Current jobs related to Claims Department Manager - Fremont - AppleOne

  • Claims Department Manager

    2 months ago

    Fremont, United States TITAN Insurance Administrators, Inc. Full time

    Claims Department ManagerA progressive third-party administrator of union health and welfare benefits, TITAN Insurance Administrators Inc. is seeking an experienced Claims Department Manager with a proven track record in Managing a Claims Processing Department to join our dedicated team. This is a highly visible leadership position.Job Description:The...

  • Claims and Benefits Manager

    2 weeks ago

    Fremont, California, United States TITAN Insurance Administrators, Inc. Full time

    Job SummaryThe Claims Department Manager will oversee the day-to-day operations of the claims department, ensuring timely and accurate processing of claims. This role requires a strong leader with excellent communication and analytical skills.Key ResponsibilitiesManage claims evaluation, adjudication, analysis, auditing, and customer serviceOversee...

  • Claim Resolution Specialist

    4 weeks ago

    Fremont, California, United States Info Way Solutions Full time

    Job Title: Claim OperatorAt Info Way Solutions, we are seeking a highly skilled Claim Operator to join our team. As a Claim Operator, you will play a critical role in ensuring the timely and accurate resolution of claims.Key Responsibilities:Review new submissions to ensure all required documentation and claim details are includedFile and manage shortage...

  • Claim Resolution Specialist

    4 weeks ago

    Fremont, California, United States Info Way Solutions Full time

    Job Title: Claim Resolution SpecialistAt Info Way Solutions, we are seeking a highly skilled Claim Resolution Specialist to join our team. As a key member of our logistics team, you will be responsible for resolving freight claims in a timely and accurate manner.Review new submissions to ensure all required documentation and claim details are included.File...

  • Claim Resolution Specialist

    3 weeks ago

    Fremont, California, United States Info Way Solutions Full time

    Job SummaryAs a Claim Resolution Specialist at Info Way Solutions, you will play a critical role in ensuring timely and accurate resolution of freight claims. Your attention to detail and analytical skills will be essential in reviewing new submissions, investigating damage claims, and communicating with logistics service providers. If you have a strong...

  • Freight Claims Processor

    3 weeks ago

    Fremont, California, United States Info Way Solutions Full time

    Freight Claims ProcessorAt Info Way Solutions, we are seeking a skilled Freight Claims Processor to join our team. As a key member of our operations team, you will be responsible for reviewing new submissions, investigating claims, and communicating with logistics service providers to ensure timely and accurate resolutions.Key Responsibilities:Review new...

  • ESIS Claims Representative, WC

    3 weeks ago

    Fremont, California, United States Chubb Full time

    Job SummaryThe ESIS Claims Representative, WC is responsible for investigating and settling workers compensation claims in a timely and equitable manner. This role requires strong analytical and communication skills, as well as the ability to work independently and as part of a team.Key Responsibilities Investigate and analyze workers compensation claims to...

  • Insurance Aging Claim Specialist-IN PERSON ONLY

    2 months ago

    Fremont, United States Cedar Dental Care Part time $25 - $32

    Job Title: Insurance Aging Claims SpecialistREMOTE BILLERS PLEASE DO NOT REACH OUTReports to: Office Manager/Dental AdministratorJob Summary:We are seeking an experienced Insurance Aging Claims Specialist to join our dental team. The successful candidate will be responsible for managing and resolving outstanding insurance claims, ensuring timely payment, and...

  • Deputy Labor Commissioner III

    4 weeks ago

    Fremont, California, United States Department of Industrial Relations Full time

    Job Description and DutiesUnder the direction of the Deputy Labor Commissioner IV (Regional Manager), the Senior Deputy is responsible for supervising, planning, organizing, and reviewing the work of team members as well as offering ongoing training and education. In addition, the Senior Deputy collaborates with other programs and stakeholders to promote...

  • Public Affairs Manager

    4 weeks ago

    Fremont, California, United States Department of Transportation Full time

    Job Title: Public Affairs ManagerUnder the direction of the Deputy of External Affairs, the Public Affairs Manager is responsible for assisting in the planning, organization, direction, coordination, evaluation, and management of media relations for the Department of Transportation. The Public Affairs Manager is responsible for media relations, strategic...

