Claims Auditor/Trainer Job at Robert Half (Oakland)

Claims Auditor/trainer

Unlock Your Next Career Move: Claims Auditor/Trainer Are you meticulous, complia...

Location

United States , Oakland

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High school diploma, GED or equivalent
Four or more years of medical claims payment experience in an HMO environment
Experience with CPT-4, ICD-9CM, RBRVS, ASA, and HCPCS
Understanding of Medicare Guidelines and COB
Knowledge of medical terminology
Experience in benefit determination and claims adjudication
Understanding of detail oriented and facility reimbursement methodologies
Strong organizational skills
Computer proficiency with Microsoft Office
Knowledge of claims adjudication systems (Easy Cap a plus)

Job Responsibility

Conduct audits of processed claims (paid, pending, denied) to verify accuracy in medical coding (ICD-10, CPT, HCPCS), benefit application, and compliance with California's Knox-Keene Act and Medi-Cal regulations
Develop and deliver training for Claims Examiners, including creation of educational materials on workflows, policy updates, and new technologies
Investigate complex claim issues, provider disputes, and appeals
identify root causes for systemic issues and recommend corrective actions
Track and report statistical data on MSO quality and production
Prepare regular reports for management
Maintain current knowledge of state and federal billing laws (CMS/Medicare) to ensure compliance and readiness for audits

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

New

Cloud Support Engineer/Specialist

Qualified candidate will provide unified production management support for the C...

Location

Mexico , Guadalajara

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

Bachelor’s degree in Information Technology, Computer Information Systems, Computer Science, or a related field
3-5 years of experience in Cloud Support Engineer role
Strong understanding of AWS, Cloud infrastructure, Unix/Linux-based operating system, commands and utilities, as well as Configuration Management Tools
Experience of multiple AWS services: IAM, Lambda, ECS, S3, Security, VPC, Load Balancing, Monitoring & Audit
General troubleshooting and debugging of AWS based applications
Problem solving in a large enterprise Infrastructure support environment, including experience with observing patterns, analyzing root cause and suggesting ideas for resolution
Good communication skills with ability to articulate the technical and functional aspects of a development/production problem to help drive solutions with application development teams and senior stakeholders
Experience with Infrastructure as code (IaC)
Understanding of one of the Scripting languages: Shell script or Python

Job Responsibility

Perform Cloud Infrastructure Support activities as part of the Firm’s Technical Infrastructure team
Improve Infrastructure stability and performance by analyzing patterns, recurring failures and/or issues, and advise and drive application owners on permanent fixes
Manage incidents by effectively troubleshooting issues, knowing what the risk involved in preforming actions in a production environment
Collaborate globally with in the team, application owners, senior stakeholders and end users

Fulltime

New

Pharmacy Technician

We’re building a world of health around every individual — shaping a more connec...

Location

United States , Biddeford

Salary:

17.10 - 27.10 USD / Hour

CVS Health

Expiration Date

August 01, 2026

Requirements

Must comply with any state board of pharmacy requirements or laws governing the practice of pharmacy, which includes but is not limited to, age, education, and licensure/certification
If the state board of pharmacy does not address or mandate a minimum age requirement, must be at least 16 years of age
If the state board of pharmacy does not address or mandate a minimum educational requirement, must have a high school diploma or equivalent, or be actively enrolled in high school or high school equivalency program
State-level licensure and national certification requirements vary by state
Regular and predictable attendance, including nights and weekends
Ability to complete required training within designated timeframe
Attention and Focus: Ability to concentrate on a task over a period of time
Ability to pivot quickly from one task to another to meet patient and business needs
Ability to confirm prescription information and label accuracy, ensuring patient safety
Customer Service and Team Orientation: Actively look for ways to help people, and do so in a friendly manner

