Claims Edit Coder Cedars-Sinai Medical CenterClaims Edit CoderLos Angeles, CAWhat you will be doing in this role: The Claims Edit Coder (Coder II) operated under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team. Communicates with physicians, providers, and external departments regarding documentation clarity, specificity, ensure the completeness of documentation required for code assignment within area(s) of assignment or specialty.
Healthcare Claims Examiner Ultimate Staffing ServicesHealthcare Claims ExaminerEl Monte, California$25–$28 / hourResearch and resolve claim discrepancies, including making payment corrections, recovering overpayments, and reprocessing claims as needed. Evaluate claims for potential fraud, waste, abuse, Workers' Compensation, hospital-acquired conditions, and third-party liability; escalate issues appropriately.
Chief Claims Officer, Argo Group Argo Group International Holdings IncChief Claims Officer, Argo GroupLos Angeles, CAPossesses an extensive knowledge and experience with adjudicating and management claims for a portfolio of commercial products/program lines including surety, auto, general liability, workers' compensation, property, asbestos/environmental, reinsurance and the relevant claims handling practices supporting such products/programs. The Chief Claims Officer, Argo Group provides claim leadership and direction to the Senior Management of all the Argo Group claims operations with a focus on supporting the consistent execution of claims functions and maintenance of operational excellence.
Chief Claims Officer, Argo Group Argo Group International Holdings Ltd.Chief Claims Officer, Argo GroupLos Angeles, CAPossesses an extensive knowledge and experience with adjudicating and management claims for a portfolio of commercial products/program lines including surety, auto, general liability, workers' compensation, property, asbestos/environmental, reinsurance and the relevant claims handling practices supporting such products/programs. The Chief Claims Officer, Argo Group provides claim leadership and direction to the Senior Management of all the Argo Group claims operations with a focus on supporting the consistent execution of claims functions and maintenance of operational excellence.
Cust Serv Rep I -Claims Alert Crawford & CoCust Serv Rep I -Claims AlertCARemoteAll resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. Provides excellent customer service to all internal team members and external customers.
Sr. Manager - Claims Astrana Health, Inc.Sr. Manager - ClaimsMonterey Park, CaliforniaRemote$125,000–$140,000 / yearYou’ll partner closely with internal teams, resolve escalations, and coach a team of claims professionals to deliver compliant, efficient, and accurate outcomes in a fast‑paced environment. Minimum of a Bachelor's degree (B.A.) from a four-year college or university; or at least four (4) years current Management or equivalent experience with an MSO or IPA Management.
Claims Quality Auditor UCLA Health SystemClaims Quality AuditorLos Angeles, CA$31.51–$62.64 / hourb'nn n n n n n n n n n n n nn n n n n n n n n n n n n n n n n n Claims Quality Auditor - - 31703 - UCLA Healthn n nnnn nn n n n nn n n n n Skip to content nn n n n n n UCLA Health Home Page n n nn nnn n nn n Main menu. Press enter or space keys to expands and escape key to collapse nn n n n n n n Search jobs n n nn n n n Empl...
Client Implementation Analyst - Healthcare Billing and Claims (Remote) Experian Information Solutions IncClient Implementation Analyst - Healthcare Billing and Claims (Remote)CARemoteExperian''s people first, inclusive and purpose driven culture is multi award-winning; World''s Best Workplaces 2025 (Fortune Global Top 25), Great Place To Work in 26 countries to name a few. Monitor accuracy and completeness of all assigned jobs· Provide technical support including testing, debugging, troubleshooting and implementing necessary program updates.
Claims Specialist II Blue Cross and Blue Shield AssociationClaims Specialist IILos Angeles, CANecessary Contacts: In order to effectively fulfill this position, the Claims Specialist II must be in contact with personnel in other Units: Various internal departments and staff including, but not limited to, Provider Services, Legal, Internal Audit, IT, other Benefits Operations Management and staff, Enrollment and Billing, Administrative Services, and District Offices. Reviews, researches, and makes necessary updates to claims that may include the following: recalculation of benefits to previously processed claims, the processing of claims edits, or initiation of refund requests, according to contractual benefits or provider reimbursement rules, ultimately providing a high degree of customer satisfaction.