  • Service Operations Manager

    3 weeks ago

    Fremont, California, United States Fremont Chevrolet Full time

    Service Operations ManagerFremont Chevrolet is committed to delivering exceptional customer experiences. As a Service Operations Manager, you will oversee the service department, ensuring that customers receive prompt, courteous, and effective service.Key Responsibilities:Oversee service orders and flow of the Drive LaneEnsure daily inventory of technicians'...

  • Information Technology Manager

    4 weeks ago

    Fremont, California, United States Department of Industrial Relations Full time

    Job Description and DutiesUnder the general direction of the Assistant Chief Information Officer of the Department of Industrial Relations in the Office of Information Services, the incumbent performs managing, coordination, technical project delivery, reporting, and support over the full range of activities involving the department's Cloud Migration and...

  • Facilities Operations Manager

    4 weeks ago

    Fremont, California, United States Department of Transportation Full time

    Job Description and DutiesUnder the direction of the Office Chief of Business Operations, the Staff Services Manager II has overall responsibility for managing, directing, organizing, and planning the Facilities, Logistics, Security and Building Safety operations. Specific responsibilities include managing the programs of: Facilities Operations, Logistics...

  • Heavy Equipment Service Manager

    1 month ago

    Fremont, Nebraska, United States Gpac Full time

    Heavy Equipment Service Manager Job SummaryWe are seeking a highly skilled and experienced Heavy Equipment Service Manager to join our team at Gpac. As a key member of our service department, you will be responsible for developing and implementing effective service processes to ensure customer satisfaction.Key Responsibilities:Develop and communicate service...

  • Staff Services Manager I

    4 weeks ago

    Fremont, California, United States Department of Rehabilitation Full time

    Job Description and DutiesThis position is located in the Department of Rehabilitation and reports to the Staff Services Manager II (District Administrator). The Team Manager Staff Services Manager I provides direct supervision over the Vocational Rehabilitation Service Delivery Team staff in an office/catchment area consisting of Senior Vocational...

  • Information Technology Manager I

    3 weeks ago

    Fremont, California, United States Department of Industrial Relations Full time

    Job Title: Information Technology Manager IThe Department of Industrial Relations is seeking a highly skilled Information Technology Manager I to lead the Cloud Migration Project. As a key member of the Office of Information Services, you will be responsible for managing, coordinating, and delivering technical projects related to DIR's Cloud Migration and...

  • Heavy Equipment Service Manager

    3 weeks ago

    Fremont, Nebraska, United States Gpac Full time

    Heavy Equipment Service Manager Job SummaryGpac is seeking a highly skilled Heavy Equipment Service Manager to lead our dynamic team. As a seasoned professional with a passion for great customer service and quality repairs, you will thrive in a fast-paced environment.About Us:Gpac is working with a long-standing heavy equipment company that prides itself on...

  • CDL Safety Manager

    4 weeks ago

    Fremont, California, United States TriSearch Full time

    Job SummaryThis role reports directly to the Assistant Vice President, Safety & Risk Management. The primary responsibilities of this position are to implement and ensure detailed Safety Programs are executed for the operation. This position works with and in conjunction with the Operations Team to ensure drivers' training and in-service hours are maintained...

  • CDL Safety Manager

    3 weeks ago

    Fremont, California, United States TriSearch Full time

    Job SummaryThis position reports directly to the Assistant Vice President, Safety & Risk Management. The primary responsibilities of this position are to implement and ensure detailed Safety Programs are executed for the operation. This position works with and in conjunction with the Operations Team to ensure drivers' training and in-service hours are...

  • CDL Safety Manager

    1 month ago

    Fremont, United States TriSearch Full time

    Job SummaryThis position reports directly to the Assistant Vice President, Safety & Risk Management. The primary responsibilities of this position are to implement and ensure detailed Safety Programs are executed for the operation. This position works with and in conjunction with the Operations Team to ensure drivers’ training and in-service hours are...

Claims Department Manager

2 months ago

Fremont, United States AppleOne Full time
Job DescriptionJob DescriptionClaims Department Manager
Report to: President

A progressive third-party administrator of union health and welfare benefits, is seeking an experienced Claims Department Manager with a proven track record in Managing a Claims Processing Department to join their dedicated team. This is a highly visible leadership position.

