Hybrid Claims & Provider Relations Compliance Specialist
Western Health Advantage
Western Health Advantage is seeking a detail-oriented Claims & Provider Relations Oversight Specialist in Sacramento, CA (Hybrid). The role focuses on ensuring regulatory compliance across federal and state rules, oversight of audits, reporting, and policy development within Claims and Provider Relations. The ideal candidate brings CA managed care experience, strong analytical abilities, and collaboration across departments to implement regulatory programs and continuous improvement initiatives. #J-18808-Ljbffr Western Health Advantage
- Western Health Advantage is seeking a detail-oriented Claims & Provider Relations Oversight Specialist to support compliance operations within our Claims and Provider Relations team. This role ensures department compliance with federal/state rules, accreditation standards...Claims
- Berkshire Hathaway Homestate Companies, Workers Compensation Division, is seeking a Claims Learning and Development Supervisor to create and execute training programs that elevate skills and knowledge across claims teams. This role leads a team and travels to claims offices...Claims
$85k - $95k
...leading company in workers' compensation claims management is seeking a Sr. Work Comp... ...indemnity claims for complex cases. This hybrid position offers a salary range of $85,00... ...intricate claims efficiently, ensuring compliance with state regulations while effectively...Claims$84.82k - $116.37k
...leading insurance organization in California is looking for a Senior Claims Professional to manage a complex caseload of workers... ...claims efficiently, and negotiating settlements. This role offers a hybrid work schedule, excellent benefits, and a salary range of $84,820...Claims- ...experience to join its Construction and Infrastructure Group in Sacramento, CA. The role focuses on construction claims, arbitration, and court proceedings, with hybrid work options. Candidates must have a CA Bar admission, a JD from an accredited school, strong research and...Claims
- Liberty Mutual Insurance is seeking a Senior Workers’ Compensation Claims Specialist for the West Region. You will review, analyze and process... ...I or II based on experience. The position supports a hybrid work arrangement with onsite engagements and opportunities for...ClaimsRemote job
- Tristar is seeking a detail-oriented claims clerk to support workers’ compensation administration. You will set up new claims... ...clerical tasks while coordinating with management and providers. This is a hybrid position with office-based responsibilities. #J-18808-Ljbffr...ClaimsWork at office
- ...or co-counsel, mentoring junior attorneys and collaborating with claims partners and internal teams. A strong track record in... ...Nationwide Trial Division, supporting nationwide teams from offices in California with hybrid or remote work #J-18808-Ljbffr Jobleads-USClaimsRemote job
- ...public entities in a wide variety of cases, including personal injury claims, employment law disputes, real property disputes, construction defect disputes, premises liability and more. This firm offers hybrid/remote arrangements to support work-life balance. #J-18808-...ClaimsRemote job
- ...including recent PAGA matters. You will manage PAGA claims, supervise junior attorneys, mentor staff, and... ...strategies, while advising clients on wage-hour compliance and California labor laws. This role offers a hybrid work environment and opportunities for partnership...Claims
- ...Consultants in California is seeking a Vice President of Claims to lead our brokerage claims operations from a hybrid California office. You will develop objectives,... ...claims, supervise adjusters, and ensure policy compliance while guiding cross-functional teams. A Juris...ClaimsWork at office
$84.82k - $116.37k
A leading insurance provider is seeking an experienced Senior Claims Professional based in Sacramento, California. This role involves managing complex workers... ...,820 to $116,370 along with excellent benefits and a hybrid work-from-home schedule. #J-18808-Ljbffr Berkshire...ClaimsRemote jobWork at officeWork from home- Zurich North America in the Sacramento/Gold River area is seeking an experienced Litigation Claims Specialist to join its Commercial General Liability team. This hybrid role offers flexibility with occasional in-office attendance and the option for remote work, designed...ClaimsWork at officeRemote work
$225k
...and London market insurers for 30+ years. We defend high-exposure claims from pre-suit through jury trial and appeal across a broad... ...business you bring in Unlimited PTO, sick leave, and paid holidays Hybrid remote flexibility Practice area mix shaped by your background and...ClaimsRemote job$6,646 - $8,324 per month
