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

Pharmacy Technician

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

Location

United States , Los Angeles

Salary:

19.52 USD / Hour

CVS Health

Expiration Date

July 04, 2026

Requirements

Must be at least 16 years of age
Licensure requirements vary by state
Attention and Focus
Customer Service Orientation
Communication Skills
Mathematical Reasoning
Problem Resolution
Physical Demands: remaining upright on the feet for sustained periods, moving about on foot, picking/pinching/typing, extending hands and arms, bending at the waist, stooping, expressing or exchanging ideas by spoken word, perceiving sounds at normal speaking levels
Visual Acuity: close visual acuity for transcribing, viewing computer terminal, reading, visual inspection involving small parts
Occasional lifting of up to 30 lbs

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 State's Board of Pharmacy guidelines

What we offer

Dental
Vision
Wellness resources
Employee discounts
Access to certain voluntary benefits
Other programs

Parttime

New

Compliance Consultant – Advertising Compliance

We are seeking candidates with experience in advertising review and/or advertisi...

Location

United States , West Des Moines; Sioux Falls

Salary:

49628.00 - 93052.00 USD / Year

Sammons Financial Group

Expiration Date

Until further notice

Requirements

Bachelor's Degree business or related field preferred or equivalent business experience
3-4 years' relevant compliance, internal audit or other equivalent experience
Working knowledge of life and annuity products, with specific knowledge of insurance company operations
Ability to make sound and proper decisions by applying personal knowledge of guidelines, product information and personal professional judgement in review of assigned materials
Excellent interpersonal and customer service skills
Strong analytical solving skills, including the ability to accumulate, organize, and assimilate large amounts of information
Excellent attention to detail and accuracy
including proofreading skills
Ability to manage multiple tasks simultaneously and manage competing priorities
Ability to work independently and be a team player by demonstrating flexibility, understanding of other positions, providing constructive and relevant input to discussions

Job Responsibility

Receive, review, and research applicable state and federal regulations to ensure all regulatory requirements are incorporated into company policies and practices for both Life and Annuity
Partner with and provide subject matter expertise to Sr. Compliance Consultants, Team Advisor or Manager with the receipt, review, research, investigation of and response/preparation to regulatory agencies and client initiated complaints of small to medium scope as assigned by manager
Assist compliance senior management in all aspects of the compliance function related to developing and implementing policies, procedures and controls
conducting reviews of compliance processes and operations
ensuring implementation of any required corrective actions
managing projects
developing and implementing systems to automate processes and procedures to enhance efficiencies
Develop and maintain good relationships with both internal and external customers by handling tasks in a timely and professional manner
Research and address/resolve Red Flag issues
Communicate and train appropriate employees regarding new laws and regulations for both Life and Annuity

What we offer

Comprehensive health coverage for you and your family, including Medical, Dental, Vision, HSA & FSA options, and term life insurance
Competitive compensation with a performance-based incentive program tied to clear goals and individual and/or company success
Invest in your future with our 100% company-funded Employee Stock Ownership Plan (ESOP), plus automatic enrollment in our 401(k)
Work–life balance that means something
Friday afternoons off year-round, generous paid time off, and paid holidays
Commit to your growth with paid development time, tuition reimbursement, and professional development opportunities across industry, individual, and leadership programs
Make an impact beyond the workplace through volunteer time off, and our company nonprofit matching gift program, supporting the causes that matter most to you
An ownership culture that inspires
join a connected, values-driven workplace where employees take accountability, support one another, and are empowered to do their best work—together shaping our future shared success

Fulltime

New

Accounting Clerk - A/R

The Accounts Receivable Clerk is responsible for ensuring the integrity of suppl...

