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.
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.
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.
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.
Environmental Health and Safety Supervisor JobotEnvironmental Health and Safety SupervisorCity of Industry, CA$80,000–$100,000 / 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. A nationally recognized organization in the foodservice and supply chain industry delivers a broad portfolio of products and support services to a diverse customer base.
Insurance Unit Manager/Supervisor GEICOInsurance Unit Manager/SupervisorEl Cajon, CA$77,900–$133,250Bachelor's or Associate's degree with 2+ years of supervisory experience or a minimum of 4 years of supervisory experience in lieu of a degree (high school diploma or equivalent required). Factors include, but are not limited to, the scope and responsibilities of the role, the selected candidate’s work experience, education and training, the work location as well as market and business considerations.
NewSafety & Training Supervisor Summit School ServicesSafety & Training SupervisorPerris, CA$80,000–$95,000 / yearLicense or Certification: SBDI certification required; Commercial Driver’s License with Passenger and School Bus Endorsements required; Strong working knowledge of MS Office Software (Word, Excel, Outlook, PowerPoint, etc.) and transportation related software. Summit School Services companies share a strong commitment to provide the highest level of transportation safety, quality transportation, outstanding customer service and positive employee relations.
EHS Manager JobotEHS ManagerHayward, CA$130,000–$160,000 / yearOur client is a globally recognized, publicly traded Tier 1 automotive supplier specializing in the design and manufacture of fluid handling systems, thermal management solutions, and highly engineered plastic components for the world's leading vehicle manufacturers. Information 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.
NewAsset Protection Supervisor- LaHabra DC CVS HealthAsset Protection Supervisor- LaHabra DCLa Habra, CA$43,888–$93,574
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.
NewWorkers Compensation Coordinator Kimco StaffingWorkers Compensation CoordinatorIrvine, CA$50,000–$52,000 / yearThis position is responsible for managing workers' compensation claims and serving as the main point of contact for branch offices, injured employees, and insurance partners. We are seeking a bilingual Workers' Compensation Coordinator to join our team in Irvine, CA.
NewHuman Resources Generalist - Bilingual Gables Search GroupHuman Resources Generalist - BilingualElk Grove, CAThe Human Resources Generalist supports daily HR operations within a manufacturing plant, partnering with plant leadership to foster a positive and compliant work environment. The HR Generalist serves as a key liaison between employees and management, ensuring consistent application of HR policies and alignment with business objectives.
Claims Supervisor CorVel CorpClaims SupervisorFolsom, CARemote$73,345–$113,247 / yearPay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries.
Claims Supervisor - Worker Compensation StratAcuity Staffing Partners IncClaims Supervisor - Worker CompensationCARemote$95,000–$110,000 / yearIn terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts.
Claims Supervisor II - Property Philadelphia Insurance CompaniesClaims Supervisor II - PropertyRoseville, CA$114,408–$127,868 / yearSummary: Supervises claims adjusters and technical support staff to manage the day-to-day handling and settlement of claims, the processing and tracking of documents, making payments, tracking trends and communicating with underwriting. Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries.
Claims Supervisor II - Commercial Auto - BI Philadelphia Insurance CompaniesClaims Supervisor II - Commercial Auto - BIMission Viejo, CA$114,408–$148,058 / yearSummary: Supervises claims adjusters and technical support staff to manage the day-to-day handling and settlement of claims, the processing and tracking of documents, making payments, tracking trends and communicating with underwriting. Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries.
Claims Team Lead (Supervisor) - Workers Compensation | Brea, CA Sedgwick Claims Management Services, Inc.Claims Team Lead (Supervisor) - Workers Compensation | Brea, CABrea, CA$105,000–$118,000 / yearMental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Claims Supervisor Workers Compensation GallagherClaims Supervisor Workers CompensationSacramento, CaliforniaRemoteThe actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. How you'll make an impact: Supervise: Lead and encourage a Workers Compensation claims team handling a variety of caseload sizes and complexities to deliver high-quality and efficient service.
