Patient Account Representative - Physician Claims Guidehouse IncPatient Account Representative - Physician ClaimsEl Segundo, CA$34,000–$56,000 / yearThe Patient Account Representative has an extensive knowledge of billing, accounts receivable follow-up, timely filing guidelines and the ability to effectively review remittance advices and electronic billing reports from payer to determine the action required. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
Content Claims Specialist - Field - Level I Crawford & CoContent Claims Specialist - Field - Level ILos Angeles, CARemoteTo determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours. Communicate with adjusters/policyholders and industry vendors to explain their roles as Content Claims Specialists and their respective roles/contributions in the claims handling process.
Enterprise Account Executive - Kinetic ID Kinetic AutomationEnterprise Account Executive - Kinetic IDCosta Mesa, CAYou will work closely with Kinetic's product, operations, and executive teams to bring new carriers onto the platform and create a repeatable sales motion for future deployments. This role will require a mix of outbound pipeline creation, conference networking, in-person meetings, pilot coordination, contract support, and cross-functional execution.
Utilization Management Claims Review Nurse RN II L.A. Care Health PlanUtilization Management Claims Review Nurse RN IILos Angeles, CAPerform claims pre-payment review by supporting the Claims team in evaluating flagged claims prior to adjudication to ensure services are medically necessary, documentation supports billed services, coding is accurate and aligned with authorization when applicable, and unnecessary denials are reduced through accurate clinical validation. This position supports payment integrity initiatives through retrospective and pre-payment review processes, helps reduce unnecessary denials, and monitors for potential fraud, waste, and abuse (FWA).
Medical Claims Intake Coordinator UCLA Health SystemMedical Claims Intake CoordinatorLos Angeles, CA$26.42–$37.49 / hourb'nn n n n n n n n n n n n nn n n n n n n n n n n n n n n n n n Medical Claims Intake Coordinator - - 29680 - UCLA Healthn n nnnn nn n n n nn n n n n Skip to content nn n n n n n UCLA Health Home Page n n nn nnn n nn n Main menu. Press enter or space keys to expands and escape key to collapse nn n n n n n n Search jobs n n nn...
Claims Examiner - Workers Compensation -| Brea, CA Sedgwick Claims Management Services, Inc.Claims Examiner - Workers Compensation -| Brea, CABrea, CA$80,000–$100,000 / yearPRIMARY PURPOSE OF THE ROLE To analyze complex or technically difficult California 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. 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.
Workers Compensation Claims Examiner | Long Beach or Roseville, CA Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | Long Beach or Roseville, CALong Beach, CA$85,000–$105,000 / 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. PRIMARY PURPOSE OF THE ROLE: To analyze workers' compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Liability Claims Representative | CA, OH, IN, KY Jurisdictional Knowledge | Licensing Required | Dedicated Client Sedgwick Claims Management Services, Inc.Liability Claims Representative | CA, OH, IN, KY Jurisdictional Knowledge | Licensing Required | Dedicated ClientLake Forest, CA$45,000–$63,000 / yearPRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion. To analyze Liability claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Workers Compensation Claims Team Lead | Roseville, CA or Long Beach, CA, Sedgwick Claims Management Services, Inc.Workers Compensation Claims Team Lead | Roseville, CA or Long Beach, CA,Long Beach, CAMental: 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. Workers Compensation Claims Team Lead | Roseville, CA or Long Beach, CA, Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?.
Workers Compensation Claims Examiner | HYBRID | Orange, CA Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | HYBRID | Orange, CAOrange, CA$80,000–$100,000 / 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. PRIMARY PURPOSE OF THE ROLE: To analyze workers' compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Workers Compensation Claims Examiner | Hybrid | Orange, CA Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | Hybrid | Orange, CAOrange, CA$80,000–$100,000 / 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. PRIMARY PURPOSE OF THE ROLE: To analyze workers' compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Workers Compensation Claims Team Lead | Roseville, CA Or Long Beach, CA, Sedgwick Claims Management Services, Inc.Workers Compensation Claims Team Lead | Roseville, CA Or Long Beach, CA,Long Beach, CAMental: 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. Workers Compensation Claims Team Lead | Roseville, CA or Long Beach, CA, Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?.
Workers Compensation Claims Examiner | Brea, CA | Sign-On Bonus Eligible Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | Brea, CA | Sign-On Bonus EligibleBrea, CARemote$85,000–$105,000 / yearPRIMARY PURPOSE: 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. 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.
Workers Compensation Claims Team Lead | Hybrid |Brea, CA Sedgwick Claims Management Services, Inc.Workers Compensation Claims Team Lead | Hybrid |Brea, CABrea, CAMental: 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 Examiner | REMOTE | Must Live in CA Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | REMOTE | Must Live in CABrea, CARemote$80,000–$100,000 / 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. PRIMARY PURPOSE OF THE ROLE: To analyze Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Workers Compensation Claims Examiner | Orange, CA Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | Orange, CAOrange, CARemote$85,000–$100,000 / 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. PRIMARY PURPOSE OF THE ROLE: To analyze Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Workers Compensation - Claims Team Lead Sedgwick Claims Management Services, Inc.Workers Compensation - Claims Team LeadOrange, CAMental: 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, Complex General Liability GallagherClaims Supervisor, Complex General LiabilityTorrance, CaliforniaRemoteFull timeAbility to actively review work of others via file reviews; identify coaching opportunities, act on needed coaching opportunities and position subordinates for successful development leading to advancement within the organization. As part of Gallagher, a global leader in insurance, risk management, and consulting, you’ll be joining a team that’s passionate about helping individuals and organizations thrive.
Claims Administrator MachinifyClaims AdministratorCAThis role involves performing incoming claim reviews, organizing data, assigning statuses, and routing completed files to auditors while maintaining document hygiene and adhering to internal procedures. Additionally, this role includes analyzing data trends, monitoring file-sharing processes, verifying data transfer accuracy, and ensuring appropriate volume levels are maintained.
NewSenior Claims Examiner, Complex Liability GallagherSenior Claims Examiner, Complex LiabilityTorrance, CaliforniaFull timeBehaviors: Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges. Introduction : At Gallagher, we help clients face risk with confidence because we believe that when businesses are protected, they’re free to grow, lead, and innovate.