Claims Specialist - Professional Liability Philadelphia Insurance CompaniesClaims Specialist - Professional LiabilityRoseville, CA$95,000–$105,000 / yearEvaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries.
Claims Specialist - Property Philadelphia Insurance CompaniesClaims Specialist - PropertyRoseville, CA$84,422–$99,320 / yearEvaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries.
Sr. Claims Specialist - Commercial Auto BI Philadelphia Insurance CompaniesSr. Claims Specialist - Commercial Auto BIRoseville, CA$102,150–$120,177 / yearEvaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries.
Senior Claims Specialist I, Workers Compensation - West Region Liberty Mutual Holding Company IncSenior Claims Specialist I, Workers Compensation - West RegionSacramento, CARemoteResponsibilities: Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages. Demonstrates an advanced knowledge of claims case handling practices, legal liability, general insurance policy coverage, and the state s tort laws as normally acquired through a bachelor s degree (or equivalent training) plus 3 to 5 years directly related work experience.
Claims Specialist - Workers'''' Compensation (California) ICW GroupClaims Specialist - Workers'''' Compensation (California)Sacramento, CA$78,678.61–$132,686.15 / 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. Bachelor's degree (or equivalent combination of education and experience) required along with a minimum of 8 - 10+ years' related claims handling experience involving complex litigation, reserving, settlement strategy, and high exposure claims.
Claims Specialist, Workers Compensation - West Region Liberty Mutual Holding Company IncClaims Specialist, Workers Compensation - West RegionRocklin, CARemoteResponsibilities: Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages. As a Workers Compensation Claims Specialist, you will work within a Claims Team, using the latest technology to review, analyze, and process claims that are routinely characterized as moderately complex to complex within assigned authority limits.
Catastrophe Field Claims Specialist AAA Southern New EnglandCatastrophe Field Claims SpecialistRoseville, CABy continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. Work Environment: This position is currently able to work remotely from a home office location for day-to-day operations, with traveling to field locations as necessary to complete job responsibilities, unless occasional team building activities are specified by leadership.
Litigated Claims Specialist, General Liability Zurich Insurance Group LtdLitigated Claims Specialist, General LiabilityGold River, CARemoteOur hybrid work model is thoughtfully designed around employee needs offering autonomy to complete focused work from a preferred location, while still supporting meaningful in-person collaboration when it adds value. You will follow established best practices and protocols to ensure claims are handled efficiently and effectively, while delivering a consistent, high-quality, and customer-focused claims experience.
Senior Workers'' Comp Claims Specialist CA Claims Zenith Insurance CompanySenior Workers'' Comp Claims Specialist CA ClaimsRoseville, CA$94,502.68–$127,972.38 / yearZenith is a team of Workers'' Compensation Specialists committed to helping businesses succeed by protecting against the financial and human consequences of workplace injuries, providing for the needs of injured employees and making the workplace safer. Opens new Claims, completes three-point contact, and performs needed investigations to determine compensability as well as possible subrogation or apportionment, according to state and/or Zenith's timeframes and guidelines.
Technical Claims Specialist, Workers Compensation - West Region Liberty Mutual Holding Company IncTechnical Claims Specialist, Workers Compensation - West RegionRoseville, CAHas developed high level of knowledge of Workers Compensation claims handling techniques, a full knowledge of LMG claims procedures and is cognizant of new industry trends and claim handling techniques Uses available data to track claims trends and other claim related metrics. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role.
NewRisk Management Analyst II: Large Claims Specialist Pacific Coast Building ProductsRisk Management Analyst II: Large Claims SpecialistRancho Cordova, CA$70,000–$90,000 / yearA risk management firm in California is seeking an experienced claims manager responsible for handling major liability and workers compensation claims. Strong analytical, multi-tasking, and communication skills are essential to effectively manage and report on claims.
