Top 18 Medical claims manager Jobs in Merced, Ca

Workers' Compensation Claims Examiner
JT2 Integrated Resources —California
- From $90,000 a year
- Full-time
- Mid-level
- 3 years
- Analysis skills
- Health insurance
- Dental insurance
Quick Apply
Inventory Auditor
Costco Wholesale Corporation —Merced, CA
- Research
- Mid-level
- Driving
- AD&D insurance
- Employee stock purchase plan
Fully Remote- Pre-litigation/Litigation Attorney (Personal Injury)
THE CALIFORNIA LAW OFFICE —California
- $100,000 - $200,000 a year
- Full-time
- Remote
- Bilingual
- Spanish
- Writing skills
- Paid holidays
- Paid time off
Quick Apply
Personal Lines Account Manager - Turlock, CA
Insurance Relief —Turlock, CA
- $40,000 - $60,000 a year
- Full-time
- Mid-level
- Business development
- In-person
- Paid holidays
- Health insurance
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Branch Manager
Bobcat Central —Merced, CA
- $75,000 - $85,000 a year
- Full-time
- Background check
- Spanish
- Clean driving record
- Paid holidays
- Health insurance
Quick Apply
Location Manager
First Student —Merced, CA
- $80,000 - $90,000 a year
- Full-time
- Mid-level
- 3 years
- Bachelor's degree
- Health insurance
- Dental insurance
Quick Apply
Worker's Compensation Program Manager
Foster Farms —Livingston, CA
- $93,825 - $117,275 a year
- Full-time
- Customer service
- 5 years
- Office
Quick Apply
Application Services Director
Central California Alliance for Health —Merced, CA
- $205,000 - $265,000 a year
- Email
- Hybrid work
- Computer science
- Computer Science
- System design
- Wellness program
- Paid holidays
Quick Apply
Pharmacy Technician / Pharm Tech Apprenticeship
Walgreens —Merced, CA
- $19.50 - $23.00 an hour
- Part-time
- Computer literacy
- English
- Fair chance
- Health insurance
- Dental insurance
6d
Risk Adjustment Director
Central California Alliance for Health —Merced, CA
- $200,000 - $250,000 a year
- Email
- Hybrid work
- Finance
- Master's degree
- SQL
- Wellness program
- Paid holidays
Quick Apply
Certified Pharmacy Technician
Walgreens —Merced, CA
- $20.50 - $24.00 an hour
- Part-time
- Computer literacy
- English
- Fair chance
- Continuing education credits
- Health insurance

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Inventory Auditor
Costco Wholesale Corporation —Merced, CA
Researches and audits accrued merchandise payables, receiving documents, shipping documents and verifies vendor payments in SAP.

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Claims Analyst - REMOTE
Ryder System —Columbus, OH
Interacts with Law Department on significant cases, and updates field operations personnel on claim status. Investigates and adjusts claims, as well as directs…
$90,000 - $100,000 a year
12d
Long-Term Care Rate Setting Manager (Medicaid Health Systems Administrator 1)
State of Ohio - Medicaid —Columbus, OH
Or, in order to operate a state vehicle, you must have a valid driver's license from state of residence. Exp. in the delivery of a health services program or…
$40.40 an hour
16h

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medical claims manager jobs near merced, ca

Workers' Compensation Claims Examiner

JT2 Integrated Resources -
California

Quick Apply

Job Details

Full-time
From $90,000 a year

Benefits

Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Vision insurance

Qualifications

Customer communication
Caseload management

Full Job Description

Claims Examiner - Workers Compensation, JT2 Integrated Resources

JT2 has over two decades of experience in claims administration and has delivered consistent cost savings to clients while providing quality care to claimants. We partner with our clients to provide fully customized and innovative solutions that integrate claims administration with risk control solutions.

We are searching for a highly motivated Claims Examiner to join our team! Under supervision of the Claims Supervisor, the Claims Examiner will manage claims from inception to conclusion. The position requires an individual that adheres to best practices and State of California statutes to work directly with clients, injured workers, agents, vendors, and attorneys to resolve workers compensation claims.

Minimum Requirements

Three (3) years of claims management experience
Bachelor's degree from an accredited college or university preferred.
Possession of a current Self-Insurance Plan (SIP) Certificate and insurance-related course work: CPCU, WCCA, WCCP, ARM.
Must be able to administer any type of indemnity claim within the assigned caseload including those involving lost time, those likely to involve permanent disability residuals, and future medical claims.

Duties and Responsibilities

Ensure proper handling of claims from inception to conclusion per client service agreements and JT2 service standards.
Prepare accurate and timely issuance of benefits notices and required reports within statutory limits.
Reserve files in compliance with injury type, identify potential costs of medical care investigation and indemnity benefits.
Ensure timely payment of benefits, bills and appropriate caseload and performance goals.
Negotiate and prepare claims for settlement, provide manager/supervisor with complete and accurate settlement data.
Monitor, report, and assign claims for fraud potential and subrogation possibilities.
Monitor claims for pre-established criteria for case-management and vocational rehabilitation in accordance with State laws.
Prepare and present claims summaries to clients during file reviews.
Train and direct Claims Assistants to meet goals and deadlines.
Review and approve priority payments and other documents from Claims Assistants.
Performs other duties as assigned.

Knowledge, Skills, and Abilities

Strong knowledge of workers" compensation policy, concepts and terminology and benefit provisions.
Strong knowledge of adjusting workers" compensation claims for municipalities and administering LC 4850 benefits.
Strong skills with use of general office administration technology, including Microsoft Office Suite and related software.
Excellent verbal and written communication skills.
Excellent interpersonal and conflict resolution skills.
Excellent organizational skills and attention to detail.
Excellent interpersonal, negotiation, and conflict resolution skills.
Strong analytical and problem-solving skills.
Ability to act with integrity, professionalism, and confidentiality, at all times.
Remote work is acceptable.

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.

JT2 Integrated Resources provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Job Type: Full-time

Pay: From $90,000.00 per year

Benefits:

401(k)
Dental insurance
Flexible spending account
Health insurance
Paid time off
Vision insurance

Work Location: Remote

Quick Apply

Refine Your Search

medical claims manager jobs in merced, ca

Workers' Compensation Claims Examiner

Inventory Auditor

Fully Remote- Pre-litigation/Litigation Attorney (Personal Injury)

Personal Lines Account Manager - Turlock, CA

Branch Manager

Location Manager

Worker's Compensation Program Manager

Application Services Director

Pharmacy Technician / Pharm Tech Apprenticeship

Risk Adjustment Director

Certified Pharmacy Technician

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