Health Source MSOClaims Supervisor Health Source MSOClaims SupervisorAlhambra, CAFull timeProviding expertise or general claims support to teams in reviewing, researching, investigating, negotiating, process, and adjusting claims. Responsibilities include, but not limited to: • Maintain up-to-date knowledge of procedures for all ICD-10, CPT, HCPC codes including: Contractual agreement rates.
Health Source MSOClaims Auditor Health Source MSOClaims AuditorAlhambra, CAFull timeResponsibilities include, but not limited to: Maintain up-to-date knowledge of procedures for all ICD-10, CPT, HCPC codes including:Contractual agreement rates. Job Description: Claims Auditor will be responsible for auditing claims processed by Claims Examiners.
IconmaNewClaims Examiner - Workers Compensation IconmaClaims Examiner - Workers CompensationRancho Cucamonga, CA$45–$50 / hourResponsibilities:To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
IconmaClaims Examiner - Workers Compensation (Hourly) IconmaClaims Examiner - Workers Compensation (Hourly)Brea, CA$43–$48 / hourResponsibilities:Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
JobotNewPre-Lit Case Manager JobotPre-Lit Case ManagerTorrance, CA$40–$45 / hourInformation collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from Jobot, and/or its agents and contracted partners.
JobotNewEH&S Manager JobotEH&S ManagerDowney, CA$110,000–$140,000 / yearInformation collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. Founded nearly a century ago and based in Downey, California, with operations spanning multiple locations throughout the region, we are one of the nation's premier beverage distributors and manufacturers.
Health Source MSOCustomer Service Representative Health Source MSOCustomer Service RepresentativeAlhambra, CAFull timeAbility to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time as needed. Review and research incoming healthcare claims from members and providers(doctors, clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g.
Pinnacle Technical ResourcesSenior Manager, Applications - OVC Pinnacle Technical ResourcesSenior Manager, Applications - OVCIrvine, California$160,000–$210,000 / yearThe specific compensation for this position will be determined by several factors, including the scope, complexity, and location of the role, as well as the cost of labor in the market; the skills, education, training, credentials, and experience of the candidate; and other conditions of employment. The Sr Manager Applications – Oracle Idea to Market (PLM) will play a pivotal role in driving the success of Oracle Fusion initiatives, focusing on the Idea to Market (PLM) domain.
JobotNewPublic Entity Defense Associate Attorney JobotPublic Entity Defense Associate AttorneyOrange, CA$140,000–$175,000 / yearKey Responsibilities: The ideal candidate will assist with all aspects of public entity defense litigation, including but not limited to: Handling a variety of matters involving public agencies and municipalities, such as: Police Liability and Excessive Force: Defending law enforcement personnel and agencies in claims arising from use of force, wrongful arrest, and other alleged misconduct. My client's office representation includes the defense of high exposure personal injury actions, traumatic brain injuries, exposures to environmental contaminants, habitability claims, state and federal class actions and the investigation and defense of 1st party insurance fraud claims.
JobotNewProfessional Liability Counsel JobotProfessional Liability CounselOntario, CA$160,000–$250,000 / yearThe ideal candidate is an attorney with a clinical background, such as a former Registered Nurse or healthcare professional who has obtained a J.D., or an experienced healthcare attorney with deep in-house or private practice experience supporting hospital systems in clinical operations, professional liability, and risk management. Information collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal.
JobotNewAssociate-Sr Attorney Hybrid or 100% remote JobotAssociate-Sr Attorney Hybrid or 100% remoteIrvine, CARemote$140,000–$220,000 / yearInformation collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. Our firm delivers legal services in the workers’ compensation arena, supporting a broad range of organizations including risk managers, insurers, and claims administrators.
Chili'sNewRestaurant Manager - Immediate Opening Chili'sRestaurant Manager - Immediate OpeningCypress, CA$68,000–$73,000 / yearFrom leading the team through a high-energy shift to exceeding Guest expectations on every occasion to ensuring we meet our financial responsibilities, Managers are the critical link to making it all happen. Since then, we've boldly claimed our place in the casual dining industry as the place to go for Big Mouth burgers, house smoked ribs, full on fajitas, and hand shaken margaritas!
