NewFraud Detection Analyst, Senior Blue Cross and Blue Shield AssociationFraud Detection Analyst, SeniorWoodland Hills, CAIn this role, you will partner closely with auditors, compliance partners, business leaders, data analytics teams, legal, human resources, finance, claims, procurement, and technology stakeholders to identify fraud risk scenarios, evaluate control design and operating effectiveness, advise on anti-fraud control enhancements, and develop practical detection strategies that protect the company, members, providers, employees, and other stakeholders. The Internal Audit Fraud Advisor will serve as a fraud subject matter expert supporting internal audits, proactive fraud detection activities, and business advisory efforts focused on preventing, identifying, and remediating fraud risk across the enterprise.
Team Lead - Healthcare - Hospital PFS GuidehouseTeam Lead - Healthcare - Hospital PFSEl Segundo, CA$59,000–$98,000 / yearCompensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. The Team Lead will and may work closely with their team, project supervisors, operations managers, and the client to work on opportunities with new and emerging approaches to our clients' business processes.
Clinical Informatics Specialist 4 University of CaliforniaClinical Informatics Specialist 4Los Angeles, CA$110,977.20–$246,216.96 / yearResponsibilities include managing and analyzing large datasets, developing analytic files for observational research studies, supporting advanced statistical analyses, and collaborating closely with multidisciplinary teams of clinicians, epidemiologists, biostatisticians, and researchers to generate evidence that shapes healthcare policy, regulatory decisions, and clinical practice. The ideal candidate will bring strong analytical and programming skills, experience working with complex healthcare datasets, and a passion for leveraging real-world data to improve patient care and inform healthcare decision-making.
Business Office Coordinator CompassusBusiness Office CoordinatorPomona, CA$15–$33.88 / hourThe Business Office Coordinator is accountable for the planning, coordination, and management of the business office as well as related operational activities of the program in accordance with hospice policy and procedure, including but not limited to, billing for reimbursement, payroll, and administrative quality improvement. Aligns clinical team with appropriate training, such as Homecare Homebase, the Online Learning Hub (Modules) on Promise Point, or the Homework's Manuals on iConnect for Cerner.
AVP, Underwriter, Environmental Sompo International Holdings LimitedAVP, Underwriter, EnvironmentalIrvine, CA$140,000–$185,000 / yearYou will build and manage partnerships with agents, brokers, and other distribution partners, leveraging strategic thinking to develop and maintain a strong pipeline of opportunities that supports profitable growth in Sompo's Environmental business. As we continue to grow, we strive to find diverse, innovative and driven professionals to join our teams and offer a broad range of career and development opportunities at all levels, in multiple business areas, in each of our locations throughout the world.
Healthcare Billing Coordinator ApolisHealthcare Billing CoordinatorAlhambra, CA$18–$20 / hourSupport research billing activities, including invoicing non-industry trial claims, creating accounts for billable insurance charges, and tracking denials returned from CTU. • Perform additional ad hoc administrative and vendor coordination tasks, including submission of documentation (upload, email, fax, or mail to payers).
AEM Insurance Infosys LtdAEM InsuranceNewport Beach, CA$10–$30 / hourWe deliver measurable outcomes-higher straight‑through processing (STP), faster claims cycles, lower cost‑to‑serve, and improved NPS-through digital self‑service, intelligent underwriting, and streamlined back‑office operations. 149019BRCaliforniaUSAInfosys Limited Associate Engagement ManagerITL USA Newport Beach, CA, San Diego, CAInsuranceDomain|Sales|Sales Execution Associate Client Partner, Insurance100000187000.
Collector I TalentBurst, Inc.Collector ICosta Mesa, CA$1,000 / weekKnowledge of HMO, POS, PPO, EPO, IPA, Medicare Advantage, Covered California (Exchange), capitation, commercial and government payors (i.e. Medicare, Medi-Cal, TriCare, etc.) and how these payors process claims. Interprets Explanation of Benefits (EOBs) and Electronic Admittance Advices (ERAs) to ensure proper payment as well as assist and educate patients and colleagues with understanding of benefit plans.
Benefits Specialist Kia CorpBenefits SpecialistIrvine, CA$69,964–$91,147 / yearJob Demands: May include reading (documents), detailed work, confidentiality, problem solving, language, reasoning skills, oral communication, written communication, customer contact, ability to effectively present information in one-on-one and small group situations to customers, vendors, and other employees, multiple concurrent tasks, ability to work with frequent interruptions, etc. Respond to benefits inquiries from managers and employees on plan provisions, benefits enrollments, status changes and other general inquiries within compliance requirements to include required documentation.
Janitor Allied UniversalJanitorOrange, CAAllied Universal SkillBridge Program Allied Universal® partners with the U.S. Department of Defense (DoD) SkillBridge Program to support transitioning service members with up to 180 days of on-the-job training during their final months of active duty, while they continue to receive full DoD pay and benefits. Dog Detection Spotlight - Kyle and Maverick As part of Allied Universal Enhanced Protection Services fleet of detection canine teams, Kyle and Maverick are trained and certified to screen cargo under the U.S. Transportation Security Administrations (TSA) Third-Party Canine (3PK9) Program.
