Claims Auditor Health Source MSOClaims AuditorAlhambra, CAFull timeResponsibilities include, but not limited to: Maintain up-to-date knowledge of procedures for all ICD-10, CPT, HCPC codes including:Contractual agreement rates. Job Description: Claims Auditor will be responsible for auditing claims processed by Claims Examiners.
Claims Supervisor Health Source MSOClaims SupervisorAlhambra, CAFull timeProviding expertise or general claims support to teams in reviewing, researching, investigating, negotiating, process, and adjusting claims. Responsibilities include, but not limited to: • Maintain up-to-date knowledge of procedures for all ICD-10, CPT, HCPC codes including: Contractual agreement rates.
NewClaim Specialist - Property Field Inspection State Farm Mutual Automobile Insurance CompanyClaim Specialist - Property Field InspectionSanta Monica, CA$64,965.62–$111,595 / yearAdditional Details: Employees must successfully complete all required training, including applicable licensing exam(s), Motor Vehicle Record (MVR) checks, and background checks required of various state(s). With the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you!
Claims Adjuster Kinetic Personnel GroupClaims AdjusterMonrovia, CA$55,000–$75,000 / yearTemporaryThe ideal candidate has a strong understanding of coverage analysis, liability evaluation, and California insurance regulations, and is able to resolve claims efficiently and fairly. This role is responsible for providing high-quality customer service while managing a volume of property damage claims.
NewClaims Examiner - Workers Compensation (Hourly) IconmaClaims Examiner - Workers Compensation (Hourly)Brea, CA$43–$48 / hourResponsibilities:Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
Claims Examiner - Workers Compensation IconmaClaims Examiner - Workers CompensationRancho Cucamonga, CA$45–$50 / hourResponsibilities:To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
NewAuto Claims Adjuster - Temp Vaco LLCAuto Claims Adjuster - TempIrwindale, CA$29–$30Determining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to: the individual’s skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; other business and organizational needs. Pay: $29-30/hrVaco by Highspring values a diverse workplace and strongly encourages women, people of color, LGBTQ+ individuals, people with disabilities, members of ethnic minorities, foreign-born residents, and veterans to apply.
Quality Control Supervisor JobotQuality Control SupervisorLos Angeles, CA$75,000–$110,000 / yearInformation collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. Corrective Actions and Continuous Improvement: Identify non-compliant practices on the production floor, propose corrective actions, and collaborate with production leaders to implement improvements.
Medical Billing Specialist JobotMedical Billing SpecialistLos Angeles, CA$25–$29 / hourInformation collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. This role is responsible for preparing, reviewing, and submitting claims, resolving denied or unpaid claims, and maintaining compliance with local, state, and federal billing regulations.
Customer Service Representative Health Source MSOCustomer Service RepresentativeAlhambra, CAFull timeAbility to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time as needed. Review and research incoming healthcare claims from members and providers(doctors, clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g.
Claims Processors x2 - San Francisco CA Lee Hecht HarrisonClaims Processors x2 - San Francisco CASan Francisco, CA$25–$27 / hourPosition Summary: The Claims Processor provides customer service and processes routine health, and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.
NewThird-Party Medical Claims Processor Hire Up Healthcare (Division of Hire Up Staffing)Third-Party Medical Claims ProcessorFresno, CAIdeal Candidate: The perfect fit for this role has at least 3 years of experience in medical billing or claims processingespecially if that experience includes working with a third-party administrator (TPA) within an insurance company. Prior TPA exposure is highly preferred due to the nature of this employers group benefit processing.
Sr. Medical Claims Processor Ultimate Staffing ServicesSr. Medical Claims ProcessorPasadena, California$24–$29 / hourEnsure accuracy of claim details, including patient information, coding (ICD-10, CPT, HCPCS), and billing data prior to submission. Investigate and resolve denied, rejected, or pending claims by working with providers, payers, and internal departments.
Claims Processor I Alura Workforce SolutionsClaims Processor IRancho Cucamonga, CAREQUIREMENTSTwo (2) years of experience as a Data Entry Processor Data Entry Processor experience preferably in an HMO or Managed Care setting. This includes validating member coverage, clearing system edits and categorizing a claim type to ensure the claim routes to the appropriate workgroup for adjudication.