Chili'sNewRestaurant Manager Chili'sRestaurant ManagerCypress, CA$68,000–$73,000 / yearFrom leading the team through a high-energy shift to exceeding Guest expectations on every occasion to ensuring we meet our financial responsibilities, Managers are the critical link to making it all happen. Since then, we've boldly claimed our place in the casual dining industry as the place to go for Big Mouth burgers, house smoked ribs, full on fajitas, and hand shaken margaritas!
Chili'sNewRestaurant Manager - Cypress, CA - Chili's Chili'sRestaurant Manager - Cypress, CA - Chili'sCypress, CA$68,000–$73,000 / yearFrom leading the team through a high-energy shift to exceeding Guest expectations on every occasion to ensuring we meet our financial responsibilities, Managers are the critical link to making it all happen. Since then, we've boldly claimed our place in the casual dining industry as the place to go for Big Mouth burgers, house smoked ribs, full on fajitas, and hand shaken margaritas!
Chili'sNewRestaurant Manager - Team Lead Chili'sRestaurant Manager - Team LeadCypress, CA$68,000–$73,000 / yearFrom leading the team through a high-energy shift to exceeding Guest expectations on every occasion to ensuring we meet our financial responsibilities, Managers are the critical link to making it all happen. Since then, we've boldly claimed our place in the casual dining industry as the place to go for Big Mouth burgers, house smoked ribs, full on fajitas, and hand shaken margaritas!
Chili'sNewRestaurant Manager - Now Hiring Chili'sRestaurant Manager - Now HiringCypress, CA$68,000–$73,000 / yearFrom leading the team through a high-energy shift to exceeding Guest expectations on every occasion to ensuring we meet our financial responsibilities, Managers are the critical link to making it all happen. Since then, we've boldly claimed our place in the casual dining industry as the place to go for Big Mouth burgers, house smoked ribs, full on fajitas, and hand shaken margaritas!
Chili'sNewRestaurant Manager - Quarterly Bonus Available Chili'sRestaurant Manager - Quarterly Bonus AvailableCypress, CA$68,000–$73,000 / yearFrom leading the team through a high-energy shift to exceeding Guest expectations on every occasion to ensuring we meet our financial responsibilities, Managers are the critical link to making it all happen. Since then, we've boldly claimed our place in the casual dining industry as the place to go for Big Mouth burgers, house smoked ribs, full on fajitas, and hand shaken margaritas!
Chili'sNewRestaurant Manager - Carson, CA - Chili's Chili'sRestaurant Manager - Carson, CA - Chili'sCarson, CA$68,000–$74,000 / yearFrom leading the team through a high-energy shift to exceeding Guest expectations on every occasion to ensuring we meet our financial responsibilities, Managers are the critical link to making it all happen. Since then, we've boldly claimed our place in the casual dining industry as the place to go for Big Mouth burgers, house smoked ribs, full on fajitas, and hand shaken margaritas!
Chili'sNewRestaurant Manager - Buena Park, CA - Chili's Chili'sRestaurant Manager - Buena Park, CA - Chili'sBuena Park, CA$68,000–$74,000 / yearFrom leading the team through a high-energy shift to exceeding Guest expectations on every occasion to ensuring we meet our financial responsibilities, Managers are the critical link to making it all happen. Since then, we've boldly claimed our place in the casual dining industry as the place to go for Big Mouth burgers, house smoked ribs, full on fajitas, and hand shaken margaritas!
Health Source MSOCase Management Coordinator Health Source MSOCase Management CoordinatorAlhambra, CAFull timeJob Description: In the UM department, Case Management Coordinator is to assist with the coordinating of the day-to day activities in the medical group, request for authorization for ancillary services, and certify the group is utilizing the most cost effective provider. Also, identify patients found in out-of-network facilities and send the information timely to the concurrent-review nurse for coordination with the hospital and group.