Claims Supervisor - Hybrid University of CaliforniaClaims Supervisor - HybridSan Diego, CARemoteUC San Diego is a student-centered, research-focused, service-oriented public institution recognized as one of the top fifteen research universities worldwide, and a top ten public university. 15 years later, my work improves operational efficiencies, provides valuable programs to the university, and even helps students bring their innovations to life.
Supervisor, Claims- Roseville, CA- Hybrid Gainwell Technologies LLCSupervisor, Claims- Roseville, CA- HybridRoseville, CA$54,200–$85,000 / yearGainwell Technologies defines wages and wage rates to include all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits. Intercedes with third parties in unusual situations involving payment or adjustment of charges on accounts; consults with departments concerning services which affect collection of charges.
Claims Quality Supervisor University of CaliforniaClaims Quality 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. Provide direct supervision and guidance for Quality Control and Customer Service staff and provide developmental and training opportunities for team members.
Supervisor, Claims Zenith American SolutionsSupervisor, ClaimsSan Francisco, CAFull timeZenith 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.
Claims Quality Supervisor UCLA Health SystemClaims Quality 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.n. Provide direct supervision and guidance for Quality Control and Customer Service staff and provide developmental and training opportunities for team members.
Health Claims Audit Supervisor Withum Smith+Brown, PCHealth Claims Audit SupervisorSan Ramon, CA$85,000–$110,000 / yearIn addition to the base compensation, Withum offers a competitive benefits package and bonus program (for eligible roles) based on individual and firm performance. How You'll Spend Your Time: Working closely with our clients, and their vendors, to ensure that health, dental, prescription and vision claims are being paid in compliance with regulations and plan documents.
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.
NewWorkers' Compensation Claim Supervisor CCMSIWorkers' Compensation Claim SupervisorConcord, CaliforniaRemote$90,000–$100,000 / yearResponsibilities: When we hire supervisors at CCMSI, we look for people-leaders who recognize that every claim impacts a real person’s livelihood, hold themselves and their teams accountable for results, and approach challenges as opportunities to develop others and drive excellence. At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.
Claims Resolution and Reconciliation Supervisor UCLA Health SystemClaims 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.
Claims Adjuster II/Senior Claims Adjuster (Senior Workers' Compensation Claims Adjuster) County of Riverside, CaliforniaClaims Adjuster II/Senior Claims Adjuster (Senior Workers' Compensation Claims Adjuster)Riverside, CA$112,778.77–$159,740.22 / yearKnowledge of: State of California Labor Code, Workers Compensation Law and rules and regulations (Title 8); Applicable case law of leading decisions of the Workers Compensation Appeals Board, Court of Appeals, and Supreme Court regarding workers compensation cases; Medical terminology, anatomy and technical terminology used in medical and legal fields regarding industrial cases; Jurisdiction, functions and procedures of the Workers Compensation Appeals Board; Vocational rehabilitation and procedures as it applies to Workers Compensation; Reserving practices and procedures; in-house litigation procedures; WCAB procedures; and hearing processes. Candidates must have achieved the level of Experienced Claims Adjuster (as defined by California Code of Regulations, Title 10, Chapter 5, Subchapter 3) defined as possessing one of the following: 1) Working 5 out of the last 8 years as a California Workers Comp Claims Adjuster, 2) Has worked continuously in California adjusting claims since passing the Self-Insurance Test, or 3) Has passed the Self-Insurance test in the last 2 years.
Supervisor Property Claims Branch Mercury Insurance CompanySupervisor Property Claims BranchRancho Cucamonga, CA$94,458–$179,048 / yearAs a supervisor your role is to provide inspired leadership, technical and administrative oversight for a team of claims adjusters/examiners responsible for the adjudication and settlement of minor to moderate complexity first party property claims through efficient and compassionate service. Position Summary: If you're passionate about helping people restore their lives when the unexpected happens to their homes and providing the best customer experience, then our Mercury Insurance Property Claims team could be the place for you!
