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.
NewClaim Specialist - Property Field Inspection State Farm Mutual Automobile Insurance CompanyClaim Specialist - Property Field InspectionConcord, CA$78,862.06–$118,245 / yearCompetitive candidates should reside within one of the listed zip codes and will service this same territory: 94505, 94506, 94509, 94513, 94517, 94518, 94519, 94520, 94521, 94523, 94525, 94526, 94531, 94553, 94561, 94565, 94595, 94596, 94597, 94598. Additional Details: Employees must successfully complete all required training, including applicable proficiency, licensing exam(s), Motor Vehicle Record (MVR) checks, and background checks required of various state(s).
Third-Party Medical Claims Processor Hire Up Staffing ServicesThird-Party Medical Claims ProcessorFresno, CAIdeal Candidate: The perfect fit for this role has at least 3 years of experience in medical billing or claims processing especially 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 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 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.
Junior Claims Processor Southern California Pipe Trades Administrative CorporationJunior Claims ProcessorLos Angeles, CAFull timeJOB RESPONSIBILITIES:Specific:Review and resolve participant repayment accounts, including determining amounts owed and issuing repayment notices through the WEX online benefits platform. Review and resolve vision auto-adjudication claims, including approving claims and requesting additional information through the WEX online benefits platform.
Claims Processor ArsenaultClaims ProcessorLos Angeles, CaliforniaThrough our dedicated associates, Arsenault 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. It is essential to have a good understanding of EOBs, FSAs, how to read receipts, doctor bills, and basic medical paperwork.
OHS Claims Processor I (Bilingual) FT Kaiser PermanenteOHS Claims Processor I (Bilingual) FTLos 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.
Cash/Claims Processor GlobalchannelmanagementCash/Claims ProcessorWhittier, CaliforniaCash/Claims Processor duties: Manage the flow of processes completed by Cash Processors to ensure all cash is applied in a timely manner to outstanding invoices and provide Cash Supervisor for daily updates. Train associates on how to process transactions, which include researching and applying cash for both Payers and Members, Provide a point of contact for any questions/issues regarding Cash for other areas of Assignment.
Part-Time (34 hours/week) Data Entry Claims Intake Processor Staffing Data Services AgencyPart-Time (34 hours/week) Data Entry Claims Intake ProcessorSan Francisco, CaliforniaRemoteWork collaboratively with other team members to ensure that work is completed in accordance to designated turnaround times. If selected for further consideration, candidates will be required to complete an online alphanumeric data entry assessment.
Cash/Claims Processor Assignment ObjectWin Technology IncCash/Claims Processor AssignmentCAResearches and resolves data issues through coordination and communication with internal and/or external clients and team members, ensuring timely application of payments on open receivables. Detailed working knowledge of basic computer operations and systems, i.e. Web-based search engines, Windows, and Microsoft Office products.
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.
NewProject Manager TPI Global SolutionsProject ManagerDPH-Public Health, CA$78.18 / hourTemporaryContractorFull timeThe Senior PM determines appropriate products or services with clients or customers to define project scope, requirements and deliverables; develops, modifies or provides input to project plans; implements project plans to meet objectives; coordinates and integrates project activities; manages, leads or administers project resources; monitors project activities and resources to mitigate risk; implements or maintains quality assurance processes; makes improvements, solves problems or takes corrective action when problems arise; gives presentations or briefings on all aspects of the project; participates in phase, milestone and final project reviews; identifies project documentation requirements or procedures; and develops and implements project schedules and release plans. The Senior PM will possess knowledge and experience in customer service; decision making; flexibility; interpersonal skills; leadership; organizational awareness; problem solving, reasoning; team building; oral communication, speaking and writing; business process reengineering; capital planning and investment assessment; contracting/procurement; cost-benefit analysis; financial management; planning and evaluating; project management; quality assurance; requirements analysis and risk management; configuration, data, and information management; information resources strategy and planning; information technology architecture; information technology performance assessment; infrastructure design; systems integration; systems life cycle; and technology awareness.
Lead Claims Specialist - Claims Processing Providence Health & ServicesLead Claims Specialist - Claims ProcessingMission Hills, CARequsition ID: 451045 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 Mission Hills 11165 N Sepulveda Blvd Work Location: Facey Sepulveda Annex-Mission Hills Workplace Type: Hybrid Pay Range: $27.92 - $42.73 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.
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.
Lead Claims Specialist - Claims Processing Providence St. Joseph HealthLead 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. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Manager Claims Admin - Revenue Cycle Claims Processing - Sharp Corporate - Day Shift - Full Time Sharp HealthCareManager Claims Admin - Revenue Cycle Claims Processing - Sharp Corporate - Day Shift - Full TimeSan Diego, CaliforniaDemonstrate safe work practices by identifying and reporting potential safety hazards to appropriate personnel, including but not limited to the following: Assuring staff’s appropriate chair height, keyboard and screen placement, securing of electrical wiring, use of proper body mechanics, etc. The 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.