Vaco LLCNewSenior Employment Law Attorney Vaco LLCSenior Employment Law AttorneyOrange, CA$230,000–$300,000This exceptional team operates with over 100 Attorneys companywide, and they are continuing to grow so if you are an Attorney with worker’s comp or employment law experience looking for a highly motivated group that takes pride in excellence, integrity, career growth and respect, I suggest you apply for this position! Determining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to: the individual’s skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; other business and organizational needs.
CVS HealthNewAsset Protection Supervisor- LaHabra DC CVS HealthAsset Protection Supervisor- LaHabra DCLa Habra, CA$43,888–$93,574Responsibilities include ensuring the security of company assets (including employees, building, product, supplies, etc.), conducting internal and external investigations, overseeing Environmental Health and Safety (EHS) programs, conducting operational audits, monitoring compliance with local, state, and federal regulations, and supporting business operations. This position reports to the IQC Manager and collaborates across the supply chain network to create, develop, and improve processes and procedures to maximize operational efficiencies in collaboration with Distribution Operations, Corporate Compliance, Corporate Security, Finance, and COE's.
Vaco LLCNewTrademark Associate Attorney Vaco LLCTrademark Associate AttorneyCosta Mesa, TX$310,000–$420,000Determining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to: the individual’s skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; other business and organizational needs. Determining compensation for this role (and others) at Vaco/Highspring depends upon a wide array of factors including but not limited to the individual’s skill sets, experience and training, licensure and certifications, office location and other geographic considerations, as well as other business and organizational needs.
Vaco LLCNewEmployment Law Partner Vaco LLCEmployment Law PartnerOrange, CA$230,000–$300,000This exceptional team operates with over 100 Attorneys companywide, and they are continuing to grow so if you are an Attorney with worker’s comp or employment law experience looking for a highly motivated group that takes pride in excellence, integrity, career growth and respect, I suggest you apply for this position! Determining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to: the individual’s skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; other business and organizational needs.
Vaco LLCNewWorker's Compensation Attorney Vaco LLCWorker's Compensation AttorneyOrange, CA$100,000–$220,000This exceptional team operates with over 100 Attorneys companywide, and they are continuing to grow so if you are an Attorney with worker’s comp or employment law experience looking for a highly motivated group that takes pride in excellence, integrity, career growth and respect, I suggest you apply for this position! Determining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to: the individual’s skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; other business and organizational needs.
Great American Insurance CompanySenior Claims Manager, Remote - CA Workers'''' Compensation Great American Insurance CompanySenior Claims Manager, Remote - CA Workers'''' CompensationWork at Home, CARemote$135,000–$145,000 / yeargain buy-in from our insureds regarding the direction each claim is taking, develop a strategy of how to best mitigate the potential loss through interaction with the claimant, and making sure that light duty jobs are available for quick return to work. We need someone who has the ability to help and direct when needed, a group of strong, carefully chosen senior level adjusters to: focus on fresh, creative, and quick approaches on every claim resulting in proactive claim resolutions.
Collectors Holdings, Inc.Claims Manager Collectors Holdings, Inc.Claims ManagerSanta Ana, CA$102,000–$138,000 / yearYou will also advise on coverage strategy (e.g., adding new locations, adjusting limits) and leverage data to set appropriate values for buildings and other assets, maintaining strong relationships with underwriters. You will be accountable for end-to-end claims operations, ensuring every claim is filed and adjusted in strict accordance with policy terms, limits, deductibles, and exclusions-while driving timely, accurate resolution.
Kemper CorpSenior Major Loss Claims Manager Kemper CorpSenior Major Loss Claims ManagerCerritos, CA$99,000–$164,800 / yearWe believe a high-performing culture, valuable opportunities for personal development and professional challenge, and a healthy work-life balance can be highly motivating and productive. The Claims Manager will provide technical expertise, staff development and guidance on California claims handling practices/procedures and provide training as appropriate and necessary.