Customer Service Claims Processor Zenith American SolutionsCustomer Service Claims ProcessorSan Francisco, CAFull timeThe Customer Service Claims Processor is focused on providing customer service via call handling to participants, beneficiaries, union locals and providers regarding eligibility, benefits and claims status in conjunction with claims processing as business needs dictate. We are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day.
Claims Processor 2 Zenith American SolutionsClaims Processor 2San Francisco, CaliforniaZenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. We are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day.
NewDental Financial Insurance Coordinator Brea EndodonticsDental Financial Insurance CoordinatorPlacentia, CA$19–$26 / hourAt Specialized Dental Partners, its affiliates, related companies and independently owned supported clinical practices, we are committed to ensuring fair and equitable pay for all employees. Responsibilities include answering phone calls, scheduling patients, and helping ensure an efficient and welcoming experience for patients and team members.
Claims Processor 1 Zenith American SolutionsClaims Processor 1San Francisco, CaliforniaWe are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide.
Claims Processor Highmark IncClaims ProcessorRemote Position, WVRemoteReviews processed claims and inquiries to determine corrective action including adjusting claims as necessary and takes the corrective action steps using enrollment, benefit and historical claim processing information; may coordinate benefits and interact with customers. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
Claims Processor Conduent IncClaims ProcessorCARemoteThrough our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded: click here to access or download the form.
Special Investigation Unit Investigator II Solugenix CorpSpecial Investigation Unit Investigator IILos Angeles, CA$43.29–$48.29 / hourTemporaryContractorFull timeAfter making a conditional offer and running a background check, if we are concerned about conviction that is directly related to the job, applicants will be given the chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report. Minimum of 3 years of experience in healthcare fraud investigation/detection and/or healthcare related specialty including but not limited to; Pharmacy, DME, Mental Health, Behavioral Health, Hospice, Home Health, Dental etc.
Special Investigation Unit Investigator III Solugenix CorpSpecial Investigation Unit Investigator IIILos Angeles, CA$42.71–$55.53 / hourTemporaryContractorFull timeThe Special Investigation Unit Investigator III performs in-depth evaluation of potential fraud & abuse cases and develops complex investigations that involve high dollar amounts, sensitive issues, or that otherwise meet criteria for fraud, waste & abuse. After making a conditional offer and running a background check, if we are concerned about conviction that is directly related to the job, applicants will be given the chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.
Claims Processor 3 Zenith American SolutionsClaims Processor 3San Francisco, CaliforniaWe are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day. High school diploma or general education degree (GED); two years related experience processing all types of group health and/or dental benefit claims.
Claims Processor - Revenue Cycle Claims Processing - Sharp Corporate - Day Shift - Full Time Sharp Health PlanClaims Processor - Revenue Cycle Claims Processing - Sharp Corporate - Day Shift - Full TimeSan Diego, CA$25.15–$28.95 / hourThe actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. Demonstrate ability to work independently and manage time well with any free time used to help in other areas as directed.
Claims Processor II - CHOC MSO Rady Children's HospitalClaims Processor II - CHOC MSOSan Diego, CA$23.10–$31.77 / hourCountry Code+1+1242+1246+1264+1268+1284+1340+1441+1473+1649+1664+1670+1671+1684+1758+1767+1784+1849+1868+1869+1876+1939+20+211+212+213+216+218+220+221+222+223+224+225+226+227+228+229+230+231+232+233+234+235+236+237+238+239+240+241+242+243+244+245+248+249+250+251+252+253+254+255+256+257+258+261+262+264+265+266+267+268+269+27+290+291+297+298+299+30+31+32+33+34+345+350+351+352+353+354+355+356+357+358+359+36+370+371+372+373+374+375+376+377+378+379+380+381+382+385+386+387+389+39+40+41+420+421+423+43+44+45+46+47+48+49+500+501+502+503+504+505+506+507+508+509+51+52+53+54+55+56+57+58+590+591+593+594+595+596+597+598+599+60+61+62+63+64+65+66+670+672+673+674+675+676+677+678+679+680+681+682+683+685+686+687+688+689+690+692+7+77+81+82+84+850+852+853+855+856+86+872+880+886+90+91+92+93+94+95+960+961+962+963+964+965+966+967+968+970+971+972+973+974+975+976+977+98+992+993+994+995+996+998Phone