Implementation Auditor (50487) Western GrowersImplementation Auditor (50487)Irvine, CAUsing close and comprehensive analyses, verify new and existing plans loaded on the Company's claim management system against the appropriate Summary Plan Description to determine the accuracy of present and future claims payments. This position will ensure that all new and existing health (medical/dental) insurance plans underwritten by the Western Growers Assurance Trust (WGAT) and those of Pinnacle, Inc. (PCMI) are in compliance with the respective employers' summary plan descriptions.
Plan Coder (50456) Western GrowersPlan Coder (50456)Irvine, CAThis position will ensure that all new and existing health (medical/dental/pharmacy) insurance plans underwritten by Western Growers Assurance Trust (WGAT) and those of Pinnacle Claims Management, Inc. (PCMI) are in compliance with the respective employers' summary plan descriptions. Maintain a HIPAA-compliant workstation and utilize appropriate security techniques to ensure HIPAA-required protection of all confidential/protected client data.
Financial Specialist II (50520) Western GrowersFinancial Specialist II (50520)Irvine, CAReconcile and maintain accuracy of group ledger accounts by matching incoming payments to corresponding invoices, promptly investigating and resolving discrepancies, collaborating with internal teams and external partners to make adjustments, and maintaining thorough documentation to support audit trails. Knowledge of generally accepted Health Care Eligibility and Billing procedures as well as Health Insurance Portability and Accountability Act (HIPAA), Consolidated Omnibus Budget Reconciliation Act (COBRA), Cal-COBRA, Multiple Employer Welfare Arrangement (MEWA) and Employee Retirement Income Security Act (ERISA) regulations.
Insurance Specialist (Remote) - Mountain and Pacific Time Zones MeduitInsurance Specialist (Remote) - Mountain and Pacific Time ZonesCaliforniaRemoteboth in-person and by telephone to register patients, gather or update information, obtain referrals and pre-authorizations, complete appropriate forms, conduct evaluations, determine benefits and eligibility (insurance, public programs, etc.), determine financial responsibility and/or to identify sources of payment for servicesâ¯. You will utilize your expertise in patient billing, claims submission, and payer guidelines (Medicare, Medicaid, &, commercial insurers) to effectively work with insurance companies, resolve issues, and ensure accurate and timely payments.
Senior Underwriter, Commercial Insurance Specialty Chubb LtdSenior Underwriter, Commercial Insurance SpecialtyIrvine, CA$100,000–$165,000 / yearStrong sales and marketing skills are critical; must be able to demonstrate successful agency and broker management, including building, maintaining and managing producer and customer relationships. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.
NewMedical Biller Premier Health GroupMedical BillerIrvine, CAYou will work closely with patients, insurance companies, and internal teams to resolve discrepancies and ensure timely payment of services. Collaborate with patients or customers, third-party institutions, and other team members to identify and resolve billing inconsistencies and errors.
Associate Therapist / Psychology Associate SIMPLE SOLUTIONS PSYCHOTHERAPYAssociate Therapist / Psychology AssociateRancho Cucamonga, CAFull timeGain a thorough understanding of the business goals and objectives of the organization, including Gain the organization’s Group Practice, Treatment Focus and Patient Promise. • Write evaluations of parents and children for use by courts deciding divorce and custody cases, testifying in court if necessary.
Account Manager II, Commercial Lines Hub International LtdAccount Manager II, Commercial LinesIrvine, CATHE 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 in the insurance industry. The expected salary range for this position is $100,000 - $115,000k depending on geographical location and will be impacted by factors such as the successful candidate's skills, experience and working location, as well as the specific position's business line, scope and level.
Corporate Director, Safety & Security Montage Hotels & Resorts LLCCorporate Director, Safety & SecurityIrvine, CAThis role includes operational management and oversight of issues involving injury prevention, risk and liability assessments, safety and security operations, incident investigations, claims management, event protection, site/building security monitoring, and access control. The CDSS acts as a resource for the properties, to assist and support, to provide information on a wide variety of subjects ranging from workplace safety, guest safety, incident prevention, asset protection, physical security, training, global intelligence, international matters, safety and security compliance.
Brand Manager, Toxins Galderma Group AGBrand Manager, ToxinsOrange County, CA$125,000–$160,000 / yearWe deliver an innovative, science-based portfolio of premium flagship brands and services that span the full spectrum of the fast-growing dermatology market through Injectable Aesthetics, Dermatological Skincare and Therapeutic Dermatology. Where pay falls withing the range may vary based on many factors, including, but not limited to, job responsibilities, skills, experience, education, certifications, location and applicable geographic pay zones, market conditions, internal equity and business considerations.
Brand Manager, Fillers Galderma Group AGBrand Manager, FillersOrange County, CA$125,000–$160,000 / yearWe deliver an innovative, science-based portfolio of premium flagship brands and services that span the full spectrum of the fast-growing dermatology market through Injectable Aesthetics, Dermatological Skincare and Therapeutic Dermatology. Where pay falls withing the range may vary based on many factors, including, but not limited to, job responsibilities, skills, experience, education, certifications, location and applicable geographic pay zones, market conditions, internal equity and business considerations.