Sedgwick Claims Management Services, Inc.Claims Manager - Technical Standards and Compliance | Brea, CA Sedgwick Claims Management Services, Inc.Claims Manager - Technical Standards and Compliance | Brea, CABrea, CA$110,000–$127,000 / yearLeads projects focused on large process, procedural and /or compliance changes/updates; communicates changes/updates to field offices, IT, Legal and other applicable business units regarding regulatory requirements and changes. Serves as subject matter expert responsible for the training of technical processes and requirements; leads training initiatives for colleagues, supervisors/managers and clients as needed.
Sedgwick Claims Management Services, Inc.Claims Manager - Workers Compensation | Riverside, CA Sedgwick Claims Management Services, Inc.Claims Manager - Workers Compensation | Riverside, CARiverside, CARemote$115,000–$125,000 / yearMental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Brookfield Residential Properties ULCLitigation & Claims Manager Brookfield Residential Properties ULCLitigation & Claims ManagerCosta Mesa, CA$115,000–$145,000 / yearAs part of Brookfield - one of the largest alternative asset managers in the world - we harness our resources to bring a fresh approach, unparalleled creativity, relentless innovation, and sound Sustainability practices to the planning, development, and management of buildings everywhere. The Manager will participate in mediations, arbitrations, and trials as a company representative, oversee the collection and production of documentation for litigation and discovery, maintain comprehensive litigation files, and manage related invoices, settlements, and expenses.
Providence Health & ServicesSenior Claims Manager - Medical Negligence and Multi-Line - Hybrid, FullTime, Day Providence Health & ServicesSenior Claims Manager - Medical Negligence and Multi-Line - Hybrid, FullTime, DayIrvine, CARequsition ID: 429641 Company: Providence Jobs Job Category: Financial Transactions Job Function: Health Plans Services Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 4008 SS RIS Address: WA Renton 1801 Lind Ave SW Work Location: Providence Valley Office Park-Renton Workplace Type: On-site Pay Range: $54.40 - $85.88 About the Team Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
Providence St. Joseph HealthSenior Claims Manager - Medical Negligence and Multi-Line - Hybrid, FullTime, Day Providence St. Joseph HealthSenior Claims Manager - Medical Negligence and Multi-Line - Hybrid, FullTime, DayIrvine, CATogether, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. Required Qualifications: Bachelor''s Degree in Business Administration, Finance, or a related discipline or Equivalent combination of education and experience in the insurance industry; claims management; or legal handling of claims issues.
CNAWorkers Compensation Claims Manager, West CNAWorkers Compensation Claims Manager, WestPlacentia, CaliforniaBuilds and maintains collaborative relationships with internal and external work partners by participating in round table discussions, working with claims operations and coverage resources, providing insights to underwriters, partnering with SIU and Recovery Services and interacting with external customers, brokers and vendors as appropriate. Performs a combination of duties in accordance with departmental guidelines: Oversees the work activities of a team of claims professionals and has full management responsibility by setting and communicating expectations, providing direction and coaching, facilitating training and development, managing employee performance, and contributing to employee engagement.
County of OrangeNewLiability Claims Manager County of OrangeLiability Claims ManagerSanta Ana, CA$127,878.40–$177,132.80 / yearIn your response, include the number of staff supervised, the size and scope of the program(s) managed, your key supervisory responsibilities (e.g., assigning work, performance evaluation, training, and oversight), and examples demonstrating at least three (3) years of progressively responsible supervisory or management experience. Four (4) years of professional risk management programs experience related to assignment; must include two (2) years of lead/supervisory experience AND I possess a Bachelor's degree in occupational health, safety engineering, insurance/risk management, business administration, or related field.
Astrana Health IncSr. Manager - Claims Delegation Audit Astrana Health IncSr. Manager - Claims Delegation AuditMonterey Park, CAThis role will be responsible for the development and execution of department strategies, overall Audit program, Audit process optimization, and management, identifying and leveraging technology and data to improve the quality and minimizing process cost of Claims. Working with the Department Director, Senior Manger will collaborate with other Astrana Health departments and personnel to develop strategies to identify, mitigate and optimize operational and financial gaps.