Job Responsibility

Living our purpose by following all company SOPs at each workstation to help our Pharmacists manage and improve patient health
Following pharmacy workflow procedures at each pharmacy workstation (i.e., production, pick-up, drive-thru, and drop-off) for safe and accurate prescription fulfillment
Contributing to positive patient experiences by showing empathy and genuine care: creating heartfelt and personalized moments while serving patients at pick-up, drive-thru, and over the phone
keeping patients healthy by offering immunizations and other services at the register and over the phone
and demonstrating compassionate care by solving or escalating patient problems
Completing basic inventory activities, as permitted by law, and as directed by the pharmacy leadership team, such as accurately putting away medication deliveries and completing cycle counts, returns-to-stocks, waiting bin inventories, etc.
Contributing to a high-performing team, embracing a growth mindset, and being receptive to feedback
actively seeking opportunities to expand clinical and technical knowledge needed to better assist patients
Remaining flexible for both scheduling and business needs, while contributing to a safe, inclusive, and engaging team dynamic
voluntarily traveling to stores in the market to work shifts as needed by the business

What we offer

Medical, dental, and vision coverage
Paid time off
Retirement savings options
Wellness programs

Fulltime

New

Pharmacy Technician

We’re building a world of health around every individual — shaping a more connec...

Location

United States , Ipswich

Salary:

17.00 - 27.00 USD / Hour

CVS Health

Expiration Date

Until further notice

Requirements

Must comply with any state board of pharmacy requirements or laws governing the practice of pharmacy, which includes but is not limited to, age, education, and licensure/certification
If the state board of pharmacy does not address or mandate a minimum age requirement, must be at least 16 years of age
If the state board of pharmacy does not address or mandate a minimum educational requirement, must have a high school diploma or equivalent, or be actively enrolled in high school or high school equivalency program
Attention and Focus
Customer Service Orientation
Communication Skills
Mathematical Reasoning
Problem Resolution
Physical demands: remaining upright on the feet particularly for sustained periods
moving about on foot

Job Responsibility

Manage all assigned pharmacy workstations and tasks to support the team’s ability to promptly, safely and accurately fill patient prescriptions
provide caring service that exceeds customer expectations
complete an extensive CVS Pharmacy Technician Training Program
satisfy all registration, licensing and certification requirements according to your State’s Board of Pharmacy guidelines

What we offer

Medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
other resources based on eligibility

Fulltime

New

Demand Planner

As Demand Planner, you’ll sit at the heart of our supply chain owning demand for...

Location

United Kingdom , Uxbridge

Salary:

Not provided

Advocate Group

Expiration Date

Until further notice

Requirements

2+ years’ experience in Demand Planning within FMCG
Experience with SAP IBP (preferred)
Strong Excel and analytical capability
Solid understanding of S&OP processes
Ability to manage multiple priorities in a fast-paced environment
Confident communicator with strong stakeholder management skills
A proactive, solutions-focused mindset with a strong sense of ownership

Job Responsibility

Analyse and manage demand forecasts from distributors and bottlers across EMEA
Maintain and optimise forecast data within SAP IBP
Identify trends, risks, and opportunities to improve forecast accuracy and inventory health
Monitor slow-moving and obsolete stock, driving actions with key stakeholders
Proactively flag demand shifts and mitigate risks such as stock-outs
Partner closely with cross-functional teams including Commercial, Supply Planning, and NPD
Support new product launches with accurate demand planning inputs
Lead demand review meetings and contribute to the wider S&OP process
Track and publish forecast performance metrics

New

National Account Manager

Location

United Kingdom , Newcastle upon Tyne

Salary:

35000.00 - 40000.00 GBP / Year

Advocate Group

Expiration Date

Until further notice

Requirements

Previous experience within a National Accounts, Commercial, or Category role, such as NAE, JNAM, Buying Assistant, or a similar customer-facing position
A strong understanding of the FMCG or consumer goods landscape and how major retail accounts operate
Confident building and delivering engaging retailer presentations that combine data, insight, and commercial recommendations
Comfortable analysing data from multiple sources to identify trends, opportunities, and areas for improvement
Experience using market, retailer, or category data platforms such as Nielsen, Kantar, retailer portals, or similar tools
Commercially minded, with the ability to turn insight into practical actions that deliver measurable results
Strong relationship-building skills with the confidence to influence both internal and external stakeholders
Highly organised, with the ability to manage multiple priorities and deadlines in a fast-paced environment
A proactive, solutions-focused individual with a positive attitude and a desire to continuously learn and develop
Passionate about driving growth, delivering results and building long-term partnerships with customers.

