Medicare Full-Risk Claims Specialist
Jobfu
Hill Physicians Medical Group in San Ramon, CA is seeking a Full Risk Claims Specialist to process Medicare Advantage claims across multiple lines. The role requires deep knowledge of MS DRG inpatient, ASC, home health care, DME, and related coding and pricing rules. You will adjudicate claims on Epic Tapestry, ensure accuracy, and respond to complex disputes while maintaining high productivity and compliance with CMS and DMHC guidelines. #J-18808-Ljbffr Jobfu
$28 - $32 per hour
Full Risk Claims Specialist - 26-13 San Ramon, CA, US USD 28-32 Skills Managed CareDisabilitiesMedicareLeadershipResearchManagementClaims ResolutionSurgeryHome... ...(DMHC). HPCS handles the highly visible and fast-growing Medicare Advantageclaims for the full risk line of business. Under...SuggestedHourly pay$44k - $115k
...our ongoing growth and success. What We're Looking For The Risk Placement Specialist supports the sales process to retain and grow the business... ...insurance license. Note: The above is not all encompassing of the full position description. Relation Insurance Inc. provides...SuggestedWork at officeLocal area$3,500 per month
...Subsurface Analyst will join a highly trained team of field specialists responsible for identifying and designating critical subsurface... ...destructive investigations of underground infrastructure. *This is a Full-Time, On-Site position. * Duties and Responsibilities:...SuggestedFull timeLocal areaImmediate startRelocation package- ...apply for other labor markets outside of NCAL.Support Health Plan Risk Adjustment strategy through data analysis, performance monitoring... ...field.Job Field: Strategy ConsultingJob Type: StandardSchedule: Full-timeJob Level: Individual ContributorTravel: NoEmployee Status: RegularSuggested
- ...identifies and manages their inherent risk factors. Additionally they are expected... ...relationships with Underwriting, Claim, Risk Control Specialists, and Brokers to service customers as a... ...please visit .SummaryLocation: CA - Rancho Cordova; CA - Walnut CreekType: Full timeSuggestedFull timeLocal areaLong distanceNight shift
$66k - $75k
A leading insurance brokerage firm located in San Ramon, California is seeking an entry-level individual for a full-time Business Development role. This position offers a competitive base salary between $66,000 and $75,000 annually, along with an attractive incentive bonus...Full time$85.6k - $141.2k
...0 Target Openings 1 What Is the Opportunity? The Risk Control Property Specialist team consists of individuals with deep risk engineering expertise... ...and loss controls and supporting underwriting and claim execution and processes. What Will You Do? Maintain...Local areaLong distanceNight shift$104.13k - $175.6k
...Development Underwriters are responsible for underwriting more complex risks within assigned line(s) of business (e.g., Workers’ Compensation... ...federal, state or local law.___________________Job CategoryUnderwritingSummaryLocation: Pleasanton, CA; Sacramento, CAType: Full timeFull timeWork at officeLocal area- Relation Insurance Services in Pleasant Hill, CA is seeking a Risk Placement Specialist to support sales and retention by delivering marketing support, evaluating referrals for HNW/UHNW criteria, and routing to Private Client or Personal Lines as needed. You will develop...