Claims Training Specialist CorVel Enterprise Claims, Inc.Claims Training SpecialistFolsom, CARemote$77,960–$120,368 / yearPart timeOther duties to be carried out by Claims Training Specialist will include conducting classroom, virtual, and field training to internal employees/colleagues, developing training materials to meet specific needs, and monitoring new hires, and other tasks as required by management. In order to efficiently execute daily responsibilities, the Claims Training Specialist must first obtain a deep understanding of the business to articulate what our claims model does and to clearly demonstrate all aspects of the Operations roles in order to be able to successfully conduct and oversee the department training.
Claims Training Specialist CorVelClaims Training SpecialistFolsom, CARemote$77,960–$120,368 / yearOther duties to be carried out by Claims Training Specialist will include conducting classroom, virtual, and field training to internal employees/colleagues, developing training materials to meet specific needs, and monitoring new hires, and other tasks as required by management. In order to efficiently execute daily responsibilities, the Claims Training Specialist must first obtain a deep understanding of the business to articulate what our claims model does and to clearly demonstrate all aspects of the Operations roles in order to be able to successfully conduct and oversee the department training.
Claims & Provider Relations Oversight Specialist Western Health AdvantageClaims & Provider Relations Oversight SpecialistSacramento, CAFull timeSupport Annual Network Review (ANR), Geo Access, Provider Appointment Availability Surveys (PAAS), Provider Satisfaction Surveys (PSS), after-hours surveys, and related compliance activities. Western Health Advantage is seeking a detail-oriented Claims & Provider Relations Oversight Specialist to support compliance and regulatory operations within our Claims and Provider Relations department.
Claims Analyst II (On-Site) NorthBay Medical CenterClaims Analyst II (On-Site)Fairfield, CAThe position is co-responsible for the operational functions for the organization's capitated hospital and medical group business, processing all claims, oversees customer service issues, researching/resolving payment issues and addressing corrections in the system with the Claims Specialist. Requires a high comfort level with taking initiative and responsibility, high energy and productivity, plus an orientation and ability to manage details in an organized work style.
Claims Processing Specialist Wollborg Michelson RecruitingClaims Processing SpecialistRancho Cordova, CAThis role includes processing special claims that may involve manual review of actual treatment compared to authorized treatment, and adjudicating claims for specific client programs. The Claims Processing Specialist identifies and provides solutions for processing unique claims, refunds, overpayments, and underpayments.
NewClaims Analyst II (On-Site) Northbay HealthcareClaims Analyst II (On-Site)Fairfield, California$33.29–$40.44 / hourFull timeThe position is co-responsible for the operational functions for the organization's capitated hospital and medical group business, processing all claims, oversees customer service issues, researching/resolving payment issues and addressing corrections in the system with the Claims Specialist. Maintains claims files and other recordkeeping systemsAssists Senior Analyst IV and Director and other staff as requestedInteracts and communicates effectively inside and outside NorthBay Healthcare.
Claims Adjuster Senior - Injury The Progressive CorpClaims Adjuster Senior - InjurySacramento, CA$36–$47 / hourFor ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/ . Investigating complex and high-risk claims - which may be attorney represented or have additional litigation features - you'll consult with police officers, medical professionals, claimants and others involved in the accident.
Claims Adjuster Senior - Litigation The Progressive CorpClaims Adjuster Senior - LitigationSacramento, CA$36–$47 / hourFor ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/ . Investigating complex and high-risk claims - which may be attorney represented or have additional litigation features - you'll consult with police officers, medical professionals, claimants and others involved in the accident.
Claims Adjuster II (Workers'' Compensation) | California Employers Holdings IncClaims Adjuster II (Workers'' Compensation) | CaliforniaSacramento, CARemote$50,000–$85,000 / yearThe Work comp Claims Adjuster II is responsible for timely and accurate management of workers' compensation claims with moderate medical and indemnity benefit exposure, including litigation. As a dynamic, fast-growing provider of workers'' compensation insurance and services, we are seeking a goal-oriented individual willing to put their ideas to work!
