Claims Specialist Jobs in Orange, CA

Champion underwriting strategies within a multi-disciplinary team, managing a block of stop loss business. Engage in pricing, risk analysis, renewals, and supporting new business to meet financial tar...

Lead the creation of member enrollment content, focusing on welcomed kits, by collaborating with experts, managing projects, and ensuring effective communication across teams to enhance compliance and...

Analyze legal bill audits and improve billing processes across multiple practice areas. Leverage legal expertise to communicate billing issues effectively with panel firms and enhance cost containment...

Drive the development and implementation of innovative insurance products in life sciences, collaborating across teams to meet market needs. Lead the drafting of coverage language while analyzing comp...

Deliver exceptional customer service by enhancing relationships and servicing key accounts. Drive growth through effective sales techniques and collaboration, while providing targeted solutions to mee...

Contribute to operational excellence in a leading health organization. Leverage your revenue cycle expertise to analyze complex data, optimize workflows, and ensure compliance with regulations. Strive...

Drive optimal claim resolution by investigating and negotiating high-severity property claims. Oversee the full claim lifecycle while ensuring compliance with quality standards and state regulations...

Join a team focused on investigating healthcare fraud, ensuring compliance, and recovering lost funds. Leverage your expertise in complex cases, collaborate with law enforcement, and contribute to sha...

Drive strategic marketing initiatives across diverse business lines, managing multi-channel campaigns and fostering collaboration among stakeholders. Enhance digital marketing efforts while ensuring b...

Collaborate with cross-functional teams to monitor and execute programs, providing strategic insights and detailed reporting to ensure alignment with project goals and successful outcomes...

Analyze and validate Medicare Advantage member medical records to ensure accurate risk adjustment submissions to CMS. Collaborate with healthcare providers and improve coding quality for optimal reimb...

Drive operational excellence by analyzing business processes and identifying improvements. Collaborate with teams to ensure effective project management and alignment with strategic goals, enhancing o...

Optimize financial analysis projects through forecasting and risk assessment. Bring your expertise to Medicaid knowledge and analytical skills, working strategically to enhance provider contracting pr...

Join us to lead a talented actuarial team, driving innovative data analyses and strategic objectives. You'll manage projects, prepare impactful presentations, and engage with government requests while...

Elevate risk management by partnering across teams to create tools mitigating fraud. You'll gather requirements, drive collaboration, and influence operational processes, ensuring successful project d...

Innovate legal operations through project management and continuous improvement. Take ownership of key initiatives, facilitate cross-functional collaboration, and enhance processes in a remote work en...

Shape the future of healthcare consulting by utilizing your expertise in revenue cycle operations to enhance performance, drive financial improvement, and provide strategic guidance to healthcare orga...

Lead the charge in evaluating, pricing, and managing medical underwriting for a diverse book of business, serving as a subject matter expert and mentor while ensuring high standards of productivity an...

Join a dynamic team to design and build a comprehensive metrics store, enabling data-driven insights across business functions while shaping API layers to enhance analytics engineering practices for a...

Drive business growth by assessing submissions, engaging customers, and fostering relationships in a dynamic environment committed to innovative underwriting solutions and exceptional service...

Deliver innovative pricing solutions as an Actuarial Analyst, leveraging statistical analysis to enhance insurance models. Collaborate with teams to ensure compliance and execute complex projects that...

Empower our claims team by overseeing Management and Professional Liability claims, ensuring compliance and efficacy in settlement processing. Play a vital role in strategic initiatives while managing...

Lead diverse client service programs managing relationships and ensuring customer satisfaction while driving operational excellence and retention across multiple accounts in a dynamic, global environm...

Lead the charge in optimizing full-cycle accounts payable operations in a high-growth environment. Own vendor management and ensure timely processing of invoices while supporting finance initiatives t...

Unlock potential by building an elite Sales organization, driving high-value deals, and shaping innovative insurance solutions while leading a world-class team through scaling challenges and customer...