Claims Unit Vice President CorVel CorpClaims Unit Vice PresidentFolsom, CARemote$99,250–$166,777 / yearEDUCATION & EXPERIENCE: Bachelor's Degree with course concentration in Business Administration, or related field; or 10+ years of equivalent combination of education and experience in a complex healthcare, insurance, or third party claim organization with significant project management expertise. The VP of Claims will also identify, facilitate and participate in essential strategic projects for operational improvement as well as support and directly participate in sales presentations/RFP responses and the development of opportunities to promote the company's overall growth.
Claims Team Lead - Workers Compensation | Rancho Cordova, CA Sedgwick Claims Management Services, Inc.Claims Team Lead - Workers Compensation | Rancho Cordova, CARancho Cordova, CA$100,000–$115,000 / yearMental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Workers'' Compensation Claims Team Lead - California biBerk Business Insurance IncWorkers'' Compensation Claims Team Lead - CaliforniaCalifornia, CARemote$105,000–$115,000 / yearThe Workers' Compensation Claims Team Lead will lead a lost time Workers' Compensation claims team and may handle a reduced pending consisting of complex and / or catastrophic workers' compensation claims. biBerk is where commercial insurance buyers can obtain coverage for their businesses from insurers of the Berkshire Hathaway group of Insurance Companies, one of the best capitalized insurance groups in the world.
Medical Claims Examiner Ultimate Staffing ServicesMedical Claims ExaminerPasadena, California$21–$29 / hourThis role ensures accurate and timely processing of claims while maintaining compliance with federal and state regulations and providing high‑quality service to providers and members. The Medical Claims Examiner is responsible for reviewing, analyzing, and adjudicating medical insurance claims in accordance with policy provisions, regulatory guidelines, and organizational procedures.
Workers Compensation Claims Team Lead | Orange, CA Sedgwick Claims Management Services, Inc.Workers Compensation Claims Team Lead | Orange, CAOrange, CA$105,000–$110,000 / yearSedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for high-cost or complex claims.
Claims Team Lead - Workers Compensation | Brea, CA Sedgwick Claims Management Services, Inc.Claims Team Lead - Workers Compensation | Brea, CABrea, CA$105,000–$115,000 / yearNewsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead - Workers Compensation | Brea, CA. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Claims Team Lead - Workers Compensation | Roseville, CA or San Diego, CA Sedgwick Claims Management Services, Inc.Claims Team Lead - Workers Compensation | Roseville, CA or San Diego, CASan Diego, CA$105,000–$115,000 / yearMental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Workers Compensation Claims Team Lead | Roseville, CA Sedgwick Claims Management Services, Inc.Workers Compensation Claims Team Lead | Roseville, CARoseville, CA$105,000–$110,000 / yearSedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. • Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for high-cost or complex claims.
Casualty Claims Manager, Ag Zenith Insurance CompanyCasualty Claims Manager, AgRoseville, CA$103,741–$149,552.68 / yearFrom dairies to berries, from almonds to wine, from vegetables to cattle ranches, we recognize the importance of agriculture and the effort it takes to compete in the global agriculture industry. Strengthens team performance by developing new initiatives, efficient processes and procedures to deliver exception claims service according to customer needs and industry trends.
Insurance Contracts and Claims Manager County of Santa ClaraInsurance Contracts and Claims ManagerSan Jose, CA$138,469.76–$168,324 / yearManages Countys certificate of insurance monitoring program that provides services to County departments; Administers the Countys contract insurance requirements; Negotiates, manages, and administers the Countys liability and property claims; Establishes and maintains policies and procedures for liability and property insurance contracts and claims; Manages the property and casualty insurance renewal process; Maintains and is apprised of current insurance coverage(s) and available options; Designs, implements, and monitors new insurance-related functions, as needed; Maintains inventory of County real and physical properties and the associated values and insurance coverages; Maintains current and historical list of Countys liability and property insurance coverage; Plans, organizes, and supervises the work of professional and technical staff for the Liability/Property Claims Division; Manages the claims adjusting function through participating in investigation, review, adjustment, and settlement of claims, and may supervise the settlement of claims up to the amount authorized by the Board of Supervisors; Establishes adequate reserves for property and liability claims; Represents the County on property and liability issues, including small claims court appearances; Prepares correspondence and reports which include confidential information; Maintains relationships with County department heads, insurance companies, outside agencies, and the general public; Manages the technical support functions and the policies and procedures relating to the establishment of claims; Consults with and advises top administrator on activities relating to liability contracts and claims; May be assigned as a Disaster Service Worker, as required; Performs related duties, as required. Knowledge of: Principles and procedures of risk management, loss prevention, and claims adjusting; Principles of organization and administrative, fiscal, and program management; Principles of employee supervision, hiring, training, and development; Principles of risk avoidance and risk transfer; Governmental or other self-insured programs; Insurance administrative principles and procedures; Current trends in liability insurance market conditions, including types of coverage; Automated risk management, claims reporting, and office information systems and applications; Provisions of the Government Insurance Code and the California Insurance Code; Regulations and procedures involved in collecting subrogation.
