Commercialization Professional - Contracts Jacobs Solutions IncCommercialization Professional - ContractsLos Angeles, CA$98,900–$167,625 / yearBachelor's degree in Business Management, Supply Chain Management, Procurement, Finance, Economics, Commerce, Engineering, Operations Management, or a related field; or a Master's degree in Business Administration (MBA), Supply Chain Management, Finance, Economics, Operations Management, or a related discipline. At Jacobs, we're challenging today to reinvent tomorrow by solving the world's most critical problems for thriving cities, resilient environments, mission-critical outcomes, operational advancement, scientific discovery and cutting-edge manufacturing, turning abstract ideas into realities that transform the world for good.
Eligibility Specialist II (50925) Western GrowersEligibility Specialist II (50925)Irvine, CAIntermediate 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), California Continuation Benefits Replacement Act (Cal-COBRA) and Employee Retirement Income Security Act (ERISA) legislation. The Eligibility Specialist II requires the ability to process enrollment and billing functions, both automated and manual, with in the company's processing system necessary to maintain Western Growers Assurance Trust (WGAT) and Pinnacle Claims Management, Inc. (PCMI) accounts) as assigned including groups that submit Electronic Data Interchange (EDI) eligibility.
Group Set-Up Specialist (50519) Western GrowersGroup Set-Up Specialist (50519)Irvine, CAResponsible for set-up and rate structure of new groups, maintaining and updating existing groups/clients for Western Growers Assurance Trust (WGAT), and Pinnacle Claims Management Inc. (PCMI) using the Health Care Processing System (HCPS). Proven project management abilities -including time and task management, delegating assignments, and working collaboratively to meet deadlinesInternet access provided by a cable or fiber provider with 40 MB download and 10 MB upload speeds.
Supervisor I, Enrollment and Eligibility (51068) Western GrowersSupervisor I, Enrollment and Eligibility (51068)Irvine, CAThis includes, but is not limited to, eligibility, enrollment, reinsurance and participation audits, COBRA administration and maintenance, and ACA processing functions performed in the Administration Department for Pinnacle Claims Management Inc. and Western Growers Administration Trust customers. Knowledge of Health Insurance Portability and Accountability Act (HIPAA), Consolidated Omnibus Budget Reconciliation Act (COBRA), California-COBRA, Multiple Employer Welfare Arrangement (MEWA) and Employee Retirement Income Security Act (ERISA) regulations.
CCSB Eligibility Specialist I Western GrowersCCSB Eligibility Specialist ICA$35,288.33–$45,874.31 / yearKnowledge 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), California Continuation Benefits Replacement Act (Cal-COBRA) and Employee Retirement Income Security Act (ERISA) legislation. Assist in reviewing and processing all manual and/or Electronic Data Interchange (EDI) enrollment transactions (adds, changes, terminations) in the system of record as received from the client or internal sources in accordance with Participation Agreements, Employer Policy Statement, Eligibility Guidelines and/or Summary Plan Descriptions.
NewLearning and Development Specialist (51116) Western GrowersLearning and Development Specialist (51116)Irvine, CAThis role is responsible for designing, developing, and facilitating effective learning programs for Operations employees supporting Western Growers Health (WGH) and Pinnacle Claims Management (PCMI). Reporting to the Manager, Operations Training, the (L&D) Learning and Development Specialist provides leadership in the creation, coordination, and implementation of high-quality training solutions that enhance operational performance across the organization.
NewWorkers Compensation Case Manager (Applicant) The Dominguez Firm, LLP.Workers Compensation Case Manager (Applicant)Los Angeles, CAThe Dominguez Firm—one of California’s most successful and recognized personal injury law firms—is seeking an experienced Workers’ Compensation Case Manager to join our fast-paced team. In this role, you’ll play a key part in helping injured workers navigate the claims process, working closely with attorneys to ensure clients receive the care and benefits they deserve.
Marine Claims Analyst MCD Tokio Marine America Insurance CompanyMarine Claims Analyst MCDLos Angeles, CA$27–$36 / hourMarketing Statement: TM Claims Service (TMCS) is an independent global claims management firm established in 1987 to provide clients with a broad range of claims related services in the areas of transportation, product liability and overseas travel accident insurance. Essential Job Functions: Receive, review, and approve claims as submitted from claimant and/or distributor for payment, using their own discretion and judgment up to and including authorized settling authority.
Senior Claims Manager EPL - Remote Providence St. Joseph HealthSenior Claims Manager EPL - RemoteCARemoteTogether, 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. Candidate must possess strong communication and litigation management skills to collaborate with business partners and defense counsel to direct litigation activities and claim outcomes while considering the overall impact to the company and individual stakeholders.