...Sacramento is seeking a Business Taxes Compliance Specialist. This role involves acting as the... ...technical expert and leading team operations related to billing and analysis. Candidates... ...5% of the time. The position offers a hybrid work environment and several benefits...Flexible hours- ...counseling, litigation, and compliance work-on behalf of a... ...and harassment claims, wrongful termination, and other workplace-related disputes. Candidates should... ...personnel policies, and providing day-to-day compliance advice... ...and mentorship. Hybrid work flexibility available...ClaimsFull time
- ...Worker Compensation Claims Examiner III (Hybrid) Hybrid Sacramento - Rancho Cordova, CA 95670 POSITION... ...with clients, claimants, Medical providers, Attorneys, vendors, Nurse and Vocational... ...any injury trends or other safety-related concerns. Conducts file reviews as...ClaimsWork at office
$75 - $85 per hour
...team. This organization provides the technology... ...nationwide, unifying clinical, claims, demographic, and... ...contract term) Location: Hybrid — 2x/week onsite; San... ...opportunities related to performance, reliability... ...security, privacy, and compliance requirements in regulated...ClaimsContract work$140k - $199k
...the first 25 applicants This range is provided by Jobot. Your actual pay will be based... ...on the defense of workers compensation claims and related litigation. We represent a variety of clients... ...the state. Why join us? Remote/ hybrid Great Pay! Great Team! 401(k) 401(k) matching...ClaimsRemote jobLocal areaFlexible hours$140k - $220k
...on the defense of workers compensation claims and related litigation. Our firm delivers legal services... ...in the Market! Why join us? Remote/ hybrid Great Pay! Great Team! 401(k) 401(k)... ...Jobot is an Equal Opportunity Employer. We provide an inclusive work environment that...ClaimsRemote jobLocal areaFlexible hours$70.3k - $85k
...Claims & Provider Relations Oversight Specialist Western Health Advantage Location: Sacramento, CA (Hybrid) Salary: $70,304 – $85,000 annually "Purpose that inspires. Impact... ...Relations Oversight Specialist to support compliance and regulatory operations within our...ClaimsFull timeWork experience placementWork at office$31.2k - $44.5k
Overview Small Provider Billing Unit- West Sacramento, CA - Hybrid Date: Mar 20, 2026 Location: Any city, CA, US, 99999... ...program. Review and correct provider’s claim before adjudication. Provide... ...geographic region, internal equity, job-related knowledge, skills, and experience...ClaimsFull timeWork at officeFlexible hours- Berkshire Hathaway GUARD Insurance Companies seeks a Habitability Claims Adjuster to manage litigated California habitability claims in the Complex Claims unit. The role focuses on evaluating coverage, liability and damages, with responsibility for reserves, settlements...Claims
- Liberty Mutual Insurance is seeking a dedicated Workers' Compensation Claims Specialist to join our West Region Claims Team. You will review, analyze, and process moderately complex to complex claims, determine liability and compensability, and negotiate settlements. You...ClaimsRemote job
- ...Department in Sacramento is seeking a Senior Accounting Officer, Specialist. The SAO Specialist performs the more difficult professional... ...complex monetary eligibility determinations and adjustments related to Claims Processing and Benefit Payment Control activities, including...Claims
- CVS Health is seeking a Manager, Out-of-Network Claims Negotiation to lead the strategy, operations, and performance of NSA and elective... ...negotiations. You will supervise negotiators and balance provider relations, regulatory requirements, client expectations, and member...Claims
- Join a forward-thinking law firm dedicated to defending workers' compensation claims. This role offers a competitive salary, excellent training, and a supportive team environment. You will work with a diverse range of clients and have the opportunity to participate in...ClaimsRemote jobFlexible hours
- ...Administration Unit within Cal OES is seeking an Analyst II to provide administrative and data analytics support, track mitigation grants... ..., and coordination across divisions. This position offers a hybrid telework arrangement and requires meticulous attention to deadlines...Work at officeRemote work
$19 - $23 per hour
...processing retirement related transactions within our... ...regulations to ensure compliance with the Teachers’... ...Primary role will be to provide support to the Employer... ...appointment, individuals claiming preference under one... ...is performed in a hybrid schedule. The office is...ClaimsHourly payPart timeSummer workWork at officeRemote workWork from homeMonday to FridayFlexible hoursShift work2 days per week- ...reporting, reinsurance administration, compliance reporting, rate analysis, revenue forecasting... ...impacting revenue, profitability, claims costs, and overall financial performance... ...actuarial science, Mathematics, Finance, or a related field. Minimum of five (5) years of...ClaimsPermanent employment
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