Liability Claims Manager County of OrangeLiability Claims ManagerSanta Ana, CA$127,878.40–$177,132.80 / yearIn your response, include the number of staff supervised, the size and scope of the program(s) managed, your key supervisory responsibilities (e.g., assigning work, performance evaluation, training, and oversight), and examples demonstrating at least three (3) years of progressively responsible supervisory or management experience. Four (4) years of professional risk management programs experience related to assignment; must include two (2) years of lead/supervisory experience AND I possess a Bachelor's degree in occupational health, safety engineering, insurance/risk management, business administration, or related field.
NewNon-Clinical - Finance/Accounting - Claims Examiner BesticaNon-Clinical - Finance/Accounting - Claims ExaminerWhittier, CAMinimum of 2 years claims ADJUDICATION related experience in ambulatory, acute care hospital, HMO, or IPA environment Knowledge of payment methodologies for: Professional (MD), Hospital, Skilled Nursing Facilities, and Ancillary Services * Knowledge and understanding of timeliness and payment accuracy guidelines for commercial, senior and Medi-Cal claims * Knowledge of compliance issues as they relate to claims processing Experience in interpreting provider contract reimbursement terms desirable Ability to identify non-contracted providers for Letter of Agreement consideration Data entry experience Training on basic office automation and managed care computer systems RTO MUST BE SUBMITTED AT TIME OF SUBMITTAL, NO EXCEPTIONS They are primarily responsible for the processing functions (operation, adjudication, and payment) of UB-92 and HCFA-1500 claims that are received from PHP affiliated medical groups and hospitals for HMO patients.
Liability Claims Team Lead - GL & Auto Exp. Required | Must Reside in CA Sedgwick Claims Management Services, Inc.Liability Claims Team Lead - GL & Auto Exp. Required | Must Reside in CAOrange, CA$95,000–$115,000 / yearPRIMARY PURPOSE: To supervise a team of liability claims examiners and adjusters; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
Senior Claims Representative California Workers Compensation (Remote) W. R. Berkley CorpSenior Claims Representative California Workers Compensation (Remote)California, CARemote$65,000–$95,000 / yearSalary Range: 65k - 95k The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Regularly communicate claim activity and status updates to policyholders, injured workers and other interested parties in a professional, thoughtful and tactful manner.
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.
Manager, Utilization Management Claims Review L.A. Care Health PlanManager, Utilization Management Claims ReviewLos Angeles, CAThe Manager, Utilization Management Claims Review partners with internal departments and executive leadership to promote effective workflows, mitigate fraud, waste, and abuse (FWA), and support high-quality, cost-effective care delivery and organizational performance goals. Oversee workflow and queue management to ensure claims and PDR requests are completed within required regulatory timeframes, including monitoring workload distribution.
Hospital Claims Examiner MedPOINT ManagementHospital Claims ExaminerSherman Oaks, CARemoteAdhere to MedPOINT Management’s core values: Accountability, Community, Celebration, Integrity, Innovation & Collaboration. Researches, reviews and contacts provider services for problem claims and issues, as needed.
Claims Examiner MedPOINT ManagementClaims ExaminerSherman Oaks, CARemoteAdhere to MedPOINT Management’s core value: Accountability, Community, Celebration, Integrity, Innovation & Collaboration. Researches, reviews and contacts provider services for problem claims and issues, as needed.