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 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.
NewInside Senior Property Claims Adjuster - Sacramento, CA USAAInside Senior Property Claims Adjuster - Sacramento, CASacramento, CA$63,590–$121,530 / yearProactively manage assigned claims caseload comprised of claims with moderate complexity damages that require commensurate knowledge and understanding of claims coverage. Apply proficient knowledge of estimating technology platforms and virtual inspection tools; Utilize platforms and tools to prepare claims estimates to manage moderate complexity property insurance claims.
NewHealthcare Collections Representative JobotHealthcare Collections RepresentativeLos Angeles, CA$24–$28 / 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. The successful candidate will be responsible for the accurate and timely data entry, review, and adjudication of professional, ancillary, and institutional claims for services rendered in various healthcare settings.
Full-Stack Developer (React) Vaco LLCFull-Stack Developer (React)Concord, CARemote$60–$70 / hourDetermining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to: the individual’s skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; other business and organizational needs. Determining compensation for this role (and others) at Vaco/Highspring depends upon a wide array of factors including but not limited to the individual’s skill sets, experience and training, licensure and certifications, office location and other geographic considerations, as well as other business and organizational needs.
NewQuality 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.
NewMedical 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.
Commercial Lines Account Assistant JobotCommercial Lines Account AssistantWalnut Creek, CA$70,000–$80,000 / 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.
Legal Case Manager -- Plaintiff Personal Injury JobotLegal Case Manager -- Plaintiff Personal InjuryCentury City, CA$30–$40 / 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.
Grievance Resolution Specialist Kinetic Personnel GroupGrievance Resolution SpecialistOrange, CA$25–$37 / hourTemporaryGathers pertinent information regarding the grievances and appeals received, including, but not limited to, member or provider concerns, supporting information related to initial decision-making, new information supporting the grievance or appeal, or supplemental information required to evaluate grievances and appeals within regulatory requirements. The Grievance Resolution Specialist coordinates the Grievance and Appeal resolution process, responds to verbal and written Grievances and Appeals from members and/or providers relating to member eligibility and benefits, contract administration, claims processing, utilization management decisions, and pharmacy and vision decisions.
Certified Pharm Technician (PTCB/ExCPT) – Patient Service Rep CornerStone StaffingCertified Pharm Technician (PTCB/ExCPT) – Patient Service RepFresno, CAThis position partners with pharmacies, healthcare providers, and patients to deliver accurate information, resolve claim issues efficiently, and maintain compliance with HIPAA and healthcare regulations. The Certified Pharmacy Technician plays a critical role in supporting medication access by resolving pharmacy claims, benefit verification, and prior authorization inquiries.
NewAuto Appraiser - Photo USAAAuto Appraiser - PhotoSacramento, CA$57,590–$103,870 / yearAs an Auto Appraiser – Photo, you will be responsible to investigate, evaluate and appraise vehicle damage claims for both repairable and total loss vehicles to ensure estimate accuracy in compliance with state laws and regulations. Responsible for reviewing additional damages received from repair facilities to either complete a supplement or triage to field provider method of inspection.
Third-Party Medical Claims Processor Hire Up Healthcare (Division of Hire Up Staffing)Third-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.
Accounts Receivable Lead SarnovaAccounts Receivable LeadSan Jose, CAThe A/R Management Lead also serves as a subject matter expert, identifying process improvements to increase efficiency within the A/R Management team, and acting as a resource to help team members resolve issues. Since its founding in 1984, Digitech has refined its software platform to create a cloud-based billing and business intelligence solution that monitors and automates the entire EMS revenue lifecycle.
Risk Manager Vaco LLCRisk ManagerLos Angeles, CA$90,000–$105,000 / yearDetermining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to: the individual’s skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; other business and organizational needs. With that said, as required by local law, Vaco by Highspring believes that the following salary range referenced above reasonably estimates the base compensation for an individual hired into this position in geographies that require salary range disclosure.
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.
NewEnvironmental Heath & Safety Leader - Food Manufacturing Newport Meat CompanyEnvironmental Heath & Safety Leader - Food ManufacturingIRVINE, CAThe role aims to accomplish the following: Supporting their sites in executing on various EHS processes including: EHS-related training, environmental compliance, occupational health and safety, workers’ compensation, transportation safety, contractor management, and business continuity. Support the workers’ compensation claims process by completing OSHA determinations, identifying gaps in claims management, and promoting safe and early return to work as well as any other requirements related to general liability, motor vehicle, and property damage claims.
Risk Manager MV TransportationRisk ManagerEl Monte, CA$97,000–$114,000This role is exclusively assigned to the potential contract and plays a crucial role in mitigating risk exposure, supporting safe operations, and driving continuous improvement in loss prevention efforts. The Risk Manager will serve as the primary point of contact for all Agency-related risk management matters and must be available and responsive at all times via mobile phone, email, or text message.
