Senior Medicare Claims Operations Specialist
Blue Shield of CA
Blue Shield of CA is seeking an Operations Specialist Senior to join their Medicare Operations Claims team in Rancho Cordova, California. The position involves analyzing and resolving claims processing questions, ensuring compliance with relevant policies. Candidates should have a minimum of 5 years of experience with Medicare claims knowledge and strong critical thinking skills. This role follows a hybrid work model, requiring in-office collaboration two days a week. The ideal candidate will work independently and collaboratively to enhance operational efficiency. #J-18808-Ljbffr Blue Shield of CA
- Your Role The Medicare Operations Claims team reviews and resolves Medicare claims processing questions and issue requests. This includes conducting... ...the individual claims and plan levels. The Operations Specialist Senior will report to the Claims Operations Director. In this...SeniorWork at officeLocal area2 days per week
- ...for our members and business partners. The Email Development Specialist, Senior will report to the Manager, Email Development. In this role,... ...of marketing programs. You will influence the end-to-end operations of building and activating email campaigns for an optimal member...SeniorWork at office2 days per week
- Travelers in California is seeking an experienced Workers' Compensation claims professional to manage cases from inception to closure. You will negotiate settlements, coordinate with medical case managers, and handle non-litigation and moderate litigation matters with...Senior
$18.7 - $22 per hour
...A healthcare services provider is seeking a Senior Representative for Customer Service Operations. The role involves assisting customers with medical billing and reimbursement, managing inbound and outbound communication with healthcare professionals, and ensuring compliance...SeniorHourly payRemote work$78.68k - $132.69k
ICW INSURANCE COMPANY OF THE WEST is looking for a Claims Specialist in Sacramento, California, responsible for managing complex claims with an emphasis on exceptional stakeholder service. The ideal candidate will have strong communication skills and at least 8-10 years...Senior- TRISTAR Insurance Group is seeking a Claims Examiner III for a hybrid position in Rancho Cordova, CA. This role involves managing complex and litigated indemnity claims from inception to conclusion. The ideal candidate will have at least five years of experience and demonstrate...Senior
$80k - $100k
A leading claims management company is seeking a Claims Examiner for their Rancho Cordova, CA location. The role involves analyzing complex workers' compensation claims, negotiating settlements, and ensuring compliance with service expectations. Candidates should have...Senior- ICW Group is hiring a Claims Specialist based in Sacramento, California. This role involves handling complex claims while providing exceptional service to stakeholders and managing legal counsel throughout the litigation process. The ideal candidate will have a Bachelor...Senior
- Philadelphia Insurance Companies is seeking a Claims Specialist - Auto to join our team in Roseville, California. This role focuses on investigating and settling complex first and third party commercial auto insurance claims. Ideal candidates will have over 10 years of...Senior
- First Insurance Company Of Hawaii seeks a claims adjuster to manage complex first and third-party property claims. This role requires evaluating each claim and determining coverage, as well as extensive communication with all parties involved. The ideal candidate will...SeniorRemote jobWork at office
- An insurance provider in California is looking for a Claims Specialist - Auto. The role involves investigating, evaluating, and settling complex insurance auto claims. Candidates should possess a High School Diploma, with a Bachelor's preferred, and have over 10 years of...Senior
- Philadelphia Insurance Companies is looking for a Claims Specialist - Professional Liability to investigate and settle complex commercial insurance claims. The role requires comprehensive knowledge of policy terms and extensive experience in claims handling and customer...Senior
- A leading claims management company is looking for a Workers Compensation Claims Examiner to analyze complex claims, negotiate settlements, and manage the litigation process. This role offers a hybrid work environment and a diverse benefits package including medical, dental...Senior
$75k - $105k
Gallagher is hiring a Senior Claims Examiner in California. This remote position requires managing Workers' Compensation claims, negotiating settlements, and collaborating with legal teams for optimal outcomes. The ideal candidate should have at least 5 years of claims...SeniorRemote job$75k - $105k
