Insurance Contracting Specialist (Hybrid) Discovery Behavioral HealthInsurance Contracting Specialist (Hybrid)Irvine, CAFull timeThis role is responsible for engaging with healthcare providers and multi-specialty groups within the behavioral healthcare continuum (including eating disorder, mental health and substance use disorder services) in accordance with corporate guidelines to secure Single Case Agreements (SCAs), insurance contracts, and provider credentialing. Research and analyze the behavioral healthcare market, including provider types, levels of care, and regional access gaps, to identify and engage providers for potential partnerships, beginning with SCAs and/or payer contracts.
Litigation Case Manager L.A. Injury AttorneysLitigation Case ManagerBurbank, CaliforniaCommunicate with providers and creditors to confirm lien amounts and negotiate liens · Maintain accurate and detailed records of all negotiations, agreements, and communications pertaining to lien resolution · Draft reduction letters to resolve and negotiate medical liens · Negotiate all medical liens, Medpay reimbursement claims, waivers, and attorney liens in settled personal injury cases. Injury Attorneys is one of the top rated personal injury law firms in California and belongs to the Million Dollar Advocates Forum and the Multi- Million Dollar Advocates forum which is exclusive to those law firms that have excelled in their profession and secured multi-million dollar settlements and verdicts for their clients.
Bilingual Case Manager TORKLAWBilingual Case ManagerIrvine, CA$60,000–$85,000 / yearThis role is ideal for someone who thrives on keeping cases moving forward, building meaningful client relationships, and working collaboratively with attorneys and support staff to deliver outstanding service and results. We foster a supportive, team-oriented environment where employees are encouraged to grow professionally, contribute meaningfully, and make a real impact every day.
Risk Adjustment Coding Specialist II Astrana Health, Inc.Risk Adjustment Coding Specialist IICA, California$70,000–$85,000 / yearPerform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines. Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements.
Account Manager II, Commercial Lines Hub International LtdAccount Manager II, Commercial LinesNewport Beach, CATHE OPPORTUNITY: HUB's Customer Service professionals provide critical support to our customers through account management, claims management, day-to-day client oversight, and underwriting services that make us a leading sales and service organization in the insurance industry. The expected salary range for this position is $100,000 - $115,000k depending on geographical location and will be impacted by factors such as the successful candidate's skills, experience and working location, as well as the specific position's business line, scope and level.
New[Q & CC] Sr. Reverse Logistics Materials Planner TTE Technology Inc[Q & CC] Sr. Reverse Logistics Materials PlannerIrvine, CA$60,000–$80,000 / yearFull timePhysical and Work Environment Requirements:Primarily office-based work involving prolonged periods of computer use, including viewing computer screens and using a keyboard, mouse, and other office equipmentAbility to communicate effectively in person, by telephone, video conference, email, and other electronic communication platforms. This role serves as the primary owner of parts forecasting, supply planning, inventory governance, procurement coordination, and reverse logistics support between HQ China, repair centers, logistics partners, customers, finance, and regional leaderships.
IT Product Manager, Consultant Blue Cross and Blue Shield AssociationIT Product Manager, ConsultantLong Beach, CAThe Operations Portfolio team within Blue Shield of California provides robust solutions for our business partners, providers and members which improve the overall health care experience from claims processing to benefit enrollment. In this role, you will: Define product and technical vision, roadmap, and growth opportunities for the Commissions platform, aligning SAP S/4HANA/ECC and Informatica deliverables with business goals across Membership, Provider and Claims workflows.
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.
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 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 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.
Medical Claims Resolution Specialist Kinetic Personnel GroupMedical Claims Resolution SpecialistOrange, CA$25–$31 / hourTemporaryA full time permanent position includes a pay raise, telecommute options, a CalPERS Pension and excellent government benefits including generous holiday, PTO and sick pay days off, year one! Job duties: Addresses provider inquiries, questions, and concerns in all areas including enrollment, claims submission and payment, benefit interpretation, and referrals/authorizations for medical care.
NewClaims 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.
Denials Representative Insight GlobalDenials RepresentativeTorrance, CA$28–$32 / hourFull timeThe Denials Representative works closely with hospital revenue cycle and collections teams, identifies denial trends, and reports findings to leadership to help improve reimbursement processes and reduce future denials. This role researches denial reasons, contacts insurance companies, submits appeals, and follows up on outstanding claims until payment is received.
Workers' Compensation Defense Attorney - Newly Barred CA Attorneys! JobotWorkers' Compensation Defense Attorney - Newly Barred CA Attorneys!Orange, CA$100,000–$105,000 / 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. By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from Jobot, and/or its agents and contracted partners.
NewPre-Lit Case Manager JobotPre-Lit Case ManagerTorrance, CA$40–$45 / 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. By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from Jobot, and/or its agents and contracted partners.
New100% Remote Insurance Defense Trial Attorney Jobot100% Remote Insurance Defense Trial AttorneyCosta Mesa, CARemote$145,000–$220,000 / 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. Job Description: A leading nationwide insurance carrier is seeking a highly skilled and experienced Insurance Defense Trial Attorney to join our legal team.
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.
Independent Insurance Claims Adjuster in Bellflower, California MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Bellflower, CaliforniaBellflower, CaliforniaHow We Can Help You Succeed: At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting. You can also find us on YouTube at: ( https://www.youtube.com/channel/UC9nTRXrwnbC2TuYphDUVhWg ) and Facebook at: ( https://www.facebook.com/milehighadjustershouston ) for additional resources and updates.
Independent Insurance Claims Adjuster in Rialto, California MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Rialto, CaliforniaRialto, CaliforniaHow We Can Help You Succeed: At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting. You can also find us on YouTube at: ( https://www.youtube.com/channel/UC9nTRXrwnbC2TuYphDUVhWg ) and Facebook at: ( https://www.facebook.com/milehighadjustershouston ) for additional resources and updates.