Senior Provider Disputes & Claims Resolution Lead
$91.67k - $128.33kVentura County Medi-Cal Managed Care Commission
Ventura County Medi-Cal Managed Care Commission is seeking a qualified professional to manage complex provider disputes and claims related issues. The role is exclusively for California residents and includes key responsibilities like providing technical guidance and performing quality reviews. The ideal candidate should have at least five years of relevant experience, strong analytical skills, and be familiar with Medi-Cal, Medicare, and managed care operations. The position offers a competitive pay range between $91,667 and $128,333 yearly, based on experience and qualifications. #J-18808-Ljbffr Ventura County Medi-Cal Managed Care Commission
$91.67k - $128.33k
...is looking for a qualified professional to handle complex provider disputes, claims adjustments, reimbursement methodologies, and provider payment... ..., claim adjudication, contract interpretation, and resolution activities. Assists with daily workflow coordination, inventory...ClaimsContract workWork experience placementRemote work$110k - $240k
Senior Director, Construction Disputes & Advisory (PLDC): Architect page is loaded##... ...capabilities to provide independent... ....**Role Overview:**Lead and serve as the primary... ...disputes, claims, and litigation matters... ...million-dollar dispute resolutions by providing objective...SeniorClaimsFor contractorsWork at officeRemote work$135k - $145k
Strategic Comp is looking for a Senior Claims Manager to oversee claims processes in California while working remotely. This role involves managing a team and ensuring proactive resolutions for claims, with responsibilities including team development and oversight of claims...SeniorClaimsRemote job- Sedgwick Claims Management Services Ltd is seeking a Claims Team Lead for Workers Compensation in West Hills, CA. This hybrid role requires overseeing teams handling complex claims, providing technical guidance, and ensuring quality standards. The ideal candidate will...SeniorClaims
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Progressive Insurance is seeking a Claims Specialist in California to investigate intricate large-loss injury claims valued over $60k. In this hybrid role, you will consult with various stakeholders to determine coverage and claims value. Ideal candidates have significant...SeniorClaims- Blue Shield of California is seeking a Provider Contracting Specialist, Principal to manage contract negotiations with providers in Southern California. This role involves comprehensive management of Medical Group and Hospital networks, driving strategic initiatives to...SeniorFull timeContract workWork at office
$125k - $180k
Associate or Senior Attorney, Civil Litigation Location: Offices... ...as required by each case. Provide effective and timely communications... ...services to clients and claims on legal and factual issues.... ..., and alternative dispute resolutions. Accurately log and record...SeniorClaimsWork at officeRemote work- A public entity in California is looking for a Senior Risk Control Specialist to manage their risk control program. This full-time position... ...vendor services, identifying trends, and collaborating with claim management for loss control design. Candidates must reside in California...SeniorClaimsRemote jobFull time
- ...executives in a variety of workplace disputes, including wrongful... ...rights. Role Description The Senior Labor & Employment Attorney will... ...to workplace disputes, and providing expert legal advice. Day-to-day... ...cases, including high-value claims NY Bar license and CA Bar...SeniorClaimsFull timeRemote work
$33 - $39 per hour
...settlement or declination of insurance claims through effective research, negotiation... ...by contacting injured workers, medical providers, and employer representatives. Determining... ...management, settlement strategy and claim resolution. Qualifications 2+ years experience as...ClaimsFlexible hours$14.9 - $29.06 per hour
Job Summary Provides senior level support for claims examination activities including evaluation of adjudication of claims to identify incorrect coding... ...recommendations for further investigation and/or resolution of claims. Oversees the reduction of defects by identifying...SeniorClaimsHourly payWork experience placementWork at office- Chumashcareers is seeking a dedicated Risk Manager to oversee the risk management team. This role includes managing insurance and claims, ensuring compliance with regulations, and fostering a safe work environment. Candidates should have a Bachelor's degree and five years...SeniorClaims
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...seeking an experienced Senior Counsel - Patent Litigation... ...ideal candidate will lead complex IP cases,... ...their growth, and resolve disputes efficiently and effectively... ..., including discovery, claim construction, motion... ...and trial preparation. Provide strategic counsel to clients...SeniorClaimsFlexible hours- Job Description Title: Senior Property Adjuster Department: EMA Loss Adjusting Reports To: Claims Manager Status: Regular, Full-Time... ...to insurance carriers, providing conclusions and recommendations... ...investigative skills. Conflict resolution and persuasion abilities...SeniorClaimsFull timeWork at officeNight shiftWeekend workAfternoon shift
- ...Operations, etc. Review Contractor Potential Change Order Claims for Merit and negotiate to final resolution Required Qualifications 20 years or more... ...Equal Opportunity KDG Construction Consulting is a leading provider of program, project, and construction management services...SeniorClaimsFor contractors
$45.39k - $88.51k
Molina Healthcare in California is seeking a Claims Supervisor to lead the claims activities team. Responsibilities include supervising claims processing, managing team performance, and analyzing claims reports to improve efficiency. Ideal candidates will have over 5 years...SeniorClaims- ...workers compensation insurance provider that does all of our business... ...workers’ compensation claims by interviewing injured workers... ...timely and cost-effective claims resolution Monitor the expenses and... ...defense attorneys Coordinate and lead special projects or processes...SeniorClaimsRemote jobFull timeWork experience placementWork at office
$227.95k - $341.93k
Job Overview The VP, Provider and Member Appeals and... ...appeals, grievances and dispute resolution processes Own and... ...and cost optimization Lead organizational design... ...appeal trends, denials, claims edits, and contract disputes... ...including Directors, Senior Managers, and Managers...ClaimsContract work$160k - $190k
Join Tyson & Mendes - Senior Counsel, Complex Trial Teams (... ...tenant litigation to take the lead on high‑stakes, high‑... ...thrives on complex habitability claims, wrongful eviction disputes, and high‑exposure... ...owners, insurers, and housing providers in landlord‑tenant cases....SeniorClaimsRemote jobFull timeFlexible hours$110k - $120k
## Senior Claims Specialist - CA Workers' Compensation**Be Here. Be Great.** Working for a leader... ...strategies to bring claims to resolution.* The candidate hired for this position... ...and business needs. Your recruiter will provide details about benefits and specific compensation...SeniorClaimsFull timePart timeSeasonal workWork at officeNight shift$100k - $231.54k
...a time. Position Summary The Lead Director is accountable for developing... ...most complex and challenging Providers in accordance with Company... ...plan in managing costs. Ensures resolution of escalated issues related, but not limited to, claims payment, contract...ClaimsHourly payFull timeContract workTemporary workWork at officeLocal area- ...Joint Powers Authority (JPA), is seeking a Senior Risk Control Specialist to manage PERMA's... ...for trend identification, collaborate with claim management teams in the design of loss control programs, develop reports, and provide excellent member service related to risk...SeniorClaimsFull timeRemote work
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$90k - $110k
A leading insurance agency in California is seeking a Property & Casualty Claims Analyst. In this role, you will manage the claims process, analyze complex issues, and provide exceptional client support. The ideal candidate has at least 5 years of experience in the Property...SeniorClaims- CCMSI is seeking a Workers’ Compensation Claim Specialist in Concord, CA. The role involves managing a portfolio of claims, leading investigations, and ensuring timely resolutions. Candidates should have over 5 years of claims handling experience and strong analytical...SeniorClaims
$142k - $213k
Senior Manager, Operations - Applications & Analytics Gold Coast... ...Applications and Analytics leads claims-related services, including... ...processing, auditing, research, resolution, reporting, and continuous... ..., accurate payments, and provider satisfaction. Reports to the...SeniorClaimsFull timeContract work
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