NewClaims Examiner I Clever Care Health PlanClaims Examiner IHuntington Beach, CAThis position requires considerable interaction with clients, claimants on the phone, with management, other Claims Examiners, and other staff in the office; therefore, consistently being at work in the office or home office location as applicable, in a timely manner, is inherently required of this position. At Clever Care, you'll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation.
Claims Examiner - Workers Compensation (Hourly) Iconma LLCClaims Examiner - Workers Compensation (Hourly)Brea, CAResponsibilities: 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.
GLOVIS: Temp Analyst, Claims Revenue and Cost Integration Elevated ResourcesGLOVIS: Temp Analyst, Claims Revenue and Cost IntegrationIrvine, CaliforniaThis role will focus on collecting, organizing, validating, and analyzing claims-related data to help develop an AI solution that can review claim photos, inspection reports, repair estimates, and other documentation to identify damages, estimate severity, and assist with determining liability. Collect, organize, and maintain claim photos, inspection reports, repair estimates, invoices, incident reports, and supporting documentation.
Sr. Manager - Claims Astrana Health IncSr. Manager - ClaimsMonterey Park, CAThis role will report to the AVP - Claims Operations and enable us to continue to scale in the healthcare industry. About the Role: We are currently seeking a highly motivated Claims Manager.
Lead - Claims Examiner Astrana Health IncLead - Claims ExaminerMonterey Park, CAManager - Claims and enable us to continue to scale in the healthcare industry. We are currently seeking a highly motivated Lead - Claims Examiner.
Claims Resolution Specialist, Covered California CalOptimaClaims Resolution Specialist, Covered CaliforniaOrange, CA$53,813–$80,720 / yearWe are hoping you will join us as a Claims Resolution Specialist, Covered California and help shape the future of healthcare where you'll be an integral part of our Claims Administration team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet.
Assistant Director, Claims Operations Impresiv HealthAssistant Director, Claims OperationsHuntington Beach, CA$95,000–$120,000 / yearThe Assistant Director will provide operational, analytical, administrative, and project support across claims processing, 837 file oversight, payment integrity, issue resolution, provider and IPA coordination, reporting, audit readiness, system initiatives, and process improvement. Track, document, escalate, and help resolve complex claims issues involving providers, IPAs, delegated entities, vendors, and internal departments.
Senior Trial Attorney -Subrogation (Hybrid) Onebeacon Professional Insurance IncSenior Trial Attorney -Subrogation (Hybrid)Anaheim, CA$159,000–$186,000 / yearWorks with Lead Attorney on all aspects of pre-suit and litigated files including retaining experts, sending pre-suit notice letters, coordinating joint inspections and exams, initiating litigation and conducting all phases of litigation through trial. Some of the Senior Trial Attorney responsibilities include but are not limited to: Handles a consistent workload of subrogation files representing Intact's subrogation interests in property, maritime, financial and cyber matters.
Dental Front Office Receptionist A R BAKER DDSDental Front Office ReceptionistSan Fernando, CA$23–$26 / hourFull timeWe believe in developing long-term team members who are committed to professional growth, exceptional patient care, and creating an outstanding patient experience. A R Baker DDS is a trusted dental practice serving the San Fernando, CA community with a commitment to high-quality, compassionate dental care.
Claims Examiner - Lead CalOptimaClaims Examiner - LeadOrange, CA$55,966–$83,949 / yearWe are hoping you will join us as a Claims Examiner - Lead and help shape the future of healthcare where you'll be an integral part of our CLA - Claims Production team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet.
Vice President, Claims and Provider Operations SCAN Health PlanVice President, Claims and Provider OperationsLong Beach, CaliforniaRemote$260,000–$325,000 / yearPartners closely with IT, EDI Operations, Finance, Network Management, Compliance, Clinical, Appeals and Grievances, and other business leaders to optimize claims system configuration, edit logic, benefit loading accuracy, provider and contract data integrity, accumulator logic, dispute root cause remediation, operational readiness, provider experience, and downstream member outcomes for new products, regulations, contracts, and enterprise initiatives. Drives affordability through payment integrity, configuration discipline, and disciplined claims controls, including pre-payment and post-payment review, clinical and non-clinical editing, duplicate detection, unbundling, upcoding, billing anomaly detection, provider audits, coordination of benefits, and high-dollar claims review.
Senior Claims Specialist Macpower Digital Assets Edge Private LimitedSenior Claims SpecialistOrange, CA$110,000–$130,000 / yearJob Summary: Seeking a Senior Claims Specialist to manage a complex caseload of medical malpractice claims, supervise junior claims specialists, and contribute to ongoing training efforts. Key Responsibilities: Manage medical malpractice claims , including assigning and directing defense counsel, following Claims Technical Manual, Defense Attorney Guidelines, and MPT Agreement.
Operations Manager Dental Design of BrentwoodOperations ManagerLos Angeles, CaliforniaFull timeJoin us as a growth-oriented Dental Office Manager and lead the charge in elevating patient care, streamlining operations, and driving the success of our thriving dental practice. Qualifications: Proven experience as a Dental Office Manager or a similar leadership role with a demonstrated track record of driving growth for 2+ years required .
Authorizations and Claims Analytics Solutions Business Insights and Data Analyst III L.A. Care Health PlanAuthorizations and Claims Analytics Solutions Business Insights and Data Analyst IIILos Angeles, CAThis position combines strong data engineering fluency with analytical acumen transforming complex, multi-domain data (membership, encounters, providers, claims, quality metrics) into interpretable and actionable insights used by leaders across the health plan. The Authorizations and Claims Analytics Solutions and Data Analyst III serves as a Subject Matter expert (SME), technical and analytic integrator, responsible for designing, developing, and operationalizing advanced analytic solutions that drive strategic insight and organizational performance.
Green — Claims & Risk Data Analyst - Buyer Agency - INSU-6369 FuntoRecruitGreen — Claims & Risk Data Analyst - Buyer Agency - INSU-6369Los Angeles, California$30–$70 / hourTrace assigned work to the RFP scope, requirement or RTM row, deliverable, dependency, acceptance criterion, schedule milestone, and supporting evidence. Prepare role-specific technical inputs, work products, estimates, implementation details, quality records, and proposal or post-award delivery evidence.
Claims Examiner VenbrookClaims ExaminerLos Angeles, CaliforniaVenbrook works across the claims lifecycle with services that include Third Party Administration (TPA), Complex Claims Management, Catastrophe, Independent Adjusting, subrogation recovery, litigation management, investigative, and special investigations unit (SIU) services. Venbrook's team of experts and industry specialists partners with their clients to manage their risks, create security, promote growth, and add value by delivering best-in-class commercial property & casualty, employee benefits, and personal risk insurance products and programs.
Claims Examiner Sr, Covered California CalOptimaClaims Examiner Sr, Covered CaliforniaOrange, CA$51,744–$72,441 / yearWe are hoping you will join us as a Claims Examiner Sr, Covered California and help shape the future of healthcare where you'll be an integral part of our Claims Administration team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet.
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.