Number. Job Categoryselect categoryAccountingAdmin ServicesAdministrativeAllied HealthBehavioral Health Srvcs AdminCardiac MRICardio-Thoracic Intensive CareCardiovascular SurgeryCatheterizationClinical NutritionClinical ProfessionalClinical ProfessionalsClinical SupportClinical Support PoolCommunity ServiceCompliance / LegalCritical Care UnitDevlp'l Scrng & Enhancmnt PrgmEchocardiogramElectroencephalogramFacilitiesFacility OperationsFood ServiceForensic & Supportive ServicesGastroenterologyHealthy StepsHeart InstituteHematology/Oncology IPHuman ResourcesInformation ServicesInformation TechnologyInpatient AdmittingKitchenLabLab - AdministrationLab - Blood BankLab - HematologyLeadershipMedical UnitNeonatal Intensive CareNeurologyNICU CHETNurse Triage Answering ServiceNursingOccupational TherapyOperating RoomOphthalmologyOphthalmology/Optical ShopOrthopedicsPatient Financial ServicesPFS - RCSSDPharmacyPhysiatryPsychiatry ResourcesSchool Health ContractsSkilled Nursing CareSocial ServicesSpeechSupport ServicesTransforming Mental HealthTrauma CenterTrauma PEI InitiativesUtilization Management.
WARRANTY CLAIMS PROCESSOR Carmona's Appliance CenterWARRANTY CLAIMS PROCESSORRedding, CAWe are seeking a detail-oriented Warranty Claims Processor which is responsible for the successful submission of warranty claims to include pre-approval, proof of purchase, extended warranty, and any documentation for successful claims. · Prolonged Sitting: This role involves extensive periods of sitting at a desk and working on a computer (up to 8 hours).
Warranty Claims Processor BrandSourceWarranty Claims ProcessorRedding, CaliforniaWe are seeking a detail-oriented Warranty Claims Processor which is responsible for the successful submission of warranty claims to include pre-approval, proof of purchase, extended warranty, and any documentation for successful claims. If you’re seeking to make an impact from the start of your career, spark impressive change, learn new or innovative skills and most importantly, gain success in a field that rewards ambitious hard workers, retail is for you!
Meditech Claims Processor - UB-04 and HCFA 1500 CPSIMeditech Claims Processor - UB-04 and HCFA 1500CAEssential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include: Prepares and submits hospital, hospital-based physician and clinic claims to third-party insurance carriers either electronically or by hard copy billing. The Meditech Claims Processor position is responsible for acting as a liaison for hospitals and clinics using TruBridge's complete business office services.
OHS Claims Processor I (Bilingual) Kaiser PermanenteOHS Claims Processor I (Bilingual)Los Angeles, CAOrdering and photocopying medical records; temporarily cover other desk/functions due to vacation and workload fluctuations; clears designated Health Connect work queues daily, creates patient accounts to register patients and fills in the required KP computerized systems, provides personalized and professional patient/employer/carrier services. Promotes, ensures and improves customer service to internal/external customers by demonstrating skills which are consistent with the organizations philosophy of providing extraordinary customer relations and quality service as well as all other Kaiser Permanente Policy Procedures.
Health Claims Examiner Ultimate Staffing ServicesHealth Claims ExaminerPasadena, California$24–$28 / hourCommunicate professionally with members and providers to resolve inquiries, follow up on pended claims, and complete corrections or adjustments. This position is ideal for someone who enjoys problem‑solving, working with complex benefit plans, and collaborating with both internal teams and external partners.
Claims Adjudicator Sr Loma Linda University Medical CenterClaims Adjudicator SrRedlands, CAAble to communicate effectively in English in person, in writing, and on the telephone; think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Knowledge and Skills: Extensive experience in health insurance claims processing, HMO claims or managed care environment is required, in-depth knowledge of medical billing and coding, knowledge of health insurance, HMO and managed care principles.