Customer Service Claims Processor Zenith American SolutionsCustomer Service Claims ProcessorSan Francisco, CAFull timeThe Customer Service Claims Processor is focused on providing customer service via call handling to participants, beneficiaries, union locals and providers regarding eligibility, benefits and claims status in conjunction with claims processing as business needs dictate. 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.
NewCollections Representative AxelonCollections RepresentativeLos Angeles, CA$28–$32 / hourDocument billing activity, claim details, expected reimbursement, payments, and account actions clearly and accurately. Submit required supporting documentation, including authorizations, medical records, consent forms, and payer-specific forms.
Civil Process Specialist TPI Global SolutionsCivil Process SpecialistOakland, CARemoteJob duties include:Examine garnishments, levies, liens and information subpoenas to ensure accuracy, completeness and legal sufficiency. Claims include garnishments, levies, liens and information subpoenas received from creditors and taxing authorities.
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.
WARRANTY CLAIMS PROCESSOR Carmona's Appliance CenterWARRANTY CLAIMS PROCESSORRedding, CAWe are seeking a detail-oriented Warranty Claims Processor which is responsible for the successful submission of warranty claims to include pre-approval, proof of purchase, extended warranty, and any documentation for successful claims. · Prolonged Sitting: This role involves extensive periods of sitting at a desk and working on a computer (up to 8 hours).
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.
Disability Claims Processor On Call Kaiser PermanenteDisability Claims Processor On CallWoodland Hills, CAJob Summary: The Patient Business Services Disability Claims Processor is responsible for abstracting medical information and diagnosis, using ICD-9 codes as required. Coordinates disability claims with employers, insurance carriers, Unions, State Disability Offices, Workers Compensation and/or other third party payers.
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.
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.
Xcelys Medical Claims Examiner-REMOTE NTT DATAXcelys Medical Claims Examiner-REMOTEOntario, CARemoteActual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.
Claims Adjudicator Sr Loma Linda University Medical CenterClaims Adjudicator SrRedlands, CAAble to communicate effectively in English in person, in writing, and on the telephone; think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Knowledge and Skills: Extensive experience in health insurance claims processing, HMO claims or managed care environment is required, in-depth knowledge of medical billing and coding, knowledge of health insurance, HMO and managed care principles.
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.
Claims Specialist II - Provider Claims 26-00063 Alura Workforce SolutionsClaims Specialist II - Provider Claims 26-00063Rancho Cucamonga, CAAdditional responsibilities include handling escalated claim-related telephone inquiries, assisting with cross-training as needed, performing complex claim adjustment projects, and processing Provider Disputes in accordance with regulatory requirements. DESCRIPTION The Claims Specialist II – Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are conducted consistently and accurately.
Claims Specialist II - Provider Claims 26-00106 Alura Workforce SolutionsClaims Specialist II - Provider Claims 26-00106Rancho Cucamonga, CAAdditional responsibilities include handling escalated claim-related telephone inquiries, assisting with cross-training as needed, performing complex claim adjustment projects, and processing Provider Disputes in accordance with regulatory requirements. DESCRIPTION The Claims Specialist II – Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are conducted consistently and accurately.
Claims Specialist II - Provider Claims 26-00130 Alura Workforce SolutionsClaims Specialist II - Provider Claims 26-00130Rancho Cucamonga, CAAdditional responsibilities include handling escalated claim-related telephone inquiries, assisting with cross-training as needed, performing complex claim adjustment projects, and processing Provider Disputes in accordance with regulatory requirements. DESCRIPTION The Claims Specialist II – Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are conducted consistently and accurately.
Claims Processing Specialist Wollborg Michelson RecruitingClaims Processing SpecialistRancho Cordova, CAThis role includes processing special claims that may involve manual review of actual treatment compared to authorized treatment, and adjudicating claims for specific client programs. The Claims Processing Specialist identifies and provides solutions for processing unique claims, refunds, overpayments, and underpayments.
NewCard Services Processor (Onsite) Frontwave Credit UnionCard Services Processor (Onsite)Oceanside, California$19.73–$29.60 / hourFull timeOverview: The Card Services Processor is responsible for assisting members and employees with inquiries or issues pertaining to Visa Credit, Debit and/or ATM card services and provides general, clerical support in the Card Services Department. At Frontwave Credit Union, we are focused on creating consumer solutions to provide our members and the communities we serve with products and services that enhance the quality of life for our members through exceptional service and the progressive application of technology.
