Top 224 Senior underwriter, insurance Jobs in Napa, Ca

Claims Resolution Coordinator
Partnership HealthPlan of California —Fairfield, CA
- $37.22 - $46.53 an hour
- Full-time
- Computer literacy
- Mid-level
- Office
Claims Examiner II
Partnership HealthPlan of California —Fairfield, CA
- $31.45 - $37.74 an hour
- Research
- Mid-level
- Office
Senior Underwriter, Insurance
HUB International —Napa, CA
- $80,000 - $150,000 a year
- Full-time
- Hybrid work
- Research
- High school diploma or GED
- Business development
- Disability insurance
- Health insurance
1d
Claims Customer Service Representative I
Partnership HealthPlan of California —Fairfield, CA
- $29.95 - $35.19 an hour
- Full-time
- Computer literacy
- Research
- High school diploma or GED
Independent Insurance Field Inspector
National Risk Services —Sonoma, CA
- Contract
- Bilingual
- Background check
- Computer literacy
- Flexible schedule
Quick Apply
8d
Insurance Defense Attorney
Distinct Recruitment —California
- $145,000 - $250,000 a year
- Full-time
- Remote
- Writing skills
- Mid-level
- 2 years
- Health insurance
- Dental insurance
Quick Apply
2d
Admissions Specialist - PER DIEM
Mountain Vista Farm —Glen Ellen, CA
- $25 - $27 an hour
- Part-time
- Hybrid work
- Background check
- Mid-level
- Continuous improvement
Quick Apply
Insurance Sales - Licensed/Non-licensed
Optavise —Vacaville, CA
- $60,000 - $85,000 a year
- Full-time
- Leadership
- Entry level
Quick Apply
Medicare Sales Agent - Independent Contractor (1099) Opportunity
MyPlanAdvocate —California
- $65,000 - $85,000 a year
- Contract
- Remote
- Mid-level
Medicare Sales Independent Contractor (1099) - Remote
MyPlanAdvocate —California
- $65,000 - $85,000 a year
- Contract
- Remote
- Mid-level
Underwriting Specialist OR Executive Underwriter - Large Contract Surety
Zurich Insurance Company Ltd. —California
- $75,000 - $165,000 a year
- Full-time
- Hybrid work
- Mid-level
- High school diploma or GED
- Business development
Paralegal (Insurance Defense) #2963194
Resnick & Louis, P.C. —California
- $60,000 - $85,000 a year
- Full-time
- Remote
- 5 years
- Research
- US work authorization
- Disability insurance
- Health insurance
Quick Apply
14d
Medicare Sales Agent - Independent Contractor (1099) Opportunity
MyPlanAdvocate —California
- $65,000 - $85,000 a year
- Contract
- Remote
- Mid-level
SALES DESIGN CONSULTANT – FLOORING SHOWROOM SALES
The Floor Store —Fairfield, CA
- $25 - $35 an hour
- Weekends as needed
- Bilingual
- Sales
- Ability to walk for extended periods
- Health insurance
- Dental insurance
Quick Apply
3d
Account Manager, Commercial Lines
Heffernan Network Insurance Brokers —Sonoma, CA
- $75,000 - $90,000 a year
- Full-time
- Hybrid work
- Mid-level
- 3 years
- High school diploma or GED
Quick Apply
Commercial Auto Underwriter-Middle Mile Delivery Program
HUB International —Napa, CA
- Full-time
- Remote
- 5 years
- Bachelor's degree
- Travel
1d
Claims Trainer
Partnership HealthPlan of California —Fairfield, CA
- $33.65 - $40.38 an hour
- Mid-level
- Office
- Driver's License
High Value Residential Insurance Inspector
Signature Companies —Santa Rosa, CA
- Mid-level
- Office
- Driving
Claims Assistant (Part-Time Contract)
BayInfotech —Martinez, CA
- $26.40 - $31.80 an hour
- Part-time
- Microsoft Outlook
- Office
- Administrative experience
Quick Apply
Napa, CA - Field Inspector - Insurance Loss Control
H & S Loss Control Inspections —Napa, CA
- $60 - $75 an hour
- Online Application
- Up to 50% travel
- Customer service
- Writing skills
Quick Apply

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Claims Resolution Coordinator

Partnership HealthPlan of California -
Fairfield, CA

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Job Details

Full-time
$37.22 - $46.53 an hour

Qualifications

ICD-9
Driver's License
Typing

Full Job Description

Overview:

To research and resolve complex claims issues which cross interdepartmental lines and communicate the outcome to providers and affected Partnership managers. Develops and maintains provider training materials for all lines of business. Conducts provider trainings across Partnership departmental lines in group or individual provider settings.

