Manager, Claims Operations San Francisco Health PlanManager, Claims OperationsSan Francisco, CA$140,000–$150,000 / yearSFHP is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 175,000+ members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services. Established in 1997, San Francisco Health Plan (SFHP) is an award-winning, managed care health plan whose mission is to provide affordable health care coverage to the underserved low and moderate-income residents in San Francisco County.
Customer Operations Claims Analyst Kinder'sCustomer Operations Claims AnalystWalnut Creek, CaliforniaMost of our work happens in the office to spark creativity and community, but we also offer flexibility so team members have the autonomy to work outside the office when needed to support their work-life balance and personal commitments. This person will act as both a detective and a problem-solver — validating customer complaints or charges, identifying the true root causes, and pushing toward resolution either through claim recovery or internal process improvement.
MSO Claims Manager North East Medical ServiceMSO Claims ManagerBurlingame, CAThis role provides guidance on healthcare claims adjudication and payment processing for Medi-Cal, Medicare, PACE, and other lines of business based on member Evidence of Coverages (EOC) and CMS/DHCS guidelines, ensures that claims are processed accurately, timely, and in compliance with regulatory requirements and contractual obligations. Responsibilities include interviewing and hiring of employees; planning, assigning, scheduling, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
Fremont Michigan Claim Support Assistant I AAA Southern New EnglandFremont Michigan Claim Support Assistant IFremont, 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. Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals.
Michigan APD Claim Representative II - Fremont AAA Southern New EnglandMichigan APD Claim Representative II - FremontFremont, 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. Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals.
Complex Claim Director - Mass Tort Unit CNA Financial Corp.Complex Claim Director - Mass Tort UnitWalnut Creek, CA$97,000–$189,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Leads the work activities of medium to high severity specialized Claims Professionals, has full management responsibility for setting and communicating expectations, providing direction and situational coaching, and facilitating ongoing training. Leads a team of Claims Consultants and Consulting Directors that are responsible for the handling of complex, high exposure mass tort and environmental claims, including social media addiction, PFAS, talc, sexual molestation, and other long tail general liability and pollution related matters.
Claim Specialist - Property Field Inspection State FarmClaim Specialist - Property Field InspectionConcord, California$78,862.06–$118,245 / yearFull timeCompetitive candidates should reside within one of the listed zip codes and will service this same territory: 94505, 94506, 94509, 94513, 94517, 94518, 94519, 94520, 94521, 94523, 94525, 94526, 94531, 94553, 94561, 94565, 94595, 94596, 94597, 94598. With the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you!
NewEPL & D&O Liability Claim Counsel The Travelers CompaniesEPL & D&O Liability Claim CounselWalnut Creek, CA$111,600–$184,200 / yearTravelers' Private/Non-Profit Team provides executive and organizational management liability coverage to privately held companies and non-profit entities of all types and sizes as well as certain governmental public entities. Prepare and present reports for management that accurately reflect loss development, potential/actual financial exposure, reserve adjustments, coverage issues, and claim and recovery strategies.
NLP Scientist Claim Accuracy and Compliance - ROCGJP00042840 Triune InfomaticsNLP Scientist Claim Accuracy and Compliance - ROCGJP00042840South San Francisco, CAGiven a statement and a corpus of approved claims, product labeling, clinical study results and references, the system retrieves the relevant evidence, decomposes compound statements into checkable assertions, tests whether the evidence supports each one, and returns a decision with citations a reviewer can follow. Must Have: Evidence-Grounded NLP, Hybrid Retrieval & RAG, NLI/Entailment & Claim Verification, Claim Decomposition & Evidence Attribution, Evaluation & Human-in-the-Loop, Python & NLP Frameworks.
NewStrategy & Operations RaydarStrategy & OperationsSan Francisco, CAThe business reached multi-seven-figure annual recurring revenue in under a year, has grown roughly 50% month over month, and recently raised a $50M Series A from leading venture investors. You will work directly with the CEO, turn ambiguous problems into structured operating systems, and help build the processes that allow insurance claims to be handled efficiently at scale.
NewStaff Product Manager, Insurance HOVER IncStaff Product Manager, InsuranceSan Francisco, CARemote$186,000–$260,000 / yearHover has Hubs in San Francisco and New York City, where we expect that all employees living within a 50-mile radius of our offices will come into their local Hover office at least three times a week to build rapport and foster organic connection. Backed by leading investors like Google Ventures and Menlo Ventures, and trusted by industry leaders including Travelers, State Farm, and Nationwide - we're redefining how people understand and interact with their spaces.
