Senior Configuration Specialist QNXT - SCAN Temp SCAN Health PlanSenior Configuration Specialist QNXT - SCAN TempLong Beach, California$34.47–$49.87 / hourHowever, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. Function as a Subject Matter Expert (SME) on system capabilities, including but not limited to benefits administration, code sets, fee schedules, coding, provider contracts, workflows, authorizations, billing, enrollment, and other business processing areas.
Program Support Representative I Cencora, Inc.Program Support Representative IOrange, CA$21–$25 / hourSummary of Role: Under general supervision of the Elevate Provider Network Management Team, this associate will perform duties and tasks related to the daily operations of the Network and provide support to the managed care/pharmacy services department including primary telephone coverage, management of network database, and creation and distribution of network materials and communications. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave.
Healthcare Data Analyst Astiva Health, Inc.Healthcare Data AnalystOrange, CA$85,000–$115,000 / yearSUMMARY: The Healthcare Data Analyst is responsible for analyzing healthcare data to support clinical, operational, and financial decision-making within Medicare Advantage programs. Analyze medical and pharmacy claims, membership, supplement, lab, risk adjustment, and encounter data to support Medicare Advantage quality, risk, and operational programs.
NewCustomer Service Representative - Tier 1 Windsor IncCustomer Service Representative - Tier 1Santa Fe Springs, CAEssential Job Functions: Provide amazing (above and beyond) service across multiple channels simultaneously, including but not limited to phone calls, live chats, emails and text messages, while maintaining a high volume level of accuracy, professionalism and customer service. Responsibilities also include, but are not limited to, processing customer returns, issuing refunds, handling claims, creating package replacements, supporting store associates, guiding customers through their shopping experience, troubleshooting technical issues, and triaging issues with other departments.
Senior Guidewire ClaimCenter Developer (Cloud & Integrations) Iconma LLCSenior Guidewire ClaimCenter Developer (Cloud & Integrations)CAThis role works closely with business stakeholders, architects, analysts, QA teams, and integration teams to translate claims-processing requirements into scalable, secure, and reliable technology solutions. Design and implement integrations between ClaimCenter and internal or third-party systems using REST APIs, SOAP services, messaging, plugins, and batch processes.
Auto Physical Damage Appraiser - Field AAAAuto Physical Damage Appraiser - FieldBurbank, CaliforniaThe primary functions include analyzing and evaluating vehicle damage to assist in writing estimates, reviewing estimates, validating compliance and determining repair costs. With our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.
Healthcare Revenue Cycle Billing Specialist II (SNF) Wipfli LLPHealthcare Revenue Cycle Billing Specialist II (SNF)Irvine, CARemote$23–$30 / hourAs a Specialist II in Wipfli's Healthcare Consulting Practice, you'll work independently with a variety of healthcare clients, skilled nursing facilities, independent living, and assited living, delivering services such as financial and operational analysis, regulatory readiness, and strategic support. Under the direction of a Senior Consultant, the Specialist II provides business services independently for the firm''s more complex clients, ensuring delivery is timely, accurate and serves the client''s needs in accordance with company policies and procedures.
SIU Investigator - Fast Team Kemper CorpSIU Investigator - Fast TeamGlendale, CAWe 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 Special Investigator 1 will complete field and desk assignments that support insurance claims referred to and accepted for investigation by the Special Investigative Unit.
Director of Operations SHPCA SCAN Health PlanDirector of OperationsLong Beach, California$147,900–$214,030 / yearHowever, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models.
Director of Operations SCAN Health PlanDirector of OperationsLong Beach, CaliforniaHowever, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models.
Senior Analyst, Medical Economics - REMOTE Molina Healthcare IncSenior Analyst, Medical Economics - REMOTELong Beach, CARemoteDemonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms. Provides support and ownership for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities and improve financial performance.