Responsibilities:

Answers customer service lines as necessary and responds to provider inquiries either by phone, email, or in person regarding claims related questions.
Reviews, researches, and works with various departments to resolve complex provider inquiries, appeals, and grievances.
Acts as a resource and provides support to customer service staff, as well as Provider Relations staff for complex Provider questions regarding claims and payments.
Coordinates with Claims, Member Services, Health Services departments, the development, maintenance, and training of ongoing educational materials and tips for inclusion on the PHC website. Incorporates educational materials into the PR Manual and update on a quarterly basis.
Processes CIF's and adjustments as needed.
Writes and runs reports in Business Objects to obtain needed claim data.
Tracks and analyzes provider trends with denials and CIF's to provide support to providers with an opportunity to improve. Distributes provider scorecards.
Tracks complaints, appeals, and grievances by program. Reports activities on a quarterly basis to IQI, PHC Compliance Coordinator, and Claims Director.
Presents findings and recommendations for ongoing, long term resolutions to issues. Identifies items to address the “provider hassle factor.”
Acts as liaison and meets with designated staff from Claims, Health Services, Member Services, and QI departments to identify ongoing provider issues.
Coordinates system issues with Claims Configuration staff, IT staff, and PR Lead Project Specialist/Auditor. Leads or participates in special projects as needed.
Other duties as assigned

Qualifications:

Education and Experience

Minimum 1 year of experience in claims examining or customer service within healthcare, insurance, finance, or managed care environment; or equivalent combination of relevant experience and education.

Special Skills, Licenses and Certifications

Familiarity with Medi-Cal and/or managed care claims processing. Knowledge of CPT, HCPC procedure coding, and ICD-9 diagnostic coding. Knowledge of Partnership Claim Policy and Procedures, Medi-Cal provider manual guidelines, Title 22 regulations and any other required policies, procedures, regulations, and manuals. Typing speed 30 wpm and proficient use of 10-key calculator. Valid California driver’s license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business .

Performance Based Competencies

Ability to analyze and research claims issues. Excellent written and oral communication skills. Ability to present statistical and technical data in a clear and understandable manner. Good organization skills. Ability to work on multiple assignments simultaneously, prioritize work and complete projects within established time frames. Use good judgment in making decisions within scope of authority and handle sensitive issues with tact and diplomacy.

Work Environment And Physical Demands

Ability to use a computer keyboard. More than 60% of work time is spent in front of a computer monitor. When required, ability to move, carry or list objects of varying size, weighing up to 5 lbs.

All HealthPlan employees are expected to:

Provide the highest possible level of service to clients;
Promote teamwork and cooperative effort among employees;
Maintain safe practices; and
Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

HIRING RANGE:

$ 37.22 - $ 46.53

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Apply Now

Refine Your Search

senior underwriter, insurance jobs in napa, ca

Claims Resolution Coordinator

Claims Examiner II

Senior Underwriter, Insurance

Claims Customer Service Representative I

Independent Insurance Field Inspector

Insurance Defense Attorney

Admissions Specialist - PER DIEM

Insurance Sales - Licensed/Non-licensed

Medicare Sales Agent - Independent Contractor (1099) Opportunity

Medicare Sales Independent Contractor (1099) - Remote

Underwriting Specialist OR Executive Underwriter - Large Contract Surety

Paralegal (Insurance Defense) #2963194

Medicare Sales Agent - Independent Contractor (1099) Opportunity

SALES DESIGN CONSULTANT – FLOORING SHOWROOM SALES

Account Manager, Commercial Lines

Commercial Auto Underwriter-Middle Mile Delivery Program

Claims Trainer

High Value Residential Insurance Inspector

Claims Assistant (Part-Time Contract)

Napa, CA - Field Inspector - Insurance Loss Control

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