Location

Canada , Oakville

Salary:

Not provided

Randstad

Expiration Date

June 27, 2026

Requirements

1–2 years of relevant experience in a billing or accounts receivable role
High proficiency in Microsoft Excel is mandatory for data analysis and reporting
Solid background in accounting principles and financial analysis
Proven ability to work effectively within a team while remaining a self-initiated worker who can manage tasks independently
Familiarity with GAAP guidelines and legal accounting requirements

Job Responsibility

Book supplier invoices accurately according to GAAP guidelines and legal requirements
Act as the first point of contact for the buying organization and vendors
proactively contact suppliers to clarify questions
Identify and resolve discrepancies internally and externally with vendors, suppliers, and expediters
Open accounts, follow up on the clearance of liabilities, and release payments as assigned by management
Produce formal statements of accounts in line with established accounting guidelines
Provide essential support for month-end and year-end closing (Balance Sheet and P&L)
Cooperate closely with the purchasing organization and banking partners on defined subject matters

What we offer

Professional Growth: Gain hands-on experience with GAAP compliance and full-cycle AR processes within a reputable organization
Strategic Exposure: Contribute directly to Balance Sheet and P&L closing activities, providing a high-level view of corporate finance
Convenient Location: Join a team based in the heart of Oakville, easily accessible for local professionals
Collaborative Environment: Work in a culture that values self-initiation and rewards teamwork

Fulltime

New

Staff Pharmacist

At CVS Health, we are focused on transforming health care for our customers and ...

Location

United States , Virginia Beach

Salary:

60.00 - 76.00 USD / Hour

CVS Health

Expiration Date

June 17, 2026

Requirements

Active Pharmacist License in the state where the Store is located
Active National Provider Identifier (NPI)
Not on the DEA Excluded Parties list
Regular and predictable attendance, including nights and weekends
Ability to complete required training within designated timeframe
Attention and Focus
Customer Service and Team Orientation
Communication Skills
Mathematical Reasoning
Issue Resolution

Job Responsibility

Supporting Pharmacy Manager in leading and directing the pharmacy team
Supporting the management, oversight, and operation of all aspects within your pharmacy
Helping to manage and improve patient health through safe and appropriate dispensing, counseling, and immunizing practices
Overseeing the pharmacy as Pharmacy Manager's proxy during bench shifts without overlap
Strengthening pharmacy performance measures through effective coaching
Supporting safe and accurate prescription fulfillment
Contributing to positive patient experiences
Proactively offering and delivering immunizations
Supporting the effective management of pharmacy inventory
Partnering with the Pharmacy Manager to ensure pharmacy operations are compliant

What we offer

Medical, dental, and vision coverage
Paid time off
Retirement savings options
Wellness programs
Bonus, commission or short-term incentive program

Fulltime

New

Vp, Head Of Strategic Execution And Enablement Siag

Responsible for executing Sammons Independent Annuity Group’s (SIAG) strategic p...

Location

United States , West Des Moines; Chicago; Sioux Falls

Salary:

Not provided

Sammons Financial Group

Expiration Date

Until further notice

Requirements

Bachelor's Degree required
Master's Degree preferred
Extensive experience in product development and strategic project management
Broad knowledge of Annuity and Life functions
Possess considerable knowledge of industry trends and technologies
Ability to work effectively with individuals and groups
Flexible in coping with changing business environments
Well-developed oral and written communication skills
High degree of decision-making ability
CLU or FSA preferred

Job Responsibility

Lead execution of SIAG's strategic plan
Facilitate the annual planning process
Establish and lead operating cadence forums
Facilitate cross-functional execution alignment sessions
Translate strategic priorities into actionable roadmaps
Drive implementation of key enterprise initiatives
Oversee integration of large-scale initiatives
Build and enhance operational processes, tools, and capabilities
Leverage data and analytics to monitor performance
Support development and enablement of digital and data capabilities

What we offer

Comprehensive health coverage
Competitive compensation with performance-based incentive program
100% company-funded Employee Stock Ownership Plan (ESOP)
Automatic enrollment in 401(k)
Friday afternoons off year-round
Generous paid time off
Paid holidays
Paid development time
Tuition reimbursement
Professional development opportunities

Fulltime

New

Securities Operations Analyst

Our client, a leading global financial institution, is seeking an Operations Ana...