- ...Apply remote type Remote locations Walnut Creek, CA, USA time type Full time posted on Posted 9 Days Ago job requisition id R25_000000069... ...Personal Lines Underwriter also assists customers in determining risk placement amongst a wide variety of admitted and non-admitted...Hourly payFull timeRemote work
$28.24 - $33.21 per hour
...loan products ~ Tuition reimbursement Emotional Health: Employee Assistance Program (EAP) PTO for part-time and full-time positions Paid holidays Personal Development: On-the-job training and skills development Internal transfer opportunities...Full timeTemporary workPart timeWork experience placement$75k - $100k
...Walnut Creek, California Full time JR103305 About the Role: Analyzes and evaluates customer credit information for new and... ...Commercial Relationship Managers to identify key business and financial risks allowing Portfolio Managers, CSMs and Commercial Relationship...Full timeLocal area- .... citizens and those authorized to work in the U.S. are encouraged to apply. We are unable to sponsor at this time.Note:This is the full time job.No OPT and H1-B please.Only H4-EAD, L2-EAD, EAD-GC, Green Card, US Citizen can applySummaryType: Full-timeFunction: Information...Full time
$160.7k - $365.24k
...at generating business. This full-time, hybrid position will be... ...funding and healthcare financing, risk management and regulatory... ...to clinicians, technology specialists to plan administrators, we offer... ..., including knowledge of Medicare programs.Thorough understanding...Full timeTemporary workWork experience placementWork at officeLocal areaWorldwideFlexible hours$78.86k - $118.25k
...matter most. Grow Your Skills, Grow Your Potential Responsibilities Join our team as a Property Field Inspection Claim Specialist and showcase your expertise in handling accident and weather-related claims for homeowners, commercial properties, and large...Work experience placementInternshipWork at officeLocal areaRemote workWork from homeFlexible hours$28 - $35 per hour
...The Claims Resolution Specialist is responsible for the day-to-day investigation and resolution of claim rejections, denials, edits, and reimbursement... ...claim review and documentation. Maintain knowledge of Medicare, Medicaid, Workers' Compensation, and Commercial payer...Hourly payRemote workMonday to Friday$85.6k - $141.2k
...do and where you do it. Job Category Claim Compensation Overview The annual base... ...negotiation and resolution) including maintaining full compliance with internal and external... ...evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud...Full timeContract workLocal areaRelocation package- ...Job Description Job Description The Claims Resolution Specialist is responsible for the day-to-day investigation and resolution of claim rejections, denials, edits, and reimbursement issues across a multi-site, multi-specialty healthcare organization specializing...Remote work
- ...At Gallagher, we help clients face risk with confidence because we believe that when... ...and organizations thrive. The Senior Claims Examiner will be responsible for managing... ...How you'll make an impact Manages the full life cycle of complex general liability claims...Local areaRemote work
$73.05k - $156.96k
...healthcare? MIEC is searching for a dynamic claims professional to join our passionate team... ...Analyst, Claims and Patient Safety Specialist, or Senior Claims and Patient Safety Specialist... ..., with expanded patient safety, risk management, and senior-level leadership responsibilities...Work at officeRemote workFlexible hoursNight shift$115k - $145k
.... This individual ensures sound credit decisions while balancing risk and profitability in alignment with the bank’s credit policy, regulatory... ...values and performance go hand in hand The Fremont Bank Way Full-Service Banking with comprehensive financial solutions, advanced...Permanent employmentWork at officeLocal areaFlexible hoursShift work- ...Angeles, CA I San Francisco, CA I USA Large companies with complex risks turn to AXA XL for Commercial Umbrella and Excess Liability... ...workforce possible, and create a culture where everyone can bring their full selves to work and reach their highest potential. It’s about...Work experience placementFlexible hours
- ...available financial, operational, exposure, industry, and claims information to make data-driven decisions on risk selection, coverage, terms, conditions, and pricing,... ..., education, certifications and location. The full salary range for this role reflects the competitive...Local area
$103.4k - $133.76k
...support for researching and determining the likelihood of financial risk to the organization, reviewing actuarial documentation for... ...Start: 08:00 AM Working Hours End: 05:00 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Worker...Full timeTemporary workWork experience placementFlexible hoursShift work- Travelers is seeking a Risk Control Associate Specialist, Property in Walnut Creek, CA to support risk engineering for our clients. You will consult onsite with customers, assist underwriting and claims, and help deliver technical risk solutions to lower complexity risks...
$119.81k
...Coder (CPC), Certified Coding Associate (CCA), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT),... ...accounts receivable management. Knowledge of federal and state Medicare and Medi‑Cal policies and their impact on billing and collections...Local areaRelocation packageMonday to Friday- Delta Electronics Americas is seeking a Risk & Quality Management professional in Fremont, CA. The role provides independent risk assessment and quality oversight across High-Value and At-Risk SI projects throughout the lifecycle, ensuring adherence to Delta’s standards...
$87k - $117k
...support the integration of new tools and following employee ideas to drive success for the business. Not quite right for you? For a full listing of all our openings, please visit us at:What We Offer:A supportive and inclusive work environment that values diversity and...Full timeWork experience placementFlexible hours- ...western union, client, visa, walmart lab s etc to name a few. We are continuously looking for entry-level software programmers, Java full stack developers, Python/Java developers, data analysts/data scientists, data engineers, machine learning engineers for full time...Full time
$98k - $106k
...requirementsDocument change order requests, project status, key issues, risks and resolution, priority changes and approvals.Provide Project... ...), consulting or related space.Not quite right for you? For a full listing of all our openings, please visit us at: Who We Are:...Full timeWork experience placementWork at officeImmediate startRemote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Medicare Full-Risk Claims Specialist. Be the first to apply!