Claims Specialist - Claims Processing Providence Health & ServicesClaims Specialist - Claims ProcessingAnaheim, CA$24–$33.73 / hourRequsition ID: 429445 Company: Providence Jobs Job Category: Claims Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Day Career Track: Admin Support Department: 7520 CLAIMS PROCESSING CA HERITAGE SERVICES Address: CA Anaheim 200 W Center St Promenade Work Location: St Joseph Home Health-Anaheim Workplace Type: On-site Pay Range: $24.00 - $33.73 Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
Senior Claims Specialist - Claims Processing Providence St. Joseph HealthSenior Claims Specialist - Claims ProcessingMission Hills, CATogether, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. The Senior Claims Specialist is responsible for the processing of complex institutional claims (stop loss, contracted, non-contracted, per diem, case rate etc.) and adjudication and claims research when necessary.
Claims Specialist - Claims Processing Providence St. Joseph HealthClaims Specialist - Claims ProcessingAnaheim, CATogether, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. Required Qualifications: HMO claims processing experience in a managed care environment, preferably PMG/IPA setting within the last 3 years or any combination of education and/or experience which produces an equivalency.
Claims Specialist II - Provider Claims 26-00063 Alura Workforce SolutionsClaims Specialist II - Provider Claims 26-00063Rancho Cucamonga, CAAdditional responsibilities include handling escalated claim-related telephone inquiries, assisting with cross-training as needed, performing complex claim adjustment projects, and processing Provider Disputes in accordance with regulatory requirements. DESCRIPTION The Claims Specialist II – Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are conducted consistently and accurately.
Claims Specialist II - Provider Claims 25-00515 Alura Workforce SolutionsClaims Specialist II - Provider Claims 25-00515Rancho Cucamonga, CAAdditional responsibilities include handling escalated claim-related telephone inquiries, assisting with cross-training as needed, performing complex claim adjustment projects, and processing Provider Disputes in accordance with regulatory requirements. DESCRIPTION The Claims Specialist II – Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are conducted consistently and accurately.
Claims Specialist II - Provider Claims 26-00106 Alura Workforce SolutionsClaims Specialist II - Provider Claims 26-00106Rancho Cucamonga, CAAdditional responsibilities include handling escalated claim-related telephone inquiries, assisting with cross-training as needed, performing complex claim adjustment projects, and processing Provider Disputes in accordance with regulatory requirements. DESCRIPTION The Claims Specialist II – Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are conducted consistently and accurately.
Claims Specialist II - Provider Claims 26-00029 Alura Workforce SolutionsClaims Specialist II - Provider Claims 26-00029Rancho Cucamonga, CAAdditional responsibilities include handling escalated claim-related telephone inquiries, assisting with cross-training as needed, performing complex claim adjustment projects, and processing Provider Disputes in accordance with regulatory requirements. DESCRIPTION The Claims Specialist II – Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are conducted consistently and accurately.
Claims Specialist II - Provider Claims 26-00130 Alura Workforce SolutionsClaims Specialist II - Provider Claims 26-00130Rancho Cucamonga, CAAdditional responsibilities include handling escalated claim-related telephone inquiries, assisting with cross-training as needed, performing complex claim adjustment projects, and processing Provider Disputes in accordance with regulatory requirements. DESCRIPTION The Claims Specialist II – Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are conducted consistently and accurately.
Claim Benefit Specialist CVS Health CorpClaim Benefit SpecialistSacramento, CA$17–$31.30 / hourThe candidate will serve as a medical/hospital claim processor for rework projects, compliance, and complex issues for a specific provider/network or large-scale rework projects generated as a result of plan sponsor issues, release fallout and/or legal/regulatory/compliance concerns. We are looking for a highly motivated candidate who can effectively and accurately review and rework sensitive, complex medical and hospital claims for our rework project department.
WORKERS'' COMPENSATION CLAIMS ADJUSTER State Of CaliforniaWORKERS'' COMPENSATION CLAIMS ADJUSTERSacramento, CA$4,470–$7,628Artificial intelligence (AI) tools such as ChatGPT, website searches, and third-party reviewers can be helpful in researching responses to the SOQ; however, by submitting your application for this position, you understand and acknowledge the SOQ you submit is your own work, in your own words, and accurately reflects your knowledge, skills, abilities, and experiences. Established in 1914 by the state legislature, we offer diverse and comprehensive products and services that provide a strong and stable option for employers and injured employees with fast, reliable claims service and medical and indemnity benefits.