Compliance Specialist - Medical Billing Advantage Healthcare ServicesCompliance Specialist - Medical BillingHuntington Beach, CAThis role serves as a key operational partner to Compliance, Pharmacy Operations, Revenue Cycle, and Credentialing teams to support licensing activities, billing compliance, audit readiness, reimbursement requirements, and ongoing regulatory compliance. The ideal candidate combines strong administrative discipline with knowledge of pharmacy operations, licensing regulations, healthcare reimbursement, medical billing, pharmacy claims processing, and regulatory documentation.
Call Center Representative I (California Only) Western GrowersCall Center Representative I (California Only)Irvine, CARemote$38,625.60–$50,874.31 / yearAt Pinnacle Claims Management, we are an innovative third-party administrator (TPA) that provides a full-suite of comprehensive and customized health benefits administration services for self-funded companies, including health management and wellness solutions, and pharmacy benefit management. The Call Center Representative I will play a crucial role in assisting clients over the phone and electronically, making a real difference in their experience with the Health Benefits Exchange (HBEX).
Litigation Paralegal Jacoby and MeyersLitigation ParalegalLos Angeles, CARemote$30–$38 / hourSpecializing in all types of accident claims, including automobile, motorcycle, bicycle, Uber/Lyft, or trucking accidents, slip and falls, dog bites, construction accidents and other wrongful conduct, the attorneys at Jacoby & Meyers have recovered over a billion dollars for their clients' personal injury and wrongful death claims caused by the negligence of a third party. Maintain and update case management software to ensure accurate case tracking, documentation, and workflow efficiency.
Managed Care Coordinator Integrated Resources, IncManaged Care CoordinatorOrange, CaliforniaFull timeWhile performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell. The candidate will proactively triage and make effective decisions to coordinate work performed by physician resources in order to maximize their efficiency in performing the function of the Physician Guide, while supporting other needs of the Clinical Services product line.
Risk Compliance Analyst (P1-6265696-1) Panda Restaurant Group IncRisk Compliance Analyst (P1-6265696-1)Rosemead, CA$72,500–$101,500 / yearThis position also serves as the centralized support person to assist the Senior Safety Manager in CO safety and hazardous-material compliance, and the position supports safety, Worker's Compensation, training, and regulatory compliance programs across store locations. With close to 2,800 locations globally, we continue our mission of delivering exceptional Asian dining experiences by building an organization where people are inspired to better their lives.
Temp-Workers' Compensation Claims Adjuster Argo Group International Holdings Ltd.Temp-Workers' Compensation Claims AdjusterLos Angeles, CA$37.66–$44.33 / hourBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area), Washington, D. C. Essential Responsibilities: Working under technical direction and within significant limits and authority, adjudicate workers' compensation claims of higher technical complexity, with a direct impact on departmental results.
Associate Attorney, Workers'''' Compensation The Hartford Insurance Group IncAssociate Attorney, Workers'''' CompensationBrea, CARemote$84,800–$127,200 / yearAbout The Hartford: For more than 200 years, The Hartford has helped protect customers through changing times with a focus on integrity and service-and has been recognized by Ethisphere as one of the World's Most Ethical Companies (multiple years). As an Associate Attorney in The Hartford's Workers' Compensation group, you will support the defense of California workers' compensation matters while developing the skills needed to independently manage cases over time.
Workers Compensation Claims Specialist, West CNAWorkers Compensation Claims Specialist, WestPlacentia, California$54,000–$103,000 / yearPartners with attorneys, account representatives, agents, underwriters, doctors, nurse case managers and insureds to develop a focused strategy for timely and cost effective resolution of more complex claims. In District of Columbia,California, Colorado, Connecticut, Illinois , Maryland, Massachusetts , New York and Washington, the national base pay range for this job level is $54,000 to $103,000 annually.
Workers Compensation Claims Specialist, Complex & Settlement Focus CNAWorkers Compensation Claims Specialist, Complex & Settlement FocusPlacentia, CaliforniaEssential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
Senior Claims Manager EPL - Remote Providence Health & ServicesSenior Claims Manager EPL - RemoteOrange, CARemoteRequsition ID: 442190 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: Remote 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.
Deputy General Counsel LOW INCOME INVESTMENT FUND, THEDeputy General CounselLos Angeles, CALIIF's headquarters is in San Francisco and has offices in Los Angeles, New York, Atlanta, and Washington D.C. REPORTING RELATIONSHIPS: This position reports to the Executive Vice President, Chief Administrative Officer & General Counsel and directly supervises legal department staff, including attorneys, paraprofessionals, and other assigned personnel, as applicable. Acts on behalf of the Executive Vice President, Chief Administrative Officer & General Counsel as delegated, including advising executive leadership, managing significant legal matters, directing legal operations, and representing the Legal function in executive and cross-functional decision-making.