Client Service Representative VenbrookClient Service RepresentativeIrvine, CaliforniaRisk Specialties & Services: Advisory, risk management, insurance brokers, accident & health insurance, property & casualty insurance, employee benefits, surety & title insurance, wholesale insurance, specialty programs, reinsurance, independent field adjusting, catastrophe services, and third-party claims administration. This role resolves routine issues, escalates complex matters following defined guidelines, and supports a consistent member experience while reducing service interruptions for Client Management teams.
Contact Representative (Benefits Coordinator) US Department of Health and Human ServicesContact Representative (Benefits Coordinator)Hemet, CA$45,409–$72,644 / yearGS-08: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: interpreting and applying federal, state, Tribal, and third-party program regulations to determine eligibility and ensure compliance for programs such as Purchase Referred Care, Medicare, Medicaid, Affordable Care Act, Veterans Affairs Healthcare, and other alternate resources; conducting in-depth patient interviews to assess eligibility, verify coverage, and complete applications; registering eligible patients in various assistance programs; resolving claim denials and eligibility issues through coordination with patients, healthcare providers, and outside agencies; reviewing Medicaid eligibility information and supporting billing requirements; and utilizing effective oral and written communication to explain program requirements, provide referrals, and resolve complex patient service issues. MINIMUM QUALIFICATIONS: GS-06: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: determining patient eligibility for alternate resources programs; interpreting and applying Medicare, Medicaid, VA, and other third-party payer policies and procedures; conducting patient interviews to identify available healthcare coverage and funding sources; assisting patients with enrollment and claims processes; researching and resolving eligibility, denial, and reimbursement issues; maintaining effective working relationships with patients and resource agencies; and safeguarding confidential patient information in accordance with Privacy Act and HIPAA requirements.
Deduction Analyst Bradshaw Home IncDeduction AnalystFontana, CA$24.50–$25.50 / hourThe Deduction Analyst I maintains detailed claim records, updates the Deduction Management System, prepares weekly findings for management, and provides monthly summaries and trend analysis to help reduce recurring chargebacks and improve process accuracy. This role partners closely with Customer Service, Operations, Accounting, and other internal departments to gather supporting documentation, validate claims, identify root causes, and support corrective actions.
New(USA) Freezer/Cooler/Deli Sam's West(USA) Freezer/Cooler/DeliCorona, CaliforniaJoin our freezer, cooler, and deli team and you won’t just keep shelves stocked, you’ll play an important role in the operations and sanitary conditions of our freezers and coolers that keep our product ready for our members. 1375 E ONTARIO AVE, CORONA, CA 92881-6604, United States of America Walmart and its subsidiaries are committed to maintaining a drug-free workplace and has a no tolerance policy regarding the use of illegal drugs and alcohol on the job.
NewData Governance Analyst Alignment Healthcare USA, LLCData Governance AnalystOrange, CAFull timeWorking alongside governance operations leaders, business data stewards, and technology teams, this role provides the analytical depth and hands-on execution that keeps governance processes running reliably and data assets well-documented. Analytical Reporting & Communication: Ability to synthesize data findings into clear governance status reports, quality dashboards, and issue summaries for both technical and business audiences; proficiency with Excel or BI tools (Power BI, Tableau).
ESIS ProClaim Manager Chubb LtdESIS ProClaim ManagerIrvine, CA$86,000–$136,400 / yearThe company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. With more than 70 years of experience, and offerings in both the U.S. and globally, ESIS provides one of the industry's broadest selections of risk management solutions covering both pre- and post-loss services.
Transportation Network Representative Inland Empire Health PlanTransportation Network RepresentativeRancho Cucamonga, CAThe role also involves conducting member and provider outreach, preparing accounts payable evidence packages, maintaining thorough documentation, and supporting Voice of Member initiatives to enhance the overall experience. Success in this position requires strong organizational skills, attention to detail, and the ability to build effective relationships with providers and facilities to uphold compliance and deliver exceptional member care.
Human Resources/Risk Management Analyst City of Rialto CAHuman Resources/Risk Management AnalystRialto, CA$5–$9 / hourParticipate in the coordination of a variety of benefits programs and services, including medical, dental, vision, life, voluntary insurance plans, disability, leaves, and retirement plans offered through a variety of carriers, providers and third-party administrators; prepare and reconcile billing to various benefits vendors; evaluate program effectiveness and recommend changes; revise and edit benefits plan documents to incorporate legislative changes to ensure compliance with relevant codes and regulations. Plan, develop, coordinate, and facilitate citywide training programs; conduct needs assessments to identify citywide and department-specific training needs; design and prepare a variety of course curriculum and materials; conduct formal training sessions and act as course instructor; design, prepare and conduct course evaluation rating instruments; assess training effectiveness and modify training programs as needed.
Marketing Manager, Upstream Edwards LifesciencesMarketing Manager, UpstreamIrvine, California$121,000–$171,000 / yearPosition Summary : The Upstream Marketing Manager, will serve as a strategic marketing leader within the TMTT Upstream Marketing organization, responsible for driving global upstream marketing activities for the PASCAL Transcatheter Edge-to-Edge Repair (TEER) portfolio and future-generation TEER technologies. Possess strong clinical knowledge, experience and knowledge of the clinical areas where Edwards' products are used or intended to be used, understand the purchasing process and challenges for product adoption in complex healthcare networks.