Location

Canada , Toronto

Salary:

30.00 - 32.00 USD / Hour

Randstad

Expiration Date

June 28, 2026

Requirements

1–2 years of experience in Capital Markets operations
Strong knowledge of Canadian and U.S. Fixed Income settlements
Experience with settlements, payments, and reconciliation processes
Understanding of transaction lifecycle for Fixed Income products (e.g., Repo, Securities Lending)
Advanced proficiency in Microsoft Office (Excel, VBA preferred)
Strong analytical, organizational, and time management skills
Ability to interpret and make decisions within defined operational guidelines
Post-secondary degree in Finance, Business, or a related field
Canadian Securities Course (CSC) or other relevant financial certification (preferred/required)

Job Responsibility

Execute key operational processes supporting collateral settlements for Fixed Income trading
Process principal and interest settlements using Loan IQ for CSA agreements
Perform cash settlements via SWIFT messages (MT202, MT103) for margin and repo activities
Reconcile internal accounts, depository balances, and investigate discrepancies
Identify, analyze, and resolve settlement and reconciliation exceptions
Manage breaks related to trade discrepancies, system feeds, and trade vs. transfer reports
Collaborate with internal teams, custodians, and external partners to resolve issues efficiently
Support ongoing process improvements, testing, and implementation initiatives
Maintain and update procedural documentation in line with operational changes
Ensure compliance with internal policies, controls, and escalation procedures

What we offer

Opportunity to gain hands-on experience within a top-tier capital markets environment
Exposure to Fixed Income products, collateral management, and global settlement processes
Long-term contract with potential for extension and conversion
Collaborative team environment with strong learning and development opportunities
Involvement in process improvement initiatives and operational projects

Fulltime

New

Staff Pharmacist

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

Location

United States , Stockbridge

Salary:

60.00 - 76.00 USD / Hour

CVS Health

Expiration Date

July 12, 2026

Requirements

Active Pharmacist License in the state where the Store is located
Active National Provider Identifier (NPI)
Not on the DEA Excluded Parties list
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
Notice and understand patients' reactions, and respond appropriately

Job Responsibility

Living our purpose by helping to manage and improve patient health through safe and appropriate dispensing, counseling, and immunizing practices
Taking direction from the Pharmacy Manager and overseeing the pharmacy as their proxy during bench shifts without overlap, including strengthening pharmacy performance measures through effective coaching and consistent follow-up of pharmacy team members and providing feedback about pharmacy team performance to the Pharmacy Manager as needed
Assumes Pharmacy Manager's day-to-day duties when serving as the only or the primary pharmacist-on-duty
Supporting safe and accurate prescription fulfillment by following—and directing the pharmacy team to follow—pharmacy workflow procedures and utilizing the safety guardrails at every workstation
Contributing to positive patient experiences by showing empathy and genuine care, and coaching the pharmacy team to do the same: demonstrating compassionate care, collaborating with the patient's total healthcare team, and proactively resolving insurance and/or medication issues
Proactively offering and delivering immunizations to keep patients healthy
engaging and supporting Pharmacy Technicians to learn to immunize
Supporting the effective management of pharmacy inventory by following—and coaching the pharmacy team to follow—all inventory best practices, with a special focus on protecting cold chain products for our patients and our business
Partnering with the Pharmacy Manager to ensure pharmacy operations are compliant with the appropriate state Board of Pharmacy regulations at all times
escalating issues or concerns to the Pharmacy Manager and/or Rx DL for timely resolution if/as needed

What we offer

medical
dental
vision coverage
paid time off
retirement savings options
wellness programs
other resources
CVS Health bonus, commission or short-term incentive program

Fulltime

Claims Auditor/Trainer

Robert Half

Location:
United States , Oakland

Category:
Insurance

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
March 13, 2026

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