Top 278 Regional quality Jobs in Stockton, Ca

Claims Processor, Advanced (First Pass-Rework)
Blue Shield of California —Lodi, CA
- $22.51 - $31.52 an hour
- Full-time
- Hybrid work
- Background check
- 5 years
- Pass drug screening
- Work from home
3d
Service Coordinator
Valley Mountain Regional Center —Stockton, CA
- $25.04 - $35.24 an hour
- Full-time
- Data analysis skills
- Adults
- Office
Quick Apply
Senior Regional Quality Operations Specialist
WelbeHealth —Stockton, CA
- $82,074.03 - $108,337.72 a year
- Hybrid work
- HIPAA
- 3 years
- Master's degree
- Health insurance
- Dental insurance
Quick Apply
Safety Specialist 2 - Woodbridge
The Wine Group —Acampo, CA
- $75,400 - $113,200 a year
- Full-time
- Management
- 5 years
- Ability to lift 50 pounds
Gastroenterology Physician
MedConnect —Stockton, CA
- $435,000 - $542,723 a year
- Full-time
- BC/BE
- Clinic
- Surgery
- Health insurance
- 401(k)
Quick Apply
Senior BCBA - Social Skills Group Lead
Active Steps —Stockton, CA
- $87,000 - $92,500 a year
- Full-time
- Hybrid work
- Background check
- Experience working with individuals with developmental disabilities
- Spanish
- Travel reimbursement
- Continuing education credits
Quick Apply
SW Regional CDL-A Truck Driver
MC CARRIER LLC —California
- $0.50 - $0.57 per mile
- Clean driving record
- Dry van
- CDL A
- Passenger ride along program
- Paid time off
Quick Apply
Nurse Manager of CVOR Cardiovascular Operating Room
Clinical Management Consultants —Brentwood, CA
- $223,910 - $281,040 a year
- Full-time
- Nursing
- Surgery
- Critical & Intensive Care
- Health insurance
- Paid time off
Supplier Quality Analyst
Noramtec Consultants Americas —California
- From $35 an hour
- Contract
- Microsoft Word
- Background check
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
3d
Senior Field Service Technician
Pregis LLC —Stockton, CA
- $80,000 - $85,000 a year
- Overtime
- Clean driving record
- 5 years
- Ability to lift 50 pounds
Quick Apply
10d
Street Outreach Manager (Field-Based) - California
Pacific Health Group —Stockton, CA
- $80,000 - $90,000 a year
- Weekends as needed
- Hybrid work
- Background check
- Mid-level
- Clean MVR report
- AD&D insurance
- Paid holidays
Quick Apply
BCBA and BCaBA Career Opportunity at Team PBS in California
Positive Behavior Supports Corporation —Manteca, CA
- Up to $118,000 a year
- Part-time
- School experience
- Management
- Mid-level
- Paid holidays
- Health insurance
Occupational Therapist
Stockton Regional Rehabilitation Hospital —Stockton, CA
- $53.11 - $71.48 an hour
- Full-time
- CPR Certification
- Surgery
- Hospital
- Travel reimbursement
- Wellness program
Quick Apply
10d
Regional Sales Executive
GRAYWOLF INTEGRATED CONSTRUCTION COMPANY —California
- Weekends as needed
- Clean driving record
- Microsoft Outlook
- Up to 50% travel
Quick Apply
Program Administrator (Children's home)
YAI - Seeing Beyond Disability —Byron, CA
- $85,000 - $90,000 a year
- Full-time
- LVN
- Psychiatry
- HIPAA
- 403(b) matching
- Health savings account
Quick Apply
8d
RN Case Manager Experienced (IKC-CA)
DAVITA —Stockton, CA
- $42 - $55 an hour
- Full-time
- Hybrid work
- Microsoft Word
- CPR Certification
- Nursing
- Health insurance
- Dental insurance
Quick Apply
Federal Construction Superintendent
Leoforce —Stockton, CA
- $95,000 - $145,000 a year
- 7 years
- Construction site
- Military encouraged
- Fuel card
- Health insurance
Quick Apply
12d
OFFICE TECHNICIAN (TYPING)
California Correctional Health Care Services —San Joaquin County, CA
- $3,829 - $4,794 a month
- Multiple hires
- Administrative experience
- Fingerprint clearance
- Typing
9d
Unit Secretary - Part Time
Ernest Health —Stockton, CA
- $23.00 - $27.49 an hour
- Full-time
- Surgery
- Word processing
- Computer literacy
- Wellness program
- Health savings account
Receptionist - PRN
Ernest Health —Stockton, CA
- $23.10 an hour
- Full-time
- Surgery
- Hospital
- Word processing
- Wellness program
- Health savings account

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Claims Processor, Advanced (First Pass-Rework)

Blue Shield of California -
Lodi, CA

Apply Now

Job Details

Full-time
$22.51 - $31.52 an hour
3 days ago

Benefits

Work from home

Qualifications

Spreadsheets
High school diploma or GED
Productivity software

Full Job Description

Your Role

The Commercial First Pass Claims and Rework teams are responsible for processing work in enrollment, claims, provider, or other operational areas to meet operational, financial, and service requirements including timely and proper enrollment, adjudication of claims, or provider demographics updates in accordance with contractual requirements. The Claims Processor, Advanced will report to a Claims Operations Supervisor. In this role you will review and adjudicate complex/specialty paper/electronic claims and determine whether to return, deny, or pay claims following organizational policies and procedures, and may provide guidance or expertise to less experienced claims processors.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Work

In this role, you will:

Be proficient in front and back-end processing
Process multiple claim types or specialties
Act as a Subject Matter Expert (SME) with one product cross functionally
Possess a solid understanding and knowledge of system processing with the ability to not only identify errors but to analyze and resolve them
Act as back-up for lead role Mentors associate and intermediate level rep
Make or receive calls regarding claims processing questions and clarifications and provide excellent customer service
Understand fundamentals of end-to-end (life of a clam) claims processing

Your Knowledge and Experience

Requires a High School Diploma or GED
Requires at least 5 years of prior relevant experience
Minimum years of 2 years of backend claims processing preferred
Experience with Microsoft office, including Microsoft Excel
Ability to process calculations for claims processing

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.

ABOUT THE TEAM
About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!

Our Values:

Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

For most teams, this means coming into the office two days per week.
Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

Apply Now

Refine Your Search

regional quality jobs in stockton, ca

Claims Processor, Advanced (First Pass-Rework)

Service Coordinator

Senior Regional Quality Operations Specialist

Safety Specialist 2 - Woodbridge

Gastroenterology Physician

Senior BCBA - Social Skills Group Lead

SW Regional CDL-A Truck Driver

Nurse Manager of CVOR Cardiovascular Operating Room

Supplier Quality Analyst

Senior Field Service Technician

Street Outreach Manager (Field-Based) - California

BCBA and BCaBA Career Opportunity at Team PBS in California

Occupational Therapist

Regional Sales Executive

Program Administrator (Children's home)

RN Case Manager Experienced (IKC-CA)

Federal Construction Superintendent

OFFICE TECHNICIAN (TYPING)

Unit Secretary - Part Time

Receptionist - PRN

I want to receive the latest job alert for regional quality in stockton, ca

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