California Licensed Claims Specialist

To support a short-term assignment, the California Licensed Claims Specialist will manage technical support for appeals and call center tasks, handle escalated claim-related inquiries, and assist with complex claim adjustments while working remotely. Key responsibilities Fulfill technical support needs for appeals and support staff, ensuring consistent and accurate task execution Perform root cause analysis for claim issues and collaborate with other business units to implement preventive solutions Assist in cross-training and identify training needs and Lean improvements for unit workflows Required qualifications Four years of experience in a managed care environment focusing on claims processing, appeals, and customer service Thorough understanding of medical claim processing, including Medi-Cal/Medicare experience High school diploma or GED required Proficiency in Microsoft Office, particularly Advanced Microsoft Excel Ability to type a minimum of 45 wpm and demonstrate strong organizational skills