Janitorial Supervisor Allied UniversalJanitorial SupervisorHawthorne, CAAllied Universal SkillBridge Program Allied Universal® partners with the U.S. Department of Defense (DoD) SkillBridge Program to support transitioning service members with up to 180 days of on-the-job training during their final months of active duty, while they continue to receive full DoD pay and benefits. Dog Detection Spotlight - Kyle and Maverick As part of Allied Universal Enhanced Protection Services fleet of detection canine teams, Kyle and Maverick are trained and certified to screen cargo under the U.S. Transportation Security Administrations (TSA) Third-Party Canine (3PK9) Program.
Commercial Lines Account Manager Alera GroupCommercial Lines Account ManagerPlacentia, CaliforniaThis role will focus on commercial risk management with mid-market accounts and collaborate with Producers and Account Managers to provide exceptional client service. Provide technical support to Producers by reviewing quotations and proposals, identifying client exposures, and recommending appropriate coverage solutions.
Director, Program Manager CNA Financial CorpDirector, Program ManagerCA$97,000–$189,000 / yearThe position is accountable for program profitability, growth, and overall business performance, partnering closely with Program Administrators to define and execute strategies that drive sustainable, profitable growth. This position serves as a key liaison across underwriting, product, actuarial, and claims to ensure strong program execution, operational effectiveness, and alignment with CNA's broader business objectives.
Western Growers Family Of Companies Careers - Ccsb Call Center Representative I Western Growers AssociationWestern Growers Family Of Companies Careers - Ccsb Call Center Representative IIrvine, CARemote$38,625.60–$48,750 / 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. This position provides consultative telephonic and web-based assistance to Agents, Certified Enrollment Counselors, Qualified Health Plans (QHP), federal and state agencies and other stakeholders in Health Benefit Exchange administration.
People Specialist - Leave Specialist Talent Software Services, Inc.People Specialist - Leave SpecialistCovina, CARemote$1,176–$1,212 / weekWorking closely with other Leave Specialists and the third-party administrator for leave administration, this role will be part of the team dedicated to managing and administering all aspects of employee leave programs such as FMLA, parental, medical, and personal leaves and workers compensation while providing a high level of support and empathy to employees navigating life events. Work collaboratively with Leave staff, and serve as the backup program manager and SME for leave programs such as FMLA, parental leave, other types of paid/unpaid time off, and workers compensation.
Client Performance Manager | Dedicated Client | Workers Compensation, General Liability, & Litigation Experience Sedgwick Claims Management Services, Inc.Client Performance Manager | Dedicated Client | Workers Compensation, General Liability, & Litigation ExperienceCARemote$80,000–$85,000 / yearTo be responsible for the quality aspects (for workers compensation and general liability) of a specific client including client service instructions and training; litigation management initiatives, to resolve client issues by working with the company Quality and 0perations staff. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
Territory Manager TrueBlue IncTerritory ManagerCosta Mesa, CA$62,673–$75,207 / yearBacked by over 35 years of experience, PeopleReady's workforce solutions have been carefully crafted to service businesses and workers across a wide range of industries, including construction, manufacturing and logistics, retail, and hospitality. Associate Support: Promote a Safe Workplace by conducting on-site safety visits, performing associate check-ins, and ensure personal protective equipment (PPE) is accessible to associates.
Solutions Architect One Inc Software CorpSolutions ArchitectCARemoteOverview: As a Solutions Architect on the Delivery team, you will play a crucial role in guiding our clients to implement our products in a way that meet the clients business needs and that align to the product's best practices. You will collaborate closely with project managers, software implementation consultants, developers, product managers, and other stakeholders to ensure successful project delivery and customer satisfaction.
Community Manager FirstService CorpCommunity ManagerIrvine, CA$75,000–$78,000 / yearRequesting Information About the AEDT - NYC Local Law 144: Candidates who reside in New York City and are subject to NYC Local Law 144 may request information about the AEDT, including details on the type of data collected, the sources of such data, and our data retention policies. Effectively use company tools and resources, including ACM, Community Design Review Specialist, Call Center, and Accounting Staff in accomplishing daily tasks in an efficient, and respectful manner.
Avp, Environmental Sompo InternationalAvp, EnvironmentalIrvine, CA$140,000–$185,000 / yearYou will build and manage partnerships with agents, brokers, and other distribution partners, leveraging strategic thinking to develop and maintain a strong pipeline of opportunities that supports profitable growth in Sompo's Environmental business. Salary Range: $140,000.00 - 185,000.00 Actual compensation for this role will depend on several factors including the cost of living associated with your work location, your qualifications, skills, competencies, and relevant experience.