Executive Claims Examiner, Miscellaneous Professional E&O Markel CorporationExecutive Claims Examiner, Miscellaneous Professional E&OWoodland, CA$97,520–$134,090 / yearThis includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Manage litigation filed nationwide against insureds; appoint, direct and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist Company claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collection issues.
NewMedical Claims Review Medical Director - Surgeon - Remote UnitedHealth Group Inc.Medical Claims Review Medical Director - Surgeon - RemoteSacramento, CARemote$248,500–$373,000 / yearThe Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on post-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members.
NewSr Workers Compensation Claims Adjuster - California The Hanover Insurance Group IncSr Workers Compensation Claims Adjuster - CaliforniaRoseville, CACompensation: The target hiring range for this role may vary based on geographic location and other factors, including merit or performance, demonstrated proficiency, skills for the role, education, travel requirements, and experience. Individuals with disabilities who wish to request a reasonable accommodation to participate in the job application or interview process, or to perform essential job functions, should contact us at:HRServices@hanover.com and include the link of the job posting in which you are interested.
Claims Resolution Coordinator Partnership HealthPlan of CaliforniaClaims Resolution CoordinatorFairfield, California$37.22–$46.53 / hourFull timeThe job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. Acts as a resource and provides support to customer service staff, as well as Provider Relations staff for complex Provider questions regarding claims and payments.
Claims Adjuster - Attorney Represented Injury The Progressive CorpClaims Adjuster - Attorney Represented InjuryRancho Cordova, CA$30.29–$39.23 / hourAn ideal candidate will have experience managing an inventory independently, experience assessing and evaluating liability, coverage, and damages, as well as working independently and directly with attorneys to negotiate and settle claims. For ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/ .
Claim Operations Specialist The Travelers Companies IncClaim Operations SpecialistRancho Cordova, CA$45,400–$74,900 / yearCLAIM OPERATIONAL SERVICE AND PARTNERSHIPS: Partners with claim professionals in multiple departments to assist with the timely resolution of claims, which may include: Properly documents claim files, including notes and diaries, Requests reports and records, and reviews medical bills, mail and wage statements. CLAIM PAYMENTS AND EXPENSE PROCESSING: Ensures the proper handling of financial transactions to include: Processes and issues claim payments including outside vendor invoices, attorney expenses, and medical processing fees.
Cost Avoidance Specialist I Partnership HealthPlan of CaliforniaCost Avoidance Specialist IFairfield, California$80,140.53–$100,175.67 / yearFull timeResponsibilities: Assess, implement, and monitor activities related to recoveries and cost savings of medical claims with duties including but not limited to: Perform assessments and identify potential overpayments on claims related to all lines of business; Research and identify overpayments related to over utilization of procedures, billing procedures, potential fraudulent claims, duplicate payments, and overpayments due to lack of coordination of benefits with member's primary health care insurance policy such as a private health insurance, Medicare coverage, or an open case with CCS; Perform recovery activities associated with claim audit findings; Report dollar amounts identified for recovery, recovery amounts received, and reasons for overpayments; Responsible for identifying via reports, Medi-Cal overpayments due to retro-active Medicare or Third Party coverage and the recoupment of same. Researches and validates all provider refund checks received with duties including but not limited to: Identifies if refund check received is due to Partnership, reason for the refund; Identifies configuration or training issues related to the payment received; Recommends appropriate actions, statistical or regular adjustment, completes adjustments and reports outcome to Cost Avoidance Supervisor.
Patient Account Specialist One Community HealthPatient Account SpecialistSacramento, CAThe Patient Account Specialist will be responsible for managing various aspects of the medical administration billing process, including paper claim submission, patient account follow-up, Good Faith Estimates, claim documentation, patient communications, and patient payment processing. If you require an accommodation due to a disability to complete this application or you are experiencing difficulty submitting your application, please contact us at OCHhumanresources@onecommunityhealth.com.
