Xcelys Medical Claims Examiner (Remote) NTT DATAXcelys Medical Claims Examiner (Remote)Ontario, CARemoteAs part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.
Financial Clearance Specialist III - PreArrival - Full Time 8 Hour Rotating (Non-Exempt) (Non-Union) University of Southern CaliforniaFinancial Clearance Specialist III - PreArrival - Full Time 8 Hour Rotating (Non-Exempt) (Non-Union)Los Angeles, CaliforniaWhen extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations. As a leading academic medical center, hundreds of clinical trials are currently taking place at Keck Hospital and its affiliated research institutions, giving patients access to novel and promising therapies that are generally not available elsewhere.
Financial Clearance Specialist III - Prearrival - Full Time 8 Hour Rotating (Non-Exempt) (Non-Union) University of Southern CaliforniaFinancial Clearance Specialist III - Prearrival - Full Time 8 Hour Rotating (Non-Exempt) (Non-Union)Los Angeles, CA$26–$41.28 / hourWhen extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations. As a leading academic medical center, hundreds of clinical trials are currently taking place at Keck Hospital and its affiliated research institutions, giving patients access to novel and promising therapies that are generally not available elsewhere.
NewClient Service Representative Vicar Operating dba VCAClient Service RepresentativeOntario, California$18–$20 / hourAs a CSR, you must be a self-starter with a strong attention to detail, ability to work in fast-paced environment, be able to handle difficult cases and clients, and have outstanding communication skills. SUMMARY: As part of the Client Service Representative Team, you will help set the tone for the practice as we build and maintain each customer's trust and confidence in our abilities.
Facility Outpatient Surgical and Claims Edit Auditor (Remote) Cedars-Sinai Medical CenterFacility Outpatient Surgical and Claims Edit Auditor (Remote)Los Angeles, CARemoteMaintains appropriate open communication with internal and external partners and peer departments such as Coding Operations, Clinical Documentation Integrity (CDI), Payor Revenue Management (PRM), and Compliance Revenue Integrity (CRI). Auditors evaluate compliance with all coding guidelines including but not limited to: Internal Coding policies/procedures/handbook, American Hospital Association (AHA) and American Medical Association (AMA) coding references, local, State, and Federal Coding Guidelines.
Facility Inpatient Surgical and Claims Edit Auditor Cedars-Sinai Medical CenterFacility Inpatient Surgical and Claims Edit AuditorLos Angeles, CARemoteMaintains appropriate open communication with internal and external partners and peer departments such as Coding Operations, Clinical Documentation Integrity (CDI), Payor Revenue Management (PRM), and Compliance Revenue Integrity (CRI). Auditors evaluate compliance with all coding guidelines including but not limited to: Internal Coding policies/procedures/handbook, American Hospital Association (AHA) and American Medical Association (AMA) coding references, local, State, and Federal Coding Guidelines.
Implementation Auditor (50487) Western Growers AssociationImplementation Auditor (50487)Irvine, CAUsing close and comprehensive analyses, verify new and existing plans loaded on the Company's claim management system against the appropriate Summary Plan Description to determine the accuracy of present and future claims payments. This position will ensure that all new and existing health (medical/dental) insurance plans underwritten by the Western Growers Assurance Trust (WGAT) and those of Pinnacle, Inc. (PCMI) are in compliance with the respective employers' summary plan descriptions.
Plan Coder (50456) Western Growers AssociationPlan Coder (50456)Irvine, CAThis position will ensure that all new and existing health (medical/dental/pharmacy) insurance plans underwritten by Western Growers Assurance Trust (WGAT) and those of Pinnacle Claims Management, Inc. (PCMI) are in compliance with the respective employers' summary plan descriptions. Do everything possible to help members succeed by being curious and striving to understand what others are trying to achieve, planning, and executing work helpfully and collaboratively.
NewDecision Scientist - Clinical Informatics (Clinical Data Standards) CVS Health CorpDecision Scientist - Clinical Informatics (Clinical Data Standards)CA$64,890–$158,620 / yearA&BC leverages advanced analytics, clinical informatics, and hypothesis-driven approaches to transform data into actionable, customer-centric insights that drive growth, improve health outcomes, and expand access to healthcare across all CVS Health businesses. Collaborate with data engineering teams to inform data pipeline development, ensuring clinical data is ingested, transformed, and stored in ways that support downstream analytics needs.