Environmental Heath & Safety Leader - Food Manufacturing SyscoEnvironmental Heath & Safety Leader - Food ManufacturingIrvine, CAThe role aims to accomplish the following: Supporting their sites in executing on various EHS processes including: EHS-related training, environmental compliance, occupational health and safety, workers’ compensation, transportation safety, contractor management, and business continuity. Support the workers’ compensation claims process by completing OSHA determinations, identifying gaps in claims management, and promoting safe and early return to work as well as any other requirements related to general liability, motor vehicle, and property damage claims.
Auto Major Case Specialist The Travelers Companies IncAuto Major Case SpecialistDiamond Bar, CA$99,100–$163,400 / yearAs a Major Case Specialist, you are responsible for investigating, evaluating, reserving, negotiating, and resolving complex, serious and severe claims typically with full damage value for average claim $500,000 to over a multi-million dollar value. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
Healthcare Data Analyst Astiva HealthHealthcare Data AnalystOrange, CA$85,000–$115,000 / yearSUMMARY: The Healthcare Data Analyst is responsible for analyzing healthcare data to support clinical, operational, and financial decision-making within Medicare Advantage programs. Analyze medical and pharmacy claims, membership, supplement, lab, risk adjustment, and encounter data to support Medicare Advantage quality, risk, and operational programs.
Trust and Estate Coordinator (Wealth Coordinator) Golden Oaks Law Group, LLPTrust and Estate Coordinator (Wealth Coordinator)Upland, CADebt, Liability, and Creditor Management: Serve as the primary point of contact for all estate creditors; identify outstanding liabilities and negotiate settlements on the client's behalf to ensure the systematic payment of final debts and administration expenses . Your primary duties will involve drafting financial-related documents, working directly with clients to develop trust funding and settlement plans, preparing financial institution claim forms, and facilitating funding and settlement processes.
Mitigation Estimator Water Mold & Fire Restoration ServproMitigation Estimator Water Mold & Fire RestorationRiverside, CaliforniaWe’re seeking self-motivated, proactive, responsible, and service-oriented teammates to join us in our mission of helping customers in their greatest moments of need by repairing and restoring homes and businesses with an industry-leading level of service. This role is responsible for inspecting losses, developing accurate mitigation estimates, and working closely with operations teams, adjusters, and clients to ensure timely approvals and execution.
Case Manager Elite SourcingCase ManagerNewport Beach, CaliforniaWe are working with a Personal Injury Law Firm in Newport Beach that is seeking a resourceful and hardworking Case Manager looking for long-term stability and career growth. Review case files, evidence, and legal documents to determine settlement value.
(USA) Freezer/Cooler/Deli Walmart Inc(USA) Freezer/Cooler/DeliCorona, CA$19–$27 / hourMaintains the Sales Floor and merchandise presentation in the FreezerCoolerDeli area in accordance with Company policies and procedures by properly handling claims and returns zoning the area receiving and stocking merchandise setting up cleaning and organizing product displays removing damaged goods signing and pricing merchandise appropriately completing required audits paperwork logs and other required documentation and securing fragile and highshrink merchandise. Follows Company policies and procedures related to FreezerCooler area by complying with food handling policies operating repairing and sanitizing equipment following Cold Chain procedures when stocking merchandise cleaning freezer coolerdeli area for example windows mirrors display cases and coolers monitoring freezercooler fans drains and doors for proper operation and reporting issues to Management.
Customer Service Representative - State Farm Agent Team Member Jeff Noviello - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberTustin, CAFull timeAs a Customer Service Representative - State Farm Agent Team Member with Jeff Noviello - State Farm Agent, you will generate the kind of exceptional customer experiences that reinforce the growth of a successful insurance agency. You will enhance your career while resolving customer inquiries, coordinating with other agency team members, and anticipating the needs of the community members you support.
Customer Service Representative - State Farm Agent Team Member Maria Galli - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberWhittier, CAFull timeAs a Customer Service Representative - State Farm Agent Team Member with Maria Galli - State Farm Agent, you will generate the kind of exceptional client experiences that reinforce the growth of a successful insurance agency. You will enhance your career while resolving customer inquiries, coordinating with other agency team members, and anticipating the needs of the community members you support.