Appeals Specialist Lee Hecht HarrisonAppeals SpecialistSacramento, CA$25–$26 / hourThis role serves as a key advocate for members by ensuring concerns are thoroughly researched, properly documented, and resolved in accordance with regulatory requirements, health plan policies, and contractual obligations. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.
Telephone Inquiry Specialist - 1672 Wollborg Michelson RecruitingTelephone Inquiry Specialist - 1672Rancho Cordova, CAHandles complex inquiries and documentation related to a dental benefits program, providing information and support to beneficiaries and dental providers while ensuring accurate tracking and resolution of issues. Respond to incoming calls from dental provider offices regarding program policies and procedures, claims and TAR processing, EOB and payment inquiries, patient history, and office enrollment status.
Eligibility Benefits Specialist I Solano County CailforniaEligibility Benefits Specialist ICA$62,110.40–$75,495.57 / yearAPPLICANTS WITH DISABILITIES: Qualified individuals with a disability, who are able to perform the essential functions of the job, with or without reasonable accommodation, and need an accommodation during any phase of the recruitment/testing/examination process (as detailed in the "Selection Process"), must complete the following Request for Testing Accommodation by Applicants with Disabilities Form. The Eligibility Benefits Specialist I (EBS I) is an entry-level position responsible for learning and applying regulations and procedures to determine eligibility for multiple public assistance programs, including CalFresh, CalWORKs, and Medi-Cal.
Product Development Specialist Philadelphia Insurance CompaniesProduct Development SpecialistRoseville, CA$76,700–$85,700 / yearYou'll develop new products and strengthen existing offerings by drafting and updating coverage forms, endorsements, and rate/rule pages - making sure our products are clear, competitive, and compliant. Superior interpersonal, communication, and time management skills and ability to develop and foster relationships with key internal and external stakeholders and contribute in a dynamic, fast-paced environment and effectively deliver on multiple priority matters.
Accounts Receivable Specialist SMA AmericaAccounts Receivable SpecialistSacramento, CA$72,000–$79,000 / yearCollaborate with multiple departments to manage accounts receivable, including milestone accounts, to ensure timely payments from customers through account statements, reconciliations, reminders, demand letters, and payment plans as needed. We may also obtain your personal information from third parties, including but not limited to your former employers, background or employment check service providers or third-party recruiters; and, (b) SMA may use or process applicants' personal information for relevant purposes including but not limited to general communications with you, identity verification, background or employment checks, determination of eligibility, and making hiring decisions.
NewDental Assistant Telephone Inquiry Specialist Wollborg Michelson RecruitingDental Assistant Telephone Inquiry SpecialistRancho Cordova, CAProvides professional telephone support to dental program beneficiaries, providers, and representatives by researching and resolving complex inquiries, processing documentation, tracking correspondence, and providing accurate information about program policies, appointments, claims, and treatment authorizations. Respond to provider inquiries regarding program policies and procedures, claims and treatment authorization processing, explanation of benefits statements, payments, patient history, and enrollment status.
NewSenior Systems Specialist, Chargemaster (Onsite, Hybrid, Remote) Northbay HealthcareSenior Systems Specialist, Chargemaster (Onsite, Hybrid, Remote)Fairfield, CaliforniaRemote$46.63–$56.68 / hourFull timeManages all updates and modifications to the CDMAssists with chargemaster configurations across all relevant software applicationsAssists with cross-functional collaboration with hospital departments and IT to develop a strategic roadmap for an optimized and compliant chargemaster across all integrated systems. We are expanding access to care across our communities through two acute-care hospitals, including a Level II Trauma Center and a Level III NICU maternity unit, along with a cancer center, urgent care locations, and a growing network of primary and specialty care clinics.