Senior Manager, Claims Adjustments L.A. Care Health PlanSenior Manager, Claims AdjustmentsLos Angeles, CAThe Senior Manager, Claims Adjustments manages all adjustment-related operational workflows, including provider disputes, escalated claim reviews, complex adjustments, and litigation-related claim support. Ensures all provider adjustments meet Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), Centers for Medicare and Medicaid Services (CMS), and contractual (TAT) requirements.
RAC Manager Prime Healthcare Management IncRAC ManagerOntario, California$71,760–$94,619.20 / yearFull timeExtensive knowledge of nursing care, clinical measurement tools, and clinical outcomes; ability to establish cooperative working relationship with diverse groups and individuals, the medical staff, and other healthcare disciplines; program and database development a plus. Working with the Supervisor(s), a RAC manager functions as a subject matter expert (SME) for the appeals process and takes an active role in managing the process and coordinating with the RAC team, Corporate Utilization Review and Clinical appeals team.
Clinical Documentation Specialist 4 HX - Clinical Doc Integrity - P/T Days Remote University of California, IrvineClinical Documentation Specialist 4 HX - Clinical Doc Integrity - P/T Days RemoteIrvine, CaliforniaRemotePart timeAs Orange County’s only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region’s only American College of Surgeons-verified Level I adult and Level II pediatric trauma center , American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. *Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional 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; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.
Advanced Practice Provider (App), Nurse Practitioner (Np) Or Physician Assistant (Pa) COPE Health SolutionsAdvanced Practice Provider (App), Nurse Practitioner (Np) Or Physician Assistant (Pa)Los Angeles, CA$150,000–$200,000 / yearComprehensive AWV & Gap Closure: Perform Medicare Annual Wellness Visits in the home, completing detailed cognitive screenings, fall risk assessments, and personalized prevention plans while closing active quality care gaps and appropriately capturing HCC codes as part of documentation. This role executes in-home Annual Wellness Visits (AWVs), manages complex clinical transitions of care (TOC) immediately following hospital discharge, and provides long-term stabilization for high-acuity patients enrolled in Complex Care Management (CCM) and is proficient at HCC coding and medical disease documentation.
NewTrauma Program Coordinator - Trauma Service - F/T - Days University of California, IrvineTrauma Program Coordinator - Trauma Service - F/T - DaysOrange, CaliforniaFull timeAs Orange County’s only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region’s only American College of Surgeons-verified Level I adult and Level II pediatric trauma center , American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. *Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional 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; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.
Quality Analyst Home Health, Lead Assistant Manager ExlService Holdings IncQuality Analyst Home Health, Lead Assistant ManagerCA$60,100–$98,700 / yearContinuous Improvement/Education actively participates with team to ensure alignment and sustained results; attends training (assigned or self-initiated) to improve performance or capitalize on new overpayment trends; keeps up with CMS, OIG, and other publications related to our business. EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates.
NewMechanical Overhaul Technician Aureate Technologies IncMechanical Overhaul TechnicianSan Fernando, CAThis position is best suited for a mechanically inclined candidate who enjoys hands-on teardown, assembly, repair, cleaning, and industrial equipment work and is comfortable working in a physically demanding manufacturing environment. This is a hands-on manufacturing/overhaul position ideal for candidates with experience or training in mechanical assembly, disassembly, fabrication, machining, welding, electrical work, painting, production, or general industrial labor .
Switchboard Assembly Operator - 2nd shift Siemens AGSwitchboard Assembly Operator - 2nd shiftPomona, CAMust be able to stand for 10-12 hour shifts You'll win us over by having the following qualifications: Basic Qualifications: Basic computer skills and use of basic mechanical /measuring tools Ability to speak, read, write and understand English Ability to stand to perform job duties Ability to reach, grasp and lift up to 50lbs, push/pull and slide heavy material Ability to stoop, bend, squat, crawl and climb Must be at least 18 years of age Must be thorough and able to multi-task in a fast-paced environment. Experience level Early Professional Job type Full-time Work mode Office/Site only Employment type Permanent Location(s) Pomona - California - United States of America Here at Siemens, we take pride in enabling sustainable progress through technology.
NewSwitchboard Assembly Operator Siemens SI - North AmericaSwitchboard Assembly OperatorPomona, CAYou’ll win us over by having the following qualifications: Basic Qualifications: Basic computer skills and use of basic mechanical /measuring tools. Scans in and out of work orders (with the use of computers, scanning devices, etc.) in adherence to the production schedule or expedited orders.