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.
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.
NewClaims Examiner - Workers Compensation (Hourly) ObjectWin TechnologyClaims Examiner - Workers Compensation (Hourly)Brea, CATo 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. Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
Medicare Claims Clever Care Health Plan IncMedicare ClaimsHuntington Beach, CA$80,000–$90,000 / year5% - Facilitates and creates a team environment within the unit and with other departments; runs regular unit meetings, attends monthly claims review meetings and/or Clever Care meetings, as appropriate, in order to ensure effective communication between team members and disciplines. Skills: Ability to attend insurance and industry/business functions to promote and present a positive image of Clever Care; ability to participate in presentations to newly contracted providers; ability to travel as necessitated by business needs.
Claims Counsel Capital Insurance GroupClaims CounselOrange County, CARemote$114,364–$190,607 / yearThis is a remote position, ideally with someone based in Orange County (Irvine, Costa Mesa, Newport Beach, Santa Ana, Anaheim, Orange, Huntington Beach, and Fullerton). Responsible for consultation with claims staff in a variety of claims issues, including but not limited to, coverage, indemnification, policy limit demand reviews, indemnity agreement review, release language review.
Claims Examiner - Workers Compensation Iconma LLCClaims Examiner - Workers CompensationOrange, CASubject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. Responsibilities: 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.
Claims Examiner - Workers Compensation eTeam Inc.Claims Examiner - Workers CompensationLong Beach, CA$45–$50 / hourPRIMARY PURPOSE: 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. Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
Analyst I, Epic Application Professional Billing and Claims PDS HealthAnalyst I, Epic Application Professional Billing and ClaimsIrvine, California$83,000–$103,000 / yearFull timeOverview: The Analyst I, Epic Application Professional Billing and Claims is primarily responsible for assisting with basic Epic Professional Billing and Claims system configuration, routine tasks like build updates, testing, and report creation. Strong problem-solving and troubleshooting skills with the ability to analyze complex issues and recommend effective solutions.
Supervisor, Medicare Claims Clever Care Health PlanSupervisor, Medicare ClaimsHuntington Beach, CA5% - Facilitates and creates a team environment within the unit and with other departments; runs regular unit meetings, attends monthly claims review meetings and/or Clever Care meetings, as appropriate, in order to ensure effective communication between team members and disciplines. Participates in interviewing and hiring of new staff and facilitates or conducts effective onboarding and orientation for new employees; coordinates with the Manager for development of formal training programs; assigns staff to special projects and oversees workflow and workload of staff.
Claims Coordinator, PSA Collectors Holdings, Inc.Claims Coordinator, PSASanta Ana, CA$20.50–$23 / hourOur services span collectible trading cards, autographs, comic books, coins, video games, event tickets, and memorabilia. We grade, authenticate, vault, and sell millions of record-setting collectibles, all while modernizing and digitalizing the process to further our mission of helping collectors pursue their passions.
Senior Claims Specialist Crum & ForsterSenior Claims SpecialistORANGE, CaliforniaRemoteWith our employee-first focus, the Company is consistently recognized as a great place to work, earning multiple workplace and wellness awards, including the Great Place to Work® Award, Fortune 100 Best Companies to Work For, Fortune Best Workplaces for Parents, Fortune Best Workplaces for Millennials, and many others. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions.
Claims Resolution Specialist Edison InternationalClaims Resolution SpecialistRosemead, CACommunicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advises as to proper course of action. Once hired, the candidate must complete specified training prior to gaining un-escorted access to assigned work location and performing necessary job duties.
Workers Compensation Claims Technician Liberty Mutual Holding Company IncWorkers Compensation Claims TechnicianGlendale, CAEffective analytical skills required to learn and apply basic policy/contract coverage and recognize questionable coverage/contract situations (which necessitate supervisory involvement) along with effective interpersonal skills to explain the facts and logic used to arrive at decisions in a way that the customer understands. Verifies information from claimants, physicians, and medical providers to assess compensability and/or causal relation of medical treatment, and make evaluations for cases with claim specific on-going medical management.
Claims Specialist Lead The Progressive CorpClaims Specialist LeadIrvine, 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.
Warranty Claims Data Analyst Kawasaki Motors Corp USAWarranty Claims Data AnalystFoothill Ranch, CA$75,000–$80,000 / yearServes as back up to other warranty team members that may include the following tasks: Processes product registrations, customer updates, vehicle status changes, labor rate updates, and KPP extended service contract sales. Acts as a liaison for the Warranty department to consult with the Quality Assurance department and our Consumer Services and Product Support Hotline teams in regards to sharing information on trending warranty issues.
Claims Examiner City of Compton CAClaims ExaminerCompton, CA$79,747.80–$93,499.20 / yearEducation and Experience: Possession of a Bachelor's degree from an accredited college or university in Business Administration or a related field, AND two (2) years of experience adjusting workers' compensation claims with a public agency or third-party administrator; OR an equivalent combination of education and experience. In all entrance examinations (open-competitive only) for positions in the Classified Service, veterans who served in the armed forces of the United States during time(s) of war, and who attain an overall passing score in the examination are allowed additional preferential credit in accordance with the Personnel Rules and Regulations.
Senior Claims & Participant Services Specialist Ultimate Staffing ServicesSenior Claims & Participant Services SpecialistBurbank, California$55,000–$65,000 / hourThis highly visible role serves as a key point of contact for health plan participants, providers, hospitals, and physicians while also supporting process improvement initiatives across claims operations. This position offers the opportunity to make a meaningful impact by improving participant experiences, resolving complex claims issues, and contributing to operational excellence.
Sr. Manager - Claims Delegation Audit Astrana Health IncSr. Manager - Claims Delegation AuditMonterey Park, CAThis role will be responsible for the development and execution of department strategies, overall Audit program, Audit process optimization, and management, identifying and leveraging technology and data to improve the quality and minimizing process cost of Claims. The position alongside the leadership team will contribute to driving strategic planning, operational excellence, and accuracy of the claims process and ensure compliance with regulations and contract requirements for Medicare, Commercial Exchange, and Medicaid service lines.
Claims Manager - Risk Management Live Nation Entertainment IncClaims Manager - Risk ManagementCA$104,000–$130,000 / yearCollaborates with in-house and outside legal counsel to assure proper handling of litigated files as well as coordination of discovery including but not limited to gathering pertinent legal information and claims documentation, deposition requests, identification and preparation of witnesses and other discovery, as well as assists in developing overall defense strategy. Ability to work autonomously to a significant degree, have a high level of attention to detail, be organized and efficient and able prioritize and successfully manage multiple projects, enjoy working in a fast-paced environment, and place a high value on providing exceptional and timely service to internal and external clients.
Claims Specialist Pavement Recycling Systems, IncClaims SpecialistJurupa Valley, California$85,000–$115,000 / yearFull timeThe Claims Specialist is responsible for evaluating, processing, and managing liability, property, auto, general liability claims, and employment claims in compliance with state regulations; documenting activities; conveying information regarding claims and/or benefits; and providing testimony in benefit disputes while exercising discretion, independent judgment, critical thinking skills and demonstrate exemplary customer services skills. Serve as the face of the company in providing frequent, proactive verbal communication with our claimants, customers and/or their representatives demonstrating empathy and active listening while providing clear updates, direction and explanations regarding the claim process, benefits, and other pertinent policy provisions.