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NewClaims Coordinator I Pacer GroupClaims Coordinator ITorrance, CA$25The ideal candidate will have strong communication and organizational skills, be comfortable interacting with patients, providers, and claims adjusters, and have experience working with electronic medical records and administrative healthcare processes. The position involves direct interaction with patients and healthcare providers and requires professional communication, confidentiality, and teamwork.
Senior Claims Auditor (External Audit) Astrana Health, Inc.Senior Claims Auditor (External Audit)Monterey Park, CaliforniaRemote$70,308–$80,000 / yearKnowledge of medical terminology combined with detail knowledge and experience with CPT, HCPCS, DRG, REV, OPS, ASC, ICD10, CRVS, RBRVS, CMS, ICE for Health Plan, DMHC and DHS fee schedules and CMS Medicare regulatory agencies, COB and Third-Party Liability recovery. Detail knowledge and understanding of Industry pricing methodologies, such as Resources-Based Relative Value Scale (RBRVS), Medicare/Medi-Cal fee schedule, All Patient Refined Diagnosis Related Groups (AP-DRG), Ambulatory Payment Classifications (APC), etc.
Claims Examiner - Workers Compensation MindlanceClaims Examiner - Workers CompensationRancho Cucamonga, CARemote$49–$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. ESSENTIAL FUNCTIONS and RESPONSIBILITIESAnalyzes 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 (Hourly) MindlanceClaims Examiner - Workers Compensation (Hourly)Brea, CARemote$47–$48 / hourDuties: PRIMARY 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. 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 Adjuster - Workers Compensation MindlanceClaims Adjuster - Workers CompensationOntario, CARemote$51–$52 / 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.
NewSenior 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.
Claims Examiner - Workers Compensation ObjectWin TechnologyClaims Examiner - Workers CompensationLong Beach, CA, CARemoteTo 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.
Workers' Compensation Claims Supervisor - Orange, CA (PERM - HYBRID) Johnson Service GroupWorkers' Compensation Claims Supervisor - Orange, CA (PERM - HYBRID)Orange, CA$100,000–$110,000 / yearManaging People - Includes staff in planning, decision-making, facilitating and process improvement; Takes responsibility for subordinates' activities; Makes self available to staff; Provides regular performance feedback; Develops subordinates' skills and encourages growth; Solicits and applies customer feedback (internal and external); Fosters quality focus in others; Improves processes, products and services; Continually works to improve supervisory skills. Leadership - Exhibits confidence in self and others; Inspires and motivates others to perform well; Effectively influences actions and opinions of others; Inspires respect and trust; Accepts feedback from others; Provides vision and inspiration to peers and subordinates; Gives appropriate recognition to others; Displays passion and optimism; Mobilizes others to fulfill the vision.
CA Claims Specialist - Bilingual (Spanish) CorVel Enterprise Claims, Inc.CA Claims Specialist - Bilingual (Spanish)Rancho Cucamonga, CARemote$25.48–$41.09 / hourPart timeThe Workers’ Compensation Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
Warranty Claims Data Analyst Kawasaki Motors Corp., U.S.A.Warranty Claims Data AnalystFoothill Ranch, CA$75,000–$80,000 / yearPart timeServes 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 - Workers Compensation (On-Site Ontario, California) Sedgwick Claims Management Services, Inc.Claims Examiner - Workers Compensation (On-Site Ontario, California)Ontario, CARemote$85,000–$95,000 / yearMental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. PRIMARY PURPOSE OF THE ROLE: To analyze Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Workers Compensation - Claims Examiner | Hybrid | Riverside, CA Sedgwick Claims Management Services, Inc.Workers Compensation - Claims Examiner | Hybrid | Riverside, CARiverside, CA$80,000–$100,000 / yearMental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. PRIMARY PURPOSE OF THE ROLE: To analyze workers' compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Claims Associate - Workers Compensation (On-Site - Rancho Cucamonga) Sedgwick Claims Management Services, Inc.Claims Associate - Workers Compensation (On-Site - Rancho Cucamonga)Rancho Cucamonga, CA$25–$28 / hourMental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.