Claims Analyst Clever Care Health Plan IncClaims AnalystHuntington Beach, CA$88,000–$100,000 / yearThe Claims Analyst will work with the Senior Director of Medicare Operations in identifying potential areas for process improvement initiatives to support development of automation, payment accuracy, audit activities, business rules and P&Ps. Utilize and access computer and appropriate software (e.g., Microsoft: Word, Excel, PowerPoint) and job-specific applications/systems (e.g., EZCAP Claims Processing System and Authorization system) to produce correspondence, charts, spreadsheets, and/or other information applicable to the position.
Claims Resolution and Reconciliation Supervisor University of CaliforniaClaims Resolution and Reconciliation SupervisorLos Angeles, CA$78,500–$163,600 / yearAs a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer. The Claims Resolution and Reconciliation Supervisor oversees daily claims resolution operations, ensuring timely, accurate, and compliant processing of complex claims adjustments, provider disputes, appeals, and grievances.
Education and Training Specialist - CLAIMS PROCESSING Providence Health & ServicesEducation and Training Specialist - CLAIMS PROCESSINGMission Hills, CA$29.62–$45.31 / hourRequsition ID: 427121 Company: Providence Jobs Job Category: Learning & Development Job Function: Human Resources Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 7520 CLAIMS PROCESSING CA HERITAGE SERVICES Address: CA Mission Hills 11165 N Sepulveda Blvd Work Location: Facey Sepulveda Annex-Mission Hills Workplace Type: Hybrid Pay Range: $29.62 - $45.31 Working under the general supervision of the Claims Director, provide an effective education program to advance the quality and production level of the Claims Department by developing and delivery claims training programs that continuously improves the Claims Department performance to meet the NSS strategic goals.
Claims Auditor Western GrowersClaims AuditorIrvine, CAThis position reports to the Supervisor of Payment Integrity and performs in-depth audits to ensure existing health (medical/dental) benefit plans of Western Growers Assurance Trust and Pinnacle Claims Management, Inc. clients are in compliance with the respective employers summary plan descriptions. At Pinnacle Claims Management, we are an innovative third-party administrator (TPA) that provides a full suite of comprehensive and customized health benefits administration services for self-funded companies, including health management and wellness solutions, and pharmacy benefit management.
Claims Examiner Welbe Health LLCClaims ExaminerCA$55,930.55–$73,828.33 / yearOur Health Plan Services team helps ensure excellent care delivery for our participants, and the Claims Examiner plays a pivotal role in ensuring timely and efficient processing of claims for our contracted specialty provider partners. Understanding of Industry pricing methodologies, such as Medicare/Medi-Cal fee schedule, Diagnosis Related Groups (DRG), Multiple Procedure Payment Reduction (MPPR) and benefit interpretation and administration .
Epic Tapestry Claims Analyst UnitedHealth Group IncEpic Tapestry Claims AnalystRedlands, CA$72,800–$130,000 / yearThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. This role ensures stable, compliant, and high‑quality system performance across the claims ecosystem, with a strong focus on configuration accuracy, workflow alignment, and timely resolution of operational issues.
Claims Analyst II (On-Site) NorthBay Medical CenterClaims Analyst II (On-Site)Fairfield, CAThe position is co-responsible for the operational functions for the organization's capitated hospital and medical group business, processing all claims, oversees customer service issues, researching/resolving payment issues and addressing corrections in the system with the Claims Specialist. Requires a high comfort level with taking initiative and responsibility, high energy and productivity, plus an orientation and ability to manage details in an organized work style.
Claims Specialist II Mercury Insurance CompanyClaims Specialist IILos Angeles, CA$44,466–$77,881 / yearBodily Injury Claims Management: Analyze medical records to evaluate, negotiate, and settle moderate bodily injury claims with legal counsel for represented claimants and unrepresented parties. If you're passionate about helping people restore their lives when the unexpected happens, and providing high-quality customer experiences, then our Mercury Insurance Claims team could be the place for you!
Sr. Manager - Claims Delegation Audit Astrana Health IncSr. Manager - Claims Delegation AuditMonterey Park, CAThis role will be responsible for the development and execution of department strategies, overall Audit program, Audit process optimization, and management, identifying and leveraging technology and data to improve the quality and minimizing process cost of Claims. Working with the Department Director, Senior Manger will collaborate with other Astrana Health departments and personnel to develop strategies to identify, mitigate and optimize operational and financial gaps.