Senior Engineering Manager, Estimation HOVER IncSenior Engineering Manager, EstimationSan Francisco, CARemote$227,000–$280,000 / yearHover has Hubs in San Francisco and New York City, where we expect that all employees living within a 50-mile radius of our offices will come into their local Hover office at least three times a week to build rapport and foster organic connection. Backed by leading investors like Google Ventures and Menlo Ventures, and trusted by industry leaders including Travelers, State Farm, and Nationwide - we're redefining how people understand and interact with their spaces.
Corporate Paralegal Backblaze IncCorporate ParalegalCARemote$130,000–$159,000 / yearFamiliarity with public-company filing tools and processes (for example, EDGAR, XBRL, and Section 16 filing agents), board portals (for example, Diligent or Boardvantage), and entity management software. Coordinate filing logistics with internal stakeholders, outside counsel, auditors, investor relations, and financial printers or filing agents, including EDGAR submission support, exhibit management, and filing-package assembly.
NewStrategy & Operations Our clientStrategy & OperationsSan Francisco, CaliforniaThe business reached multi-seven-figure annual recurring revenue in under a year, has grown roughly 50% month over month, and recently raised a $50M Series A from leading venture investors. You will work directly with the CEO, turn ambiguous problems into structured operating systems, and help build the processes that allow insurance claims to be handled efficiently at scale.
COLL REPR SR UCSF Medical CenterCOLL REPR SRSan Francisco, CAThe Senior Collections Representative helps with Claim submission, Accounts receivable, working denial, Patient Billing Inquiries, Correspondence, Payment Allocation and Process Improvement to ensure compliant and through collections of professional fees performed in the Dental Center. Payment Allocation: Preparation and submission of PeopleSoft journals for payments routing to PBS centralized Lockbox, MyChart deposits, ACH, EFT, i835 and insurance credit card, adhering to the Cash Handling Procedure Policy.
Dental Office Receptionist All Care DentalDental Office ReceptionistFremont, California$22–$29Knowledgeable about dental insurance billing, insurance aging, patient aging reports, and can manage A/R for the office. Knowledge of centric ascend is a big plus and inputting patient data on computer is necessary.
Customer Service Specialist - Healthcare Billing, Revenue Cycle Management, Amazon One Medical Amazon.com IncCustomer Service Specialist - Healthcare Billing, Revenue Cycle Management, Amazon One MedicalCAHandle patient phone calls and message inquiries, de-escalate issues, ensure patient satisfaction, and assist with navigating healthcare needs including insurance, billing, medical records, authorizations, and referrals, using impeccable C-I-CARE (a framework containing the key elements of a great interaction and effective communication that we use with patients and each other) in all interactions to ensure a positive experience. Proactively reach out to patients with open balances to assist with payment options, educate admins and patients on health insurance benefits, answer complex billing inquiries, resolve payment processing issues, support One Medical's efforts to empower patients in resolving financial responsibilities, and maintain service level agreements in response time to admins and patients.
Surveillance Investigator - Peninsula Allied UniversalSurveillance Investigator - PeninsulaRedwood City, California$20–$24 / hourThe Surveillance Investigator will perform discreet mobile and stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an insurance claim. Conduct independent investigations of insurance claims across a range of coverage types, including workers’ compensation, general liability, property and casualty, and disability .
Surveillance Investigator - San Francisco Allied UniversalSurveillance Investigator - San FranciscoSan Francisco, California$20–$24 / hourThe Surveillance Investigator will perform discreet mobile and stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an insurance claim. Conduct independent investigations of insurance claims across a range of coverage types, including workers’ compensation, general liability, property and casualty, and disability .
Sr. Assurance Manager, SCS Standards & Assurance Systems SCS Global ServicesSr. Assurance Manager, SCS Standards & Assurance SystemsEmeryville, CA$76,000–$100,000 / yearIn addition, the Senior Assurance Manager serves as a senior advisor to clients, providing technical advisory services related to assurance system design, certification readiness, claims governance, chain of custody implementation, and responsible sourcing programs. The role is also responsible for monitoring emerging legislation, regulatory developments, and market expectations related to sustainability claims, environmental marketing, responsible sourcing, and certification systems to ensure SAS programs remain credible, compliant, and future-ready.