EHS Specialist Ferrara Candy CompanyEHS SpecialistFairfield, CA$75,000–$85,000 / yearIn addition to overall input to site environmental, health and safety initiatives, strategies, programs and procedures, responsibilities include: Deliver EHS programs to train employees in work site safety practices by promoting and leading a site culture where Safety is engrained as a core value with all employees. The primary objective is to ensure a safe and incident-free work environment including methodologies, initiatives and strategies that promote safe operations, safety awareness, training and continuous improvement to eliminate or control unsafe behaviors, environments and hazards.
Appeals & Grievances Specialist I Western Health AdvantageAppeals & Grievances Specialist ISacramento, CAFull timeYou will work closely with members, providers, medical groups, and internal departments to investigate concerns, coordinate resolutions, and deliver exceptional service throughout the appeals process. Research and evaluate issues related to benefits, claims, authorizations, enrollment, billing, quality of care, utilization management, and other health plan services.
Occupancy Specialist Ultimate Staffing ServicesOccupancy SpecialistSacramento, California$24–$27 / hourThe Occupancy Specialist is responsible for managing the occupancy process for a 198-unit senior apartment community, ensuring compliance with HUD and Low-Income Housing Tax Credit (LIHTC) program regulations. * EIV Report Management: Run monthly Enterprise Income Verification (EIV) reports to ensure compliance with HUD requirements and maintain EIV binders for audits.
Appeals & Grievance Specialist Ultimate Staffing ServicesAppeals & Grievance SpecialistSacramento, California$22–$25 / hourOur client is seeking an Appeals & Grievances Specialist to investigate, coordinate, and resolve member appeals and grievances while ensuring compliance with regulatory requirements and established timelines. This role requires strong analytical skills, attention to detail, and the ability to manage multiple priorities in a fast-paced healthcare environment.
Provider Enrollment Specialist (Temporary for 9-12 Months) - Remote - Nationwide CEP America LLCProvider Enrollment Specialist (Temporary for 9-12 Months) - Remote - NationwideSacramento, CARemote$22.90–$28.63 / hourPrepare, submit, and scan approximately 1,000 provider enrollment applications per year for Medicare, Medicaid, Blue Cross, Blue Shield, CAQH and other payer programs as needed and is responsible for all aspects of payer portal access for individual providers. Knowledge of Medicaid enrollment process (including revalidations, medical license expirations, deactivations, NPI taxonomy importance, how data flows to Medicaid managed cares, Medicaid billing manuals, state administrative codes, border state enrollment process, out of state enrollment process, etc.).
CAD/BIM - Design Technology Specialist II Delve UndergroundCAD/BIM - Design Technology Specialist IISacramento, CA$68,159–$123,584 / yearWe offer comprehensive design, construction management, and construction claims services, with expertise extending across a wide range of engineering disciplines, including civil, structural, and geotechnical engineering. Responsibilities: Assist in the development of plans, profiles, elevations, cross-sections, and detail documents based on sketches, redline markups, and information based on verbal instructions and notes provided by designers and engineers.
Cad/Bim - Design Technology Specialist II Delve UndergroundCad/Bim - Design Technology Specialist IISacramento, CA$68,159–$123,584 / yearWe offer comprehensive design, construction management, and construction claims services, with expertise extending across a wide range of engineering disciplines, including civil, structural, and geotechnical engineering. Responsibilities: Assist in the development of plans, profiles, elevations, cross-sections, and detail documents based on sketches, redline markups, and information based on verbal instructions and notes provided by designers and engineers.
NewHuman Resources Specialist Sacramento Superior CourtHuman Resources SpecialistSacramento, CA$35.15–$42.70 / hourReviews and processes personnel transactions for the Court's payroll system, identifies errors or deviations and resolves with division staff; processes payroll and miscellaneous pay; performs position management duties; resolves employee history and payroll issues; processes new employees, employee terminations, leaves of absence, and other personnel actions; checks personnel transactions forms and timesheets for accuracy; prepares and submits payroll accounting information for processing and reconciles any differences between payroll records and system processing reports; examines, reconciles, balances, and adjusts personnel/payroll records. This classification is distinguished from the higher level classification of Human Resources Analyst in that the Human Resources Specialist class performs a high proportion of routine duties and tasks and decisions are made within established procedures, requiring general program knowledge, and are subject to more frequent and detailed review; whereas the Human Resources Analyst performs the full range of professional human resource work with little or no immediate supervision.