Arthur J. Gallagher & Co. (AJG) is seeking a Senior Claims Examiner to manage Workers' Compensation claims in California. This role requires a high school diploma and 5 years of claims experience, focusing on negotiation and compliance. You'll play a vital role in ensuring...SeniorRemote jobFlexible hours$63.59k - $114.45k
AlphaStaffHCM is looking for an Inside Senior Property Adjuster in Sacramento, CA, to manage claims with moderate complexity. The role involves investigating damages, negotiating settlements, and ensuring compliance with claims processes. Ideal candidates will have 2 years...Senior- Cognizant is seeking a Senior Healthcare QA Analyst - Facets Claims & Medicare to ensure quality and reliability of healthcare claims processing solutions within large-scale Facets transformation initiatives. You will collaborate with business stakeholders, Facets configuration...SeniorRemote job
- Philadelphia Insurance Companies in Roseville, California, is seeking a Senior Claims Specialist for Commercial Auto BI. The role involves investigating and settling complex first and third party auto claims. Ideal candidates will have 15 years of related experience and...SeniorRemote job
$27.99 - $39.77 per hour
...Bank of Marin, voted by our employees as one of the “Best Places to Work” in the North Bay Business Journal, is seeking an Operations Specialist to join our office onsite in either Novato, California or Rancho Cordova, CA. The Operations Specialist will act as a central...Work experience placementBank staffWork at office- ...Clark Pest Control is seeking a Branch Administrator to support field teams and ensure smooth branch operations. The role emphasizes scheduling, payroll support, customer service and office administration in California. You will use PestPac to manage routes, handle billing...Work at office
$7,009 - $10,309 per month
Job Title Location 75 Iron Point Cir Ste 200, Folsom, CA, 95630-8813, United States Base Pay $7,009.00 - $10,309.00 / Month Other Compensation Performance Incentive Pay Relocation Expense Covered No Employee Type Exempt Manage Others NoSeniorRelocation$85k - $90k
...Overview Gordon Rees Scully Mansukhani, a national law firm with offices in all 50 states, has an immediate opening for a Senior Operations Coordinator in its Sacramento, CA office. This is a full-time, onsite position. The Senior Operations Coordinator supports the Office...SeniorFull timeWork experience placementWork at officeLocal areaImmediate start- ...winning and high performing $5 Billion community business bank operating through 9 offices - 5 in the Capital Region, 1 in Chico, 1 in... ...market. And they trust us. Position Overview The Loan Operations Specialist is responsible for overseeing and managing centralized loan...ApprenticeshipBank staffWork at officeLocal area
- Crowe is seeking a Talent Business Advisor Senior Associate in the United States (Sacramento, CA area). The role partners with Talent Solutions and BU Operations to drive core HR functions and improve the employee experience. You will manage onboarding, performance reviews...SeniorRemote job
- Bank of Marin is seeking an Operations Specialist to join our office in Rancho Cordova, CA. This role will act as a central resource in banking operations, responsible for data management and efficiency improvements. The ideal candidate should have strong banking operations...Work at office
$78.4k - $122.5k
Solidigm is hiring an Assistant Facilities Manager to support operations at their Rancho Cordova campus. The role involves maintaining a safe, efficient workspace, overseeing building systems, and managing vendor relationships. Applicants should have 3-5 years of experience...$84.82k - $116.37k
...experienced Workers Compensation Claims Professionals. This position... ...for their work product. The Senior Claims Professional is... ...claim management. Works with Medicare Set Asides, Structured Settlements... ...employee qualifications, operational needs and other considerations...SeniorWork at officeImmediate startWork from home- ...This role is fully remote work. How you'll make an impact Apply claims management experience to execute decision-making to analyze... ...unless the accommodation would impose an undue hardship on the operation of our business. #J-18808-Ljbffr Arthur J. Gallagher & Co. (AJG...SeniorWork at officeLocal areaRemote workFlexible hours
$25.4 - $27 per hour
Card Operations - Card Operations Sr Specialist Job Description Posted Thursday, June 4, 2026 at 10:00 AM Job Title: Card Operations Sr Specialist Status... ...operational and regulatory standards. Collaborate with the Senior Specialist peer (Credit or Debit counterpart) to ensure...SeniorHourly payWork experience placementWork at office$23.16 per hour
...and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards... ...client reports submitted to the organization, efficiency of claim operations, and adequacy of systems and procedures. Approves claim...SeniorFor contractorsWork at officeLocal area
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