227 jobs found in san diego

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm) If you are located in Ontario, CA, you will have the flexibility to telecommute* as you take on some tough challenges.  Primary Responsibilities: Accurately process institutional claims Responsible for editing and adjusting of claims per the EDI daily audit report Analyze and adjudicate claims to ensure accurate payment Interpret Fee for Service (FFS) and capitated provider contracts Review...

Summary The primary focus of the Client Administrator is to provide technical support to Client Executives and to clients in maintaining Business Insurance insurance policies in accordance with the objectives and procedures outlined by the Business Insurance Procedures Manual and by the Director, Client Services. Essential Duties & Responsibilities Process paperwork for new and renewal business to include: Applications and other documents required for a submission Binders Certificates of Insurance Policies Invoices Finance Agreements Endorsements Audits Perform account reconciliation. Review Loss Runs and Claim Status Reports.  Order any missing  loss runs or request updated loss runs as needed for marketing submission. Prepare Summary Of Insurance. Have good verbal and written communication skills for both client and internal communication. Maintain client files.  File all documentation in ImageRight per regions filing guidelines. Manage Tasks...

Department: Employee Health & Benefits Status: Non-Exempt Reports To: Client Service Executive Summary Work directly with Client Service Team (Client Managers, Client Executives and Principals) to provide a high level of client support in response to routine client requests and needs, act as liaison with carriers, and maintain client and carrier information.  Essential Duties & Responsibilities Support the Client Service Team with the renewal process. Gather client census data, current / renewal plan design and rate information, historical claims experience data, and any additionally related materials required to prepare RFP for client renewals and prospective groups. For specifically assigned clients, provide Benefit Service Associates with RFP information and respond to questions for clarification if needed.  For all other client RFP’s, follow processes and procedures to market clients for renewal process. Analyze market proposals received to verify...

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. It’s that time, isn’t it? You’re ready for the next step forward and an opportunity to build on your skills.  And it just so happens that there’s never been a better time to get on the team at UnitedHealth Group . We’ve built one of the world’s most effective and respected claims processing teams. And that’s where you come in. We’ll look to you to maintain our reputation for service, accuracy and providing a positive claims experience. We’ll back you with the great training, support and opportunities you’d expect from a Fortune 10 company leader. This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of (8:00am - 5:00pm). It may be necessary, given the business need, to work occasional overtime.  *All Telecommuters will be required to...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)   Positions in this function research and investigate key business problems through quantitative analyses of utilization and healthcare costs data. Provides management with statistical findings and conclusions. Identifies potential areas for medical cost improvements and alternative pricing strategies. Provides data in support of actuarial, financial and utilization analyses. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.     Primary Responsibilities:  Develop and improve quantitative data analytics and set performance targets Lead projects to completion by...

Department: Employee Health & Benefits Status: Exempt Reports To: Client Service Executive Summary The Client Manager provides advice and assistance requiring technical and industry knowledge and client service skills to meet client needs and resolve difficulties.  Client Managers may occasionally perform in the capacity of a Client Executive Service for specifically assigned accounts to oversee the preparation of and providing renewal and new business presentations.  Essential Duties & Responsibilities Act as the initial point of contact for Clients, Carriers and others on the Client Service Team in the following areas: RFP review and preparation. Analysis of utilization reports, carrier reports and claims data and trends. COBRA, HIPAA and coordination of 5500 data. Work closely with and instruct carrier representatives to ensure smooth implementation of new plans. Ensure required plan information and materials are sent to the client in a timely...

Summary The primary focus of the Client Administrator is to provide technical support to Client Executives and to clients in maintaining Business Insurance insurance policies in accordance with the objectives and procedures outlined by the Business Insurance Procedures Manual and by the Director, Client Services. Essential Duties & Responsibilities Process paperwork for new and renewal business to include: Applications and other documents required for a submission Binders Certificates of Insurance Policies Invoices Finance Agreements Endorsements Audits Perform account reconciliation. Review Loss Runs and Claim Status Reports.  Order any missing  loss runs or request updated loss runs as needed for marketing submission. Prepare Summary Of Insurance. Have good verbal and written communication skills for both client and internal communication. Maintain client files.  File all documentation in ImageRight per regions filing guidelines. Manage Tasks...