Part Time Business Office Specialist Bristol Hospice, LLCPart Time Business Office SpecialistRoseville, CAProvide office functions including handling correspondence and word processing for hospice organization, managing incoming calls, filing clinical notes, maintaining administrative and clerical files; and ensuring postage is purchased and kept on hand. Assist BOM in ensuring all Doctors order forms and related forms are completed and signed in compliance with Medicare and Medicaid regulations, place forms and applicable documents into patient files.
Accounts Receivable Specialist SMA Solar Technology America LLCAccounts Receivable SpecialistRocklin, CA$72,000–$79,000 / yearCollaborate with multiple departments to manage accounts receivable, including milestone accounts, to ensure timely payments from customers through account statements, reconciliations, reminders, demand letters, and payment plans as needed. We may also obtain your personal information from third parties, including but not limited to your former employers, background or employment check service providers or third-party recruiters; and, (b) SMA may use or process applicants' personal information for relevant purposes including but not limited to general communications with you, identity verification, background or employment checks, determination of eligibility, and making hiring decisions.
NewHuman Resources Specialist - Sacramento, CA Compassion ServicesHuman Resources Specialist - Sacramento, CASacramento, CAThe ideal candidate is professional, discreet, and solutions-oriented, with experience supporting payroll operations, handling sensitive employee matters, and partnering effectively across departments. This position serves as a key operational partner within the HR team and acts as an initial point of contact for employee concerns, workplace incidents, workers’ compensation matters, and payroll-related inquiries.
Safety & Health Specialist Granite ConstructionSafety & Health SpecialistSacramento, CaliforniaThe employee is occasionally required to reach with hands and arms and must have the ability to work at height, in enclosed or confined spaces and climb stairs and ladders in a construction/plant environment. The position is responsible for supporting in the administration of the Company's Safety and Health Management System (SHMS) and the corresponding regulations that relate to the safety of our work, for an assigned location in a manner consistent with the code of conduct.
Collections Specialist Wollborg Michelson RecruitingCollections SpecialistSacramento, CACommunicates and interacts with members to resolve delinquent and negative accounts promptly, minimizing loss from non-performing assets while maintaining member relationships. Evaluate payments on delinquent accounts and determine appropriate application to principal, interest, escrow, and fees, including when payments must be returned.
EH&S Specialist HP HoodEH&S SpecialistSacramento, CaliforniaPromotes a positive safety culture by developing and creating documents in Microsoft word, excel, power point to support positive employee communications & data delivery such as posters, mailings, and news regarding safety. Our portfolio of national and super-regional brands and licensed products includes Hood, Heluva Good, Lactaid, Blue Diamond Almond Breeze, Planet Oat and more.
Operations Specialist, Experienced Blue Cross and Blue Shield AssociationOperations Specialist, ExperiencedEl Dorado Hills, CAAct as subject matter expert and review operational workflows, identifying problems and develop improvements, modifications, and enhancements; identify technical formulary issues that would prevent or delay CMS approval of BSC formularies; notify appropriate managers of Medicare formulary issue requiring immediate attention for resolution; determine appropriate workflow required for maintaining formulary decisions. The Operations Specialist, Experienced will collaborate with the pharmacy claim adjudicator, analytics, benefits and claims, Pharmacy Market Experience, Compliance, prior authorization, and customer services departments to communicate formulary and utilization management changes, formulary intent, and to ensure that formulary decisions are implemented in accordance with business rules and regulatory requirements.