Top 236 Compensation claims Jobs in Auburn, Ca

Clubhouse Billing Analyst
Pacific Health Group —California
- $49,920 - $54,080 a year
- Full-time
- Spanish
- HIPAA
- English
- AD&D insurance
- Paid holidays
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Client Success Manager
Larkin Benefit Administrators —Roseville, CA
- $70,000 - $107,640 a year
- Full-time
- Microsoft Word
- Research
- Mid-level
2d
Workers' Compensation Claims Examiner (SIP) - 44846
IOS Staffing Services —Rancho Cordova, CA
- $85,000 - $95,000 a year
- Full-time
- Hybrid work
- Background check
- 5 years
- Office
- Health insurance
- Dental insurance
Quick Apply
2d
Claims Assistant, Workers' Compensation
BETA HEALTHCARE GROUP RISK MANAGEMENT —Roseville, CA
- $26.67 - $29.74 an hour
- Full-time
- Hybrid work
- Word processing
- Mid-level
- Office
Quick Apply
8d
Claims Representative (IAP): Workers Compensation Training Program | Rancho Cordova, CA
Sedgwick —Rancho Cordova, CA
- Customer service
- No experience needed
- Office
- Health savings account
- Disability insurance
Associate Claims Adjuster, Workers Compensation
Liberty Mutual —Rocklin, CA
- $50,000 - $94,000 a year
- Full-time
- Mid-level
- Office
- Analysis skills
Workers' Compensation Claims Technician
Liberty Mutual —Rocklin, CA
- $38,000 - $70,000 a year
- Full-time
- Customer service
- Mid-level
- Office
- Work from home
13d
Workers' Compensation Claims Adjuster - West Region
Liberty Mutual —Rocklin, CA
- $57,000 - $101,000 a year
- Full-time
- Customer service
- Mid-level
- Bachelor's degree
2d
Workers Compensation Claims Assistant I
AvonRisk —Rocklin, CA
- $18 - $22 an hour
- Full-time
- High school diploma or GED
- Fair chance
- Entry level
- Mileage reimbursement
- Health savings account
Quick Apply
11d
Workers Compensation Claims Associate | Rancho Cordova (Onsite)
Sedgwick —Rancho Cordova, CA
- Full-time
- Computer literacy
- No experience needed
- Office
- Health savings account
- Disability insurance
2d
Workers Compensation Claims Examiner | Long Beach or Roseville, CA (Hybrid)
Sedgwick —Roseville, CA
- Full-time
- Hybrid work
- Mid-level
- High school diploma or GED
- Bachelor's degree
- Health savings account
- Disability insurance
Workers Compensation Associate Claim Representative
The Travelers Companies, Inc. —Rancho Cordova, CA
- $52,600 - $86,800 a year
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Wellness program
- Paid holidays
Workers Compensation Claims Associate | Rancho Cordova, CA (Onsite)
Sedgwick —Rancho Cordova, CA
- Full-time
- Office
- High school diploma or GED
- Fair chance
- Health savings account
- Disability insurance
3d
Claims Training Specialist
CorVel Corporation —Folsom, CA
- $77,960 - $120,368 a year
- Full-time
- Remote
- Classroom
- Computer literacy
- HIPAA
- Health savings account
- Disability insurance
Quick Apply
Workers Compensation Claims Adjuster I
AvonRisk —Rocklin, CA
- $25 - $30 an hour
- Full-time
- Hybrid work
- Mid-level
- Conflict management
- Fair chance
- Health savings account
- Paid holidays
Quick Apply
Workers' Compensation Claims Assistant
TRISTAR RISK MANAGEMENT —Rancho Cordova, CA
- $22 - $24 an hour
- Full-time
- Microsoft Word
- Writing skills
- Basic math
- Paid holidays
- Disability insurance
Quick Apply
12d
Technical Claims Specialist, Workers Compensation - West Region
Liberty Mutual —Rocklin, CA
- $75,000 - $140,000 a year
- Full-time
- Bachelor's degree
- Experience equivalent to degree accepted
- Training & development
Claims Team Lead - Workers Compensation
Sedgwick —Roseville, CA
- Hybrid work
- Customer service
- 5 years
- Office
- Health savings account
- Disability insurance
Workers Compensation Claims Team Lead | Roseville, CA or Long Beach, CA,
Sedgwick —Roseville, CA
- Full-time
- Office
- High school diploma or GED
- Bachelor's degree
- Health savings account
- Disability insurance
Claims Adjuster - Workers Compensation | Jurisdiction: CA | Licensing: CA, SIP Preferred (Hybrid - El Dorado Hills,CA)
Sedgwick —El Dorado Hills, CA
- Full-time
- Customer service
- Mid-level
- Office
- Health savings account
- Disability insurance
4d

