Careers

In this role you will work with various departments, such as; Claims, Billing, and Legal to ensure monies which are a result of overpayments and/or claims adjustments are pursued and collected appropriately.

What you'll do:
 A.    Research, review and analyze all overpayments, refunds and voids relating to medical/dental/vision claims.
 B.    Collect monies for the WG Assurant Trust and clients of the TPA (third party administrator) that may be a result...

Job Type:
Insurance

As the Director of Sales and Account Management you will report directly to the President of Pinnacle Claims Management, Inc. (PCMI) and have the following direct reports: one Regional Sales Manager, one Account Executive, four Account Managers and one Business Development...

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The Provider Contracts Manager is accountable for the management of the contracting and network management activities to ensure superior access to the highest quality, cost-effective Providers of healthcare services for our...

Job Type:
Insurance

As an Account Manager for this Third Party Administror (TPA) you will be  responsible for managing customer accounts during and following the sale of employer benefit programs and services including third party administration (TPA) of health care benefits, complete ancillary benefits offered by PCMI vendor partners including Western Growers Insurance Services (WGIS) employer benefit programs.  The Account Manager working in collaboration with internal operation and administration...

Job Type:
Sales - Insurance

As the Care Managment Review RN you will be responsible for the management and operation of the Care Management programs to ensure program compliance, promote quality care and effective cost savings for our patients and clients. 

You can look forward to:

•    Coordinating the care management review process (electronically & telephonically) of other health care companies as necessary (i.e., American Healthcare, Anthem) and provide assistance with problem...

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This is a fast pace Call Center environment. Our Customer Service Representative I position provides consultative telephonic and web-based assistance regarding Covered California’s health plans, insurance coverage, and application/enrollment processes. We provide service to a wide range of customers including; Brokers/Agents, Doctor Offices, Small Businesses, Employees/...

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