Job Responsibility

Take ownership of a portfolio of national retail accounts, driving profitable growth and delivering against sales, margin, and commercial objectives
Manage account performance across revenue, profitability, promotional investment, and forecasting, ensuring business targets are consistently achieved
Build and maintain strong relationships with key stakeholders across customer organisations, including buying, category, supply chain, marketing, and finance teams
Protect and grow product distribution by identifying opportunities and presenting compelling, insight-led category recommendations
Develop and execute promotional plans that drive both volume and value growth, using performance data and post-campaign analysis to continuously improve results
Lead the successful launch of new products, creating tailored activation plans that maximise visibility, distribution, and customer engagement
Partner with internal marketing and eCommerce teams to deliver a seamless omnichannel experience across both physical and digital retail environments
Develop a deep understanding of retailer objectives, category performance, and market dynamics to identify opportunities for mutual growth.

Fulltime

New

National Account Manager - Boots

We're partnering with a globally recognised consumer brand who as part of contin...

Location

United Kingdom , London

Salary:

55000.00 - 60000.00 GBP / Year

Advocate Group

Expiration Date

Until further notice

Requirements

National Account Management experience within FMCG, beauty, consumer goods or a related sector
Experience managing Boots as a customer
Strong commercial negotiation skills
P&L ownership and forecasting experience
Excellent analytical capability and confidence working with data
A proactive, solutions-focused mindset
The ability to influence cross-functional stakeholders and drive alignment

Job Responsibility

Developing and executing Joint Business Plans to deliver sales, profit and market share growth
Leading customer negotiations across promotions, investment and commercial agreements
Managing account P&L, forecasting and budget performance
Identifying opportunities to maximise ROI and improve commercial performance
Working closely with internal stakeholders across Marketing, Finance, Supply Chain and Digital
Driving flawless execution of promotional and activation plans
Building senior-level customer relationships and becoming a trusted commercial partner

What we offer

Bonus

Fulltime

New

Pharmacy Technician

We’re building a world of health around every individual — shaping a more connec...

Location

United States , Lancaster

Salary:

16.50 - 25.00 USD / Hour

CVS Health

Expiration Date

Until further notice

Requirements

Must comply with any state board of pharmacy requirements or laws governing the practice of pharmacy, which includes but is not limited to, age, education, and licensure/certification
If the state board of pharmacy does not address or mandate a minimum age requirement, must be at least 16 years of age
If the state board of pharmacy does not address or mandate a minimum educational requirement, must have a high school diploma or equivalent, or be actively enrolled in high school or high school equivalency program
State-level licensure and national certification requirements vary by state
Regular and predictable attendance, including nights and weekends
Ability to complete required training within designated timeframe
Attention and Focus: Ability to concentrate on a task over a period of time
Ability to pivot quickly from one task to another to meet patient and business needs
Ability to confirm prescription information and label accuracy, ensuring patient safety
Customer Service and Team Orientation: Actively look for ways to help people, and do so in a friendly manner

Job Responsibility

Living our purpose by following all company SOPs at each workstation to help our Pharmacists manage and improve patient health
Following pharmacy workflow procedures at each pharmacy workstation (i.e., production, pick-up, drive-thru, and drop-off) for safe and accurate prescription fulfillment
Contributing to positive patient experiences by showing empathy and genuine care: creating heartfelt and personalized moments while serving patients at pick-up, drive-thru, and over the phone
keeping patients healthy by offering immunizations and other services at the register and over the phone
and demonstrating compassionate care by solving or escalating patient problems
Completing basic inventory activities, as permitted by law, and as directed by the pharmacy leadership team, such as accurately putting away medication deliveries and completing cycle counts, returns-to-stocks, waiting bin inventories, etc.
Contributing to a high-performing team, embracing a growth mindset, and being receptive to feedback
actively seeking opportunities to expand clinical and technical knowledge needed to better assist patients
Remaining flexible for both scheduling and business needs, while contributing to a safe, inclusive, and engaging team dynamic
voluntarily traveling to stores in the market to work shifts as needed by the business

What we offer

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
and other resources

Fulltime

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Claims Auditor/Trainer

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