Stanford Health CareClaims Manager - Employment Stanford Health CareClaims Manager - EmploymentRemote-CA, CARemote$66.52–$88.14 / hourUnder the direction of the Director, Claims & Litigation Strategy, the Claims Manager is primarily responsible for handling Employment Practices Liability (EPL) claims for Stanford Health Care, Stanford Health Care Tri-Valley, and Stanford Children's Health. Serve as liaison with other Stanford departments, including Human Resources and Employee & Labor Relations, and external partners, such as defense counsel, insurance brokers, and insurance carriers, to coordinate issues impacting claim resolution.
Providence St. Joseph HealthSenior Claims Manager EPL - Hybrid Providence St. Joseph HealthSenior Claims Manager EPL - HybridOrange, CATogether, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Providence Health & ServicesSenior Claims Manager EPL - Hybrid Providence Health & ServicesSenior Claims Manager EPL - HybridOrange, CARequsition ID: 430189 Company: Providence Jobs Job Category: Financial Transactions Job Function: Health Plans Services Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 4008 SS RIS Address: CA Orange 1100 W Stewart Dr Work Location: St Joseph Hospital-Orange Workplace Type: Hybrid Pay Range: $see posting - $see posting The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
Astrana Health IncSr. Manager - Claims Astrana Health IncSr. Manager - ClaimsMonterey Park, CAThis role will report to the AVP - Claims Operations and enable us to continue to scale in the healthcare industry. About the Role: We are currently seeking a highly motivated Claims Manager.
Stanford Health CareClaims Manager (Professional & General Liability) Stanford Health CareClaims Manager (Professional & General Liability)CA$66.52–$88.14 / hourInvestigates pre-suit claims, interviews providers, retains consultants when necessary, prepares case reports, communicates with patients and/or families, and directly negotiates settlements when warranted. Manages litigated claims, evaluates applicable insurance coverages such as professional and general liability, retains outside counsel, attends mediation, monitors litigation costs, and oversees decisions regarding discovery, strategy, and ultimate resolution.
The Vertex Co IncManager, Construction Claims The Vertex Co IncManager, Construction ClaimsIrvine, CA$120,000–$155,000 / yearResponsible for supporting assigned Director in meeting or exceeding the defined annual budget for the entire practice area/practice division (including proactive management of assigned resources to meet or exceed defined utilization targets, oversight of execution of profitable engagement work streams, and communication with clients as assigned or requested). The Manager, Construction Claims will assist their assigned Director with leading and managing assigned resources in support of achieving the defined overall practice area/practice division strategy, and in meeting or exceeding defined financial performance and revenue generation targets.
Collaborative SolutionsClaims Manager Collaborative SolutionsClaims ManagerSanta Ana, CaliforniaYou will also advise on coverage strategy (e.g., adding new locations, adjusting limits) and leverage data to set appropriate values for buildings and other assets, maintaining strong relationships with underwriters. We’re looking for a Claims Managerto join our Claims team to lead the claims team and serve as the subject-matter expert for our commercial insurance portfolio.
The Vertex Companies, LLCManager, Construction Claims The Vertex Companies, LLCManager, Construction ClaimsIrvine, CA$78,000–$186,000 / yearFull timeResponsible for supporting assigned Director in meeting or exceeding the defined annual budget for the entire practice area/practice division (including proactive management of assigned resources to meet or exceed defined utilization targets, oversight of execution of profitable engagement work streams, and communication with clients as assigned or requested). The Manager, Construction Claims will assist their assigned Director with leading and managing assigned resources in support of achieving the defined overall practice area/ practice division strategy, and in meeting or exceeding defined financial performance and revenue generation targets.
