorney represented losses. Basic functions include: Investigation of claims , analysis and development of facts and evidence, and conducting… more
- ICW Group (Sacramento, CA)
- …The purpose of this job is to detect, prevent, and investigate suspected fraudulent claims for all lines of insurance, with heavy emphasis on Workers' Compensation ... claims . This position exists in order to protect company...Marketing, Underwriting, Claimants, Policyholders, Agents, Brokers, SIU, Legal and Medical Professionals, Government/Regulatory Agencies, Law Enforcement and Vendors. +… more
- Sedgwick (Sacramento, CA)
- …and to share your insights. **PRIMARY PURPOSE** **:** To handle losses or claims nationally regardless of size, including having the ability to address any complex ... a plus!). **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Examines insurance policies, claims , and other records to determine insurance coverage. + Administers and… more
- Zurich NA (Sacramento, CA)
- …candidate will demonstrate experience with general liability. At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority ... your next career move. Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct… more
- United Therapeutics (Sacramento, CA)
- …benefit corporation (PBC). Our public benefit purpose is to provide a brighter future for patients through (a) the development of novel pharmaceutical therapies; and ... Compliance, Legal, Information Technology, Sales & Marketing Operations, Finance, and Medical Affairs / HEOR. Additionally, this role will support special pricing… more
- Lincoln Financial Group (Sacramento, CA)
- …organization. This position will be responsible for reviewing, analyzing, and interpreting medical information available for disability claims . In this role you ... this role you will provide coaching and guidance to claims regarding medical management **What you'll be...each of us to take charge of our own future . **What's in it for you:** + Clearly defined… more
- Cardinal Health (Sacramento, CA)
- …and adjustments as necessary. + Financial Acumen: + Analyze benefits utilization and claims data to identify opportunities for cost savings or plan enhancements that ... Oversee the end-to-end benefits administration process, including enrollment, eligibility, and claims resolution, to deliver a positive employee experience. + Stay… more
- UIC Government Services and the Bowhead Family of Companies (Sacramento, CA)
- …other protected characteristics EOE/AA/M/F/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual ... their Descendants, based on the provisions contained within The Alaska Native Claims Settlement Act. All candidates must apply online at www.uicalaska.com, and… more
- Sedgwick (Sacramento, CA)
- …+ This role will be primarily responsible for **_Large Complex Property_** claims . **PRIMARY PURPOSE** **:** To investigate losses or claims internationally ... be negotiated. + Attends litigation hearings. + Revises case reserves in assigned claims files to cover probably costs. + Prepares loss experience reports to help… more
- Elevance Health (Rancho Cordova, CA)
- …Admin (** **Evaluation and Management Coding/Auditing)** ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and ... are not limited to: + Reviews company-specific, CMS-specific, and competitor-specific medical policies, reimbursement policies, and editing rules, as well as… more
- United Therapeutics (Sacramento, CA)
- …benefit corporation (PBC). Our public benefit purpose is to provide a brighter future for patients through (a) the development of novel pharmaceutical therapies; and ... the pharmaceutical and biotech industry, including FDA advertising and promotion, False Claims Act, Anti-Kickback Statute, OIG Guidance, the PhRMA Code, the Sunshine… more