Education and Training Specialist - CLAIMS PROCESSING Providence Health & ServicesEducation and Training Specialist - CLAIMS PROCESSINGMission Hills, CA$29.62–$45.31 / hourRequsition ID: 445324 Company: Providence Jobs Job Category: Learning & Development Job Function: Human Resources Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 7520 CLAIMS PROCESSING CA HERITAGE SERVICES Address: CA Mission Hills 11165 N Sepulveda Blvd Work Location: Facey Sepulveda Annex-Mission Hills Workplace Type: On-site Pay Range: $29.62 - $45.31 Working under the general supervision of the Claims Director, provide an effective education program to advance the quality and production level of the Claims Department by developing and delivery claims training programs that continuously improves the Claims Department performance to meet the NSS strategic goals.
NewClaims Specialist II Mercury Insurance CompanyClaims Specialist IICA$44,466–$77,881 / yearBodily Injury Claims Management: Analyze medical records to evaluate, negotiate, and settle moderate bodily injury claims with legal counsel for represented claimants and unrepresented parties. If you're passionate about helping people restore their lives when the unexpected happens, and providing high-quality customer experiences, then our Mercury Insurance Claims team could be the place for you!
Claims Auditor Western GrowersClaims AuditorIrvine, CAThis position reports to the Supervisor of Payment Integrity and performs in-depth audits to ensure existing health (medical/dental) benefit plans of Western Growers Assurance Trust and Pinnacle Claims Management, Inc. clients are in compliance with the respective employers summary plan descriptions. At Pinnacle Claims Management, we are an innovative third-party administrator (TPA) that provides a full suite of comprehensive and customized health benefits administration services for self-funded companies, including health management and wellness solutions, and pharmacy benefit management.
Claims Process Specialist LancesoftClaims Process SpecialistOakland, CARemote$18Job duties include: Examine garnishments, levies, liens and information subpoenas to ensure accuracy, completeness and legal sufficiency. Claims include garnishments, levies, liens and information subpoenas received from creditors and taxing authorities.
Claims Processing Expert - Fully Remote MercorClaims Processing Expert - Fully RemoteSan Francisco, CaliforniaRemoteManage claims submission workflows including electronic claim generation, clearinghouse edits, and payer-specific billing requirements. Coordinate with coding, CDI, and collections teams to resolve billing edits and claim rejections.
Content Claims Specialist - Field - Level I Crawford & CoContent Claims Specialist - Field - Level ISan Diego, CARemote$21–$25 / hourCommunicate with adjusters/policyholders and industry vendors to explain their roles as Content Claims Specialists and their respective roles/contributions in the claims handling process. Communicate with all parties (adjusters/policyholders) in adherence with edjuster''s commitment to timely and informative updates on the content claims process.
Claims Analyst II (On-Site) NorthBay Medical CenterClaims Analyst II (On-Site)Fairfield, CAThe position is co-responsible for the operational functions for the organization's capitated hospital and medical group business, processing all claims, oversees customer service issues, researching/resolving payment issues and addressing corrections in the system with the Claims Specialist. Requires a high comfort level with taking initiative and responsibility, high energy and productivity, plus an orientation and ability to manage details in an organized work style.
Education and Training Specialist - CLAIMS PROCESSING Providence St. Joseph HealthEducation and Training Specialist - CLAIMS PROCESSINGMission Hills, CAWorking under the general supervision of the Claims Director, provide an effective education program to advance the quality and production level of the Claims Department by developing and delivery claims training programs that continuously improves the Claims Department performance to meet the NSS strategic goals. Any combination of experience or equivalent background: 5 years of experience of acquired in-depth technical knowledge of functional area i.e., claims operations, HMO products, industry claims processing procedures, contracts, billing and overall managed care processes, etc.
Claims Examiner I Western GrowersClaims Examiner IFresno, CA$40,580.28–$52,756.02 / yearAdjudicate all claims types including Dental, Vision and Medical claims for inpatient and outpatient facilities, Blue Card, physician claims, In and Out of Network claims, Medicaid reclamation (HIPD), outpatient lab and radiology, accident and Third-Party Liability (TPL) claims, by calculating benefit due to approve or deny, based on SPD and within accepted corporate cycle timeframe. Claims Examiner I is responsible for reviewing and processing medical, dental, vision, and electronic claims per state, federal, and health plan regulatory requirements and department guidelines, as well as meeting established quality and production performance benchmarks, including research and review of applicable documentation.
NewAssociate Inventory Clerk - Claims Processing Providence Health & ServicesAssociate Inventory Clerk - Claims ProcessingAnaheim, CARequsition ID: 445154 Company: Providence Jobs Job Category: Inventory Control Job Function: Supply Chain 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: $25.00 - $32.56 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.