PricewaterhouseCoopers LLPProperty & Casualty Insurance Claims Operations Consultant, Manager PricewaterhouseCoopers LLPProperty & Casualty Insurance Claims Operations Consultant, ManagerIrvine, CA$99,000–$232,000 / yearPwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy. You will analyze client needs, implement solutions, and provide training and support to validate seamless integration and utilization of business applications, enabling clients to achieve their strategic objectives.
ICW GroupClaims Account Manager II (Northern California) ICW GroupClaims Account Manager II (Northern California)CARemote$90,559.93–$152,723.07 / yearHeadquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for ten consecutive years as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people. Identifies service levels of each account and balances Claims Account Manager staffing/ratio, in conjunction with the Customer Relations Manager, to ensure claim service meets our brand level.
The Vertex Companies, LLCManager, Schedule Delay Claims The Vertex Companies, LLCManager, Schedule Delay ClaimsIrvine, CA$85,000–$202,000 / yearFull timeThe salary ranges for this role are as follows: $85,000 - $202,000 USD annually (Geographical Tier AA - Sample Locations: NY Metro, San Franscisco, San Jose, Seattle) $78,000 - $186,000 USD annually (Geographical Tier A - Sample Locations: Irvine CA, Middlesex NJ, Tacoma WA, Boston, Alexandria)$72,000 - $171,000 USD annually (Geographical Tier B - Sample Locations - Baltimore, Chicago, Anchorage, Portland) Time away matters—so we provide a generous paid time off program, including vacation, sick time, and paid holidays (with prorated options for eligible part-time employees).At VERTEX, growth never stops. The Vertex Companies, LLC (VERTEX) is a $180M global consulting firm that integrates strategic advisory, project management, and dispute resolution services for organizations facing complex challenges in a world of risk.
Astrana Health, Inc.Sr. Manager - Claims Delegation Audit Astrana Health, Inc.Sr. Manager - Claims Delegation AuditMonterey Park, California$125,000–$140,000 / yearThe position alongside the leadership team will contribute to driving strategic planning, operational excellence, and accuracy of the claims process and ensure compliance with regulations and contract requirements for Medicare, Commercial Exchange, and Medicaid service lines. External Audit planning, execution & support Own the end‑to‑end strategy and execution of all external audits (e.g., CMS, DMHC, health plan audits), ensuring readiness, successful delivery, and continuous score improvement.
County of Riverside, CaliforniaClaims Adjuster II/Senior Claims Adjuster (Senior Workers' Compensation Claims Adjuster) County of Riverside, CaliforniaClaims Adjuster II/Senior Claims Adjuster (Senior Workers' Compensation Claims Adjuster)Riverside, CA$112,778.77–$159,740.22 / yearKnowledge of: State of California Labor Code, Workers Compensation Law and rules and regulations (Title 8); Applicable case law of leading decisions of the Workers Compensation Appeals Board, Court of Appeals, and Supreme Court regarding workers compensation cases; Medical terminology, anatomy and technical terminology used in medical and legal fields regarding industrial cases; Jurisdiction, functions and procedures of the Workers Compensation Appeals Board; Vocational rehabilitation and procedures as it applies to Workers Compensation; Reserving practices and procedures; in-house litigation procedures; WCAB procedures; and hearing processes. Candidates must have achieved the level of Experienced Claims Adjuster (as defined by California Code of Regulations, Title 10, Chapter 5, Subchapter 3) defined as possessing one of the following: 1) Working 5 out of the last 8 years as a California Workers Comp Claims Adjuster, 2) Has worked continuously in California adjusting claims since passing the Self-Insurance Test, or 3) Has passed the Self-Insurance test in the last 2 years.
Astrana Health, Inc.Sr. Manager - Claims Astrana Health, Inc.Sr. Manager - ClaimsMonterey Park, California$125,000–$140,000 / yearYou’ll partner closely with internal teams, resolve escalations, and coach a team of claims professionals to deliver compliant, efficient, and accurate outcomes in a fast‑paced environment. Minimum of a Bachelor's degree (B.A.) from a four-year college or university; or four (4) years current Management or equivalent experience with an MSO or IPA Management.