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compensation claims jobs near auburn, ca

Clubhouse Billing Analyst

Pacific Health Group -
California

Quick Apply

Job Details

Full-time
$49,920 - $54,080 a year

Benefits

AD&D insurance
Paid holidays
Disability insurance
Health insurance
Dental insurance
Flexible spending account
Paid time off
Employee assistance program
Vision insurance
401(k) matching
Employee discount
Bereavement leave

Qualifications

VLOOKUP function
X12 EDI
Patient management software
High school diploma or GED
Health insurance knowledge
Electronic health record (EHR) management for billing and coding
Medical claims submission
Excel data analysis

Full Job Description

Company: Pacific Health Group
Department: Revenue Cycle / Billing
FLSA Status: Non-Exempt, Full-Time
Pay Range: $24 – $26 per hour

Position Summary

The Clubhouse Billing Analyst owns the end-to-end revenue cycle for Clubhouse Services claims submitted under San Diego County's BH-CONNECT Clubhouse Services benefit. Unlike traditional fee-for-service behavioral health billing, Clubhouse Services is reimbursed through a county-specific daily bundled (per diem) rate claimed through the county SMHS delivery system. This role is responsible for translating daily member attendance and service documentation into clean, compliant claims; managing eligibility, denials, and reconciliation; and serving as the billing subject matter expert on DHCS BH-CONNECT claiming guidance (including BHIN 25009, the BH-CONNECT EBP Policy Guide, and County of San Diego Behavioral Health Services billing requirements).

This is a hands-on role for a billing professional who is comfortable operating in a new benefit with evolving guidance — building billing workflows from the ground up, monitoring DHCS and County claiming updates, and partnering closely with program staff to make sure documentation supports every claimed day of service.

Essential Duties and Responsibilities

Claims Production & Submission

Prepare, scrub, and submit daily bundled rate claims for Clubhouse Services through the County of San Diego's designated claiming system/EHR and ShortDoyle/MediCal process, in accordance with County and DHCS requirements.
Apply correct procedure codes, modifiers, place-of-service, and rendering/billing provider data per BHIN 25009, the BH-CONNECT EBP Policy Guide, and County billing manuals.
Reconcile daily Clubhouse attendance logs and service documentation against claimable member days before submission; flag undocumented or unsupported days to program leadership prior to claiming.
Track and comply with timely filing requirements and County claim submission calendars.

Eligibility & Authorization

Verify MediCal eligibility and aid codes for all Clubhouse members monthly (and prior to claiming), including share-of-cost, other health coverage (OHC), and managed care assignment issues that affect SMHS claiming.
Coordinate resolution of eligibility discrepancies with program staff and County BHS as needed.

Denials, Corrections & Reconciliation

Work claim denials, disallowances, and voids/replacements; perform rootcause analysis and correct/resubmit within required timeframes.
Reconcile remittances (835s/EOBs) against submitted claims; maintain accurate accounts receivable aging and escalate underpayments or unpaid claims.
Prepare monthly revenue reconciliation reports (claimed vs. paid vs. expected at the County bundled rate) for leadership.

Compliance & Audit Readiness

Maintain working knowledge of BHCONNECT Clubhouse Services requirements, including the daily bundled rate structure, medical necessity/eligibility criteria, and documentation standards; monitor DHCS BHINs and County BHS updates for claiming changes.
Understand the Clubhouse International Accreditation requirement and its impact on claiming eligibility (MediCal claiming is limited to four years total prior to Accreditation); support leadership in tracking accreditation-linked billing status.
Support internal charter-claim audits and respond to County/DHCS audit requests, recoupments, and cost report or data submissions as assigned.
Ensure all billing activity complies with HIPAA, 42 CFR Part 2 (where applicable), and MediCal program integrity requirements; report suspected compliance issues immediately.