The Claims Department Manager manages day-to-day claims operations, including claims evaluation, adjudication, analysis, auditing, and customer service, in accordance with quality and production standards. Ensures that claims are processed in a timely manner in compliance with company policies and applicable regulations, concerning the processing of claims. Oversees 2 Assistant Managers in managing a staff of 12 Claims department employees for performance, HIPAA Compliance, following company policies and attendance requirements. Oversees preparation, analysis and distribution of various reports, as well as; Medical Review letters, Appeals and other Claims related information/documentation.

Requirements:

Bachelor’s Degree preferred and a least 10 years of experience Supervising claims processing, encompassing knowledge and understanding of group benefit plans, how they relate to claims processing; including plan benefits, eligibility, limitations, exclusions, etc.

Requires experience in on-line claims adjudication and a working knowledge of claims codes and descriptions, medical terminology, PPO provider guidelines, eligibility, limitations, exclusions, case management and medical review.

Must be familiar with medical terminology, R.V.S., C.P.T., I.C.D.A., Diagnosis Codes (ICD-10), and H.C.P.C.S. codes.

Ability to develop knowledge and understanding of company and applicable Carrier’s computer systems (currently Anthem Blue Cross) to the extent necessary for on-line claims processing, data entry and other related responsibilities.

Ability to accurately interpret plan benefits, process claims, re-calculate claims; performing (sometimes complicated) calculations, applying formulas using multiplication and percentages.

Develop knowledge and understanding of PPO guidelines and procedures, coordination of benefits, Medicare and supplemental plan benefits.

Apply for this great position as a claims department manager today

EEO/AA Employer/Vet/Disabled.

The Know Your Rights poster is available here:
https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf

The pay transparency policy is available here:
https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf

For temporary assignments lasting 13 weeks or longer, the Company is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.

AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.
https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf

We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

#1038

Company DescriptionFounder and CEO, Janice Bryant Howroyd, is a North Carolina native who left her hometown in 1976 armed with $1500. Since then, she has dedicated her efforts to building an organization that is committed to keeping the humanity in Human Resources and Strategic, Inclusive Procurement.

Mrs. Howroyd’s commitment to excellence has grown ActOne Group to 33 countries, with over 17,000 clients and more than 2,800 employees. The largest woman-minority-owned workforce management company founded in the US, ActOne Group professionals bring expertise in delivering corporate HR initiatives to local and global markets.

Mrs. Howroyd was selected by former President Barack Obama to serve as a White House appointee and continues to serve under the current administration as an Ambassador of Energy. Mrs. Howroyd gives generously through funding and advocacy for STEM education, particularly for women and minorities.

Mrs. Howroyd leads her teams to build business success based on the ability to connect great companies with outstanding talent. Her passion for education, mentorship, and self-empowerment initiatives have earned her many professional and philanthropic recognitions. She is a sought–after speaker and media subject matter expert in her fields. Her book, The Art of Work: How to Make Work, Work for You, is available on Amazon.com.Company DescriptionFounder and CEO, Janice Bryant Howroyd, is a North Carolina native who left her hometown in 1976 armed with $1500. Since then, she has dedicated her efforts to building an organization that is committed to keeping the humanity in Human Resources and Strategic, Inclusive Procurement.\r
\r
Mrs. Howroyd’s commitment to excellence has grown ActOne Group to 33 countries, with over 17,000 clients and more than 2,800 employees. The largest woman-minority-owned workforce management company founded in the US, ActOne Group professionals bring expertise in delivering corporate HR initiatives to local and global markets.\r
\r
Mrs. Howroyd was selected by former President Barack Obama to serve as a White House appointee and continues to serve under the current administration as an Ambassador of Energy. Mrs. Howroyd gives generously through funding and advocacy for STEM education, particularly for women and minorities.\r
\r
Mrs. Howroyd leads her teams to build business success based on the ability to connect great companies with outstanding talent. Her passion for education, mentorship, and self-empowerment initiatives have earned her many professional and philanthropic recognitions. She is a sought–after speaker and media subject matter expert in her fields. Her book, The Art of Work: How to Make Work, Work for You, is available on Amazon.com.