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.
Senior Claims Examiner (50714) Western GrowersSenior Claims Examiner (50714)Fresno, CAProficient in medical terminology, contract and benefit interpretation, UB-04 and HCFA 1500 forms (837/5010 format), medical coding, CPT, ICD10, HCPCS, DRG, National Correct Coding Initiative (NCCI) edits or Medically Unlikely Edits (MUE), with working knowledge of Federal, State and Self-funded insurance plans. Assist leadership team improve turnaround times, processes, or staff training identifying errors through data analysis and auditing, and working with various teams to ensure those errors are corrected in both the short and long term.
Claims Examiner I (50480) Western GrowersClaims Examiner I (50480)Fresno, CAAdjudicate 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.
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.
Senior Claims Examiner (50714) Western Growers AssociationSenior Claims Examiner (50714)Fresno, CAAssist leadership team improve turnaround times, processes, or staff training identifying errors through data analysis and auditing, and working with various teams to ensure those errors are corrected in both the short and long term. Examine claim files for accuracy and make necessary adjustments and corrections: verifications (i.e. eligibility, medical authorization, etc.); reach out to Health Care Providers to obtain necessary claims documentation, perform complete file reviews when appropriate.
Claims Examiner I (50480) Western Growers AssociationClaims Examiner I (50480)Fresno, CAAdjudicate 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.
Claims Receivables and Recovery Specialist (50627) Western GrowersClaims Receivables and Recovery Specialist (50627)Fresno, CAThe Claims Receivables and Recovery Specialist reports to the Supervisor, Payment Integrity, and works with various departments within the company to ensure all open claim receivables, which are results of claim overpayments and/or adjustments, are pursued and collected appropriately. Collect receivables for the Western Growers Assurance Trust (WGAT) and clients of the Third-Party Administrator (TPA) that may be a result of overpayments or claims adjustments by researching, writing letters, and actively making phone calls.
Risk Analyst (Claims Adjuster)- Personnel Services Dept. -City of Fresno Fresno Regional Workforce Development BoardRisk Analyst (Claims Adjuster)- Personnel Services Dept. -City of FresnoFresno, CaliforniaORAL EXAM - 100%: A panel of subject matter experts will conduct a job-related oral examination to evaluate a candidate's knowledge of principles, and practices and associated laws related to personal injury, liability and property claims procedures and practices, loss investigation and claim adjustment techniques, customer service concepts, ability to establish effective working relationships, speak and write clearly and concisely or other topics related to a candidate's training, experience and qualifications for the position of Risk Analyst. DROP (Deferred Retirement Option Proaram): an optional, voluntary program that allows an employee to deposit retirement benefits in a special savings account within the Retirement System while continuing to work for the City of Fresno for up to 10 years.
Claims Receivables And Recovery Specialist (50627) Western Growers AssociationClaims Receivables And Recovery Specialist (50627)Fresno, CAThe Claims Receivables and Recovery Specialist reports to the Supervisor, Payment Integrity, and works with various departments within the company to ensure all open claim receivables, which are results of claim overpayments and/or adjustments, are pursued and collected appropriately. Collect receivables for the Western Growers Assurance Trust (WGAT) and clients of the Third-Party Administrator (TPA) that may be a result of overpayments or claims adjustments by researching, writing letters, and actively making phone calls.
NewWorker Compensation Claims Examiner III (Hybrid) Roth Staffing CompaniesWorker Compensation Claims Examiner III (Hybrid)Fresno, California$35–$44 / hourThe Claims Examiner III works closely with claimants, attorneys, medical providers, nurse case managers, vocational experts, vendors, clients, and internal staff to ensure claims are handled in compliance with state regulations and company best practices. This role is responsible for managing complex and litigated workers' compensation indemnity claims from assignment through resolution.
Content Claims Specialist - Field - Level I Crawford & CoContent Claims Specialist - Field - Level IFresno, 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.
Independent Insurance Claims Adjuster in Madera, California MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Madera, CaliforniaMadera, 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 Sanger, California MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Sanger, CaliforniaSanger, 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 Clovis, California MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Clovis, CaliforniaClovis, 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 Hanford, California MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Hanford, CaliforniaHanford, 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.
Claims Specialist Lead The Progressive CorpClaims Specialist LeadFresno, CA$39.18–$51.92 / hourFor ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/ . As a claims specialist on our team, you'll play a critical role in our ability to successfully and efficiently resolve large-loss injury claims valued over $60k.
Claims Adjuster (Official Title: Risk Analyst) City of FresnoClaims Adjuster (Official Title: Risk Analyst)Fresno, CA$84,120–$101,832 / yearORAL EXAM - 100%: A panel of subject matter experts will conduct a job-related oral examination to evaluate a candidates knowledge of principles, and practices and associated laws related to personal injury, liability and property claims procedures and practices, loss investigation and claim adjustment techniques, customer service concepts, ability to establish effective working relationships, speak and write clearly and concisely or other topics related to a candidates training, experience and qualifications for the position of Risk Analyst. Do you possess two (2) years of experience in loss control, risk management, workers compensation, insurance underwriting, or employee safety and have a Bachelors Degree in Business Administration, Public Administration, or closely related field?.
Claims Adjuster Senior - Injury The Progressive CorpClaims Adjuster Senior - InjuryFresno, CA$36–$47 / hourFor ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/ . Investigating complex and high-risk claims - which may be attorney represented or have additional litigation features - you'll consult with police officers, medical professionals, claimants and others involved in the accident.
Claims Adjuster - Attorney Represented Injury The Progressive CorpClaims Adjuster - Attorney Represented InjuryFresno, CA$30.29–$39.23 / hourAn ideal candidate will have experience managing an inventory independently, experience assessing and evaluating liability, coverage, and damages, as well as working independently and directly with attorneys to negotiate and settle claims. For ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/ .
Claims Adjuster Senior - Litigation The Progressive CorpClaims Adjuster Senior - LitigationFresno, CA$36–$47 / hourFor ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/ . Investigating complex and high-risk claims - which may be attorney represented or have additional litigation features - you'll consult with police officers, medical professionals, claimants and others involved in the accident.