Director Complex Claims and Counsel Banner HealthDirector Complex Claims and CounselCA$65.70–$109.50 / hourResponsible for obtaining, entering data into claim file and monitoring such data in order to comply with deadlines for meeting Medicare, Medicaid, Ship Extension Act (MMSEA) reporting requirements in relation to claimants and others releasing medical expense claims. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained.
Claims Examiner Career AdvocatesClaims ExaminerLos Angeles, CaliforniaThe Claims Examiner will be responsible for researching and resolving pending claims, reviewing claim denials requiring manual review, and ensuring timely processing in compliance with policies, procedures, and regulatory guidelines. Assist in claims processing and report billing/error trends identified during reviews.
NewClaims Research Specialist - SHP Finance - Remote / Hybrid - Day Shift - Full Time Sharp Health PlanClaims Research Specialist - SHP Finance - Remote / Hybrid - Day Shift - Full TimeCARemote$30.37–$37.95 / hourThe 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. Develops solid professional working relationships with various internal departments and units and, as required, vendors, providers, employers, brokers and/or other customers.
Sr. Manager - Claims Delegation Audit Astrana Health, Inc.Sr. Manager - Claims Delegation AuditMonterey Park, California$125,000–$140,000 / yearThe 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. External Audit planning, execution & support Own the end‑to‑end strategy and execution of all external audits (e.g., CMS, DMHC, health plan audits), ensuring readiness, successful delivery, and continuous score improvement.
Claims Intake Coordinator University of CaliforniaClaims Intake CoordinatorLos Angeles, CA$26.42–$37.49 / hourAs a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer. Able to key between 6,000 to 8,000 keystrokes or type 40-50 WPM with high accuracy for alpha and numeric data inputting.
Claims Quality Auditor University of CaliforniaClaims Quality AuditorLos Angeles, CA$31.51–$62.64 / hourAs a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer. You will review claims (paid, pending, and denied) for accuracy, appropriate application of benefits, authorization for services, contract interpretation, Division of Financial Responsibility (DOFR), and application/compliance with policies and procedures.
Patient Account Representative - Medicare, Medicaid, Commercial Claims GuidehousePatient Account Representative - Medicare, Medicaid, Commercial ClaimsEl Segundo, CA$34,000–$56,000 / yearCompensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com.
Lead - Claims Examiner Astrana Health, Inc.Lead - Claims ExaminerMonterey Park, CA$27–$32 / hourWork closely with other Company departments and specifically, the Claims QA and Training Specialist to communicate findings of recovery audits and to facilitate accurate adjudication of claims. Ensures that all legal, regulatory and policy requirements are met by keeping informed of changes and by implementing necessary controls and/or programs to meet requirements.
EPL & D&O Liability Claim Counsel The Travelers CompaniesEPL & D&O Liability Claim CounselGlendale, CA$111,600–$184,200 / yearTravelers' Private/Non-Profit Team provides executive and organizational management liability coverage to privately held companies and non-profit entities of all types and sizes as well as certain governmental public entities. Prepare and present reports for management that accurately reflect loss development, potential/actual financial exposure, reserve adjustments, coverage issues, and claim and recovery strategies.
Claim Director Chubb LtdClaim DirectorChatsworth, CA$78,100–$114,400 / yearPerform assignments, tasks or activities that contribute to the overall objectives of the business division being supported including but not limited to; conducting audits, providing financial analysis on reserve adequacy, identifying occupational disease exposures, and providing expertise on jurisdictional nuances. Provide direction, reserve and settlement authority to claim handlers as outlined in Chubb North American Claim Handling Guidelines and within Director's authority, elevating requests above authority to appropriate management levels for approval.
Senior Claim Director Chubb LtdSenior Claim DirectorLos Angeles, CA$107,800–$156,200 / yearThe company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. Proficient computer skills and extensive knowledge of the Microsoft suite of Office products including Outlook, Word, Excel, and PowerPoint, and Adobe Acrobat.