Optum is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing  your life's best work.(sm)   The Manager (Pricing) Underwriting will develop and implement departmental procedures and maintain high quality standards to ensure Underwriting efficiencies. This individual will develop departmental control expenses within the budget and oversee the assignment of underwriting authority to their reports. They will establish controls to monitor ability to accept risks and determine pricing. The Underwriting Manager will establish audit and monitoring procedures to ensure adequate review of underwriting files. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities:...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) The Proposal Development Senior Consultant manages the overall RFP process for high-profile and complex public entity and commercial proposals, supporting medical and ancillary products for the National Accounts, Public Sector and Key Accounts sales organizations. Accountabilities include project managing the entire proposal with multiple, downstream business partners and the gathering of supporting documents and analyses.  A critical component of this position is the ability to work within a fast-paced, deadline-driven, and complex environment.  Health care background, solid interpersonal skills along with business-to-business writing and...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) The Manager Underwriting will develop and implement departmental procedures and maintain high quality standards to ensure Underwriting efficiencies. This individual will develop departmental control expenses within the budget and oversee the assignment of underwriting authority to their reports. They will establish controls to monitor ability to accept risks and determine pricing. The Underwriting Manager will establish audit and monitoring procedures to ensure adequate review of underwriting files. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S., preferably in Connecticut, (Eastern time zone hours (EST) )...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) Be part of this enterprise-wide claims transformation journey!!! The Strategic Claims Capability vision is to reimagine and simplify the end-to-end claim experience by providing a nimble and frictionless claim capability for all constituents, driving maximum affordability. The work will be challenging and rewarding!!!  Projects within pre-processing arise from across the enterprise landscape as the team focuses on delivering business critical efforts in conjunction with up and downstream partners to transform the claims experience for our provider, member, and internal constituents. This position works to establish and evolve reporting,...

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Combine two of the fastest - growing fields on the planet with a culture of performance, collaboration, and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making Healthcare data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life’s best work.SM The  Senior Recovery / Resolution Analyst  will work with a team on researching issues to determine feasibility of reducing medical costs through prospective solutions of claim system processes and claim business rules. This position is full-time (40 hours/week) Monday - Friday. Employees are required to work our normal business hours of 8:00am – 5:00pm in residing time zone. It may be necessary, given the business...

If you are located within commutable distance of Madison, WI 53713, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges. Combine two of the fastest - growing fields on the planet with a culture of performance, collaboration, and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making Healthcare data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life’s best work.SM The Patient Account Representative is responsible for insurance balances, works daily with insurance companies handling unresolved inquiries/issues/denials with payers, responsible for reviewing invoices and contact various insurance companies for payment on outstanding claims in a timely manner for physician charges. You will manage and process Medicare,...

Department: Employee Health & Benefits Status: Exempt Reports To: Practice Group Leader Summary The Client Manager provides advice and assistance requiring technical and industry knowledge and client service skills to meet client needs and resolve difficulties.  Client Managers may occasionally perform in the capacity of a Client Executive Service for specifically assigned accounts to oversee the preparation of and providing renewal and new business presentations.  Essential Duties & Responsibilities Act as the initial point of contact for Clients, Carriers and others on the Client Service Team in the following areas: RFP review and preparation. Analysis of utilization reports, carrier reports and claims data and trends. COBRA, HIPAA and coordination of 5500 data. Work closely with and instruct carrier representatives to ensure smooth implementation of new plans. Ensure required plan information and materials are sent to the client in a timely...

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work . SM This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of (8:00am - 5:00pm). It may be necessary, given the business need, to work occasional overtime. *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy. Primary Responsibilities: Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims Analyze and identify trends and provide reports as necessary...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) The Senior Provider Relations Advocate will be the assigned single point of contact for provider/healthcare system accounts while representing both government and commercial products to build and improve physician and practice manager satisfaction with UHC. This externally focused position will maximize the providers' ability to interact with UHC through both pre-scheduled engagements with the healthcare professional’s organizational representative to discuss new and upcoming changes occurring within UHC that will impact their specific account, discussing the provider/healthcare system’s organizational service issues, while also engaging on an...

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Combine two of the fastest - growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making Healthcare data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life’s best work.SM The Senior Recovery/Resolutions Analyst will work with a team on researching issues to determine feasibility of reducing medical costs through prospective solutions of claim system processes and claim business rules. This position is full-time (40 hours/week) Monday to Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 08:00am – 05:00pm....

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Combine two of the fastest - growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making Healthcare data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life’s best work.SM Investigate Optum Waste and Error stopped claims by gathering information, researching state and federal guidelines, and following internal procedure to determine the viability of the claim for further review in a production environment.    *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy. Primary Responsibilities: Clinical Case Reviews Perform clinical review of...

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life’s best work.SM The Claims Clerk is responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims. This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of (8:00am - _5:00pm CST). It may be necessary, given the business need, to work occasional overtime.  *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy. Primary Responsibilities: Provide...

Gallagher is a global leader in insurance, risk management and consulting services. We help businesses grow, communities thrive and people prosper. We live a culture defined by The Gallagher Way , our set of shared values and guiding tenets. A culture driven by our people, over 30,000 strong, serving our clients with customized solutions that will protect them and fuel their futures. Position Summary: The Branch Client Service Manager II is accountable for delivering high quality and efficient service to both internal and external clients through the day-to-day account management of an assigned group of accounts within a Branch that consistently meets or exceeds CSO revenue benchmark expectations. This role reports directly into either the Branch Client Service Director or the Branch Client Service Supervisor. Key Responsibilities: The Branch Client Service Manager II directly contributes to key business outcomes such as client retention, client satisfaction,...