Cross-Functional Support

Serve as the billing liaison to County of San Diego BHS billing/fiscal contacts for Clubhouse Services claiming questions.
Train Clubhouse program staff on documentation elements required to support the daily bundled rate.
Assist with billing workflow buildout, desk procedures, and QA processes for this new service line; support billing for other PHG lines of business as capacity allows.

Minimum Qualifications

3+ years of medical billing experience, with at least 1 year in behavioral health, MediCal, or county Specialty Mental Health Services (SMHS) billing.
Working knowledge of MediCal eligibility verification, aid codes, and claim adjudication (837/835 transactions, denial codes, void/replace processes).
Experience with an EHR/practice management system used for behavioral health claims (e.g., SmartCare, Cerner/CCBH, Netsmart, or comparable).
Strong Excel skills (pivot tables, VLOOKUP/XLOOKUP or equivalent) for reconciliation and reporting.
High attention to detail, documentation discipline, and ability to work independently in a program with new and evolving guidance.
High school diploma or GED required.

Preferred Qualifications

Direct experience billing County of San Diego BHS / ShortDoyle MediCal.
Familiarity with CalAIM, BHCONNECT, per diem or bundled rate reimbursement models, or psychosocial rehabilitation programs (Clubhouse model a plus).
Certified Professional Biller (CPB), CRCR, or equivalent credential.
Experience standing up billing operations for a new program or contract.
Bilingual English/Spanish.

Compensation & Benefits

Hourly range: $24 – $26
160 Hours of Paid Time Off (PTO)
12 Paid Holidays per year, including your birthday and one floating holiday after 1 year of employment
4 Paid Volunteer Hours per Month to support causes you care about
Bereavement Leave, including Fur Baby Bereavement
90% Employer-paid Employee-Only Medical Benefits
Dental and Vision Insurance
FSA | Dependent Care Account
401(k) with Company Match
Monthly Stipend
Short-Term & Long-Term Disability | AD&D
Employee Assistance Program (EAP)
Employee Discounts via Great Work Perks and Perks at Work
Quarterly In-Person Events
Fully remote work within California
Opportunities for professional development and internal growth

Work Environment

Remote
Monday - Friday 8:30 am - 5 pm

Equal Employment Opportunity

Pacific Health Group is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, national origin, ancestry, age, disability, medical condition, genetic information, marital status, military or veteran status, or any other characteristic protected by federal, state, or local law. Pacific Health Group will provide reasonable accommodations to qualified individuals with disabilities in accordance with the ADA and California FEHA.

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Refine Your Search

compensation claims jobs in auburn, ca

Clubhouse Billing Analyst

Client Success Manager

Workers' Compensation Claims Examiner (SIP) - 44846

Claims Assistant, Workers' Compensation

Claims Representative (IAP): Workers Compensation Training Program | Rancho Cordova, CA

Associate Claims Adjuster, Workers Compensation

Workers' Compensation Claims Technician

Workers' Compensation Claims Adjuster - West Region

Workers Compensation Claims Assistant I

Workers Compensation Claims Associate | Rancho Cordova (Onsite)

Workers Compensation Claims Examiner | Long Beach or Roseville, CA (Hybrid)

Workers Compensation Associate Claim Representative

Workers Compensation Claims Associate | Rancho Cordova, CA (Onsite)

Claims Training Specialist

Workers Compensation Claims Adjuster I

Workers' Compensation Claims Assistant

Technical Claims Specialist, Workers Compensation - West Region

Claims Team Lead - Workers Compensation

Workers Compensation Claims Team Lead | Roseville, CA or Long Beach, CA,

Claims Adjuster - Workers Compensation | Jurisdiction: CA | Licensing: CA, SIP Preferred (Hybrid - El Dorado Hills,CA)

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