NewSenior Claim Benefit Specialist - Remote CVS Health CorpSenior Claim Benefit Specialist - RemoteCARemote$18.50–$42.35 / hourOur teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Applies medical necessity guidelines, determines coverage, verifies eligibility, identifies discrepancies, and implements cost‑containment measures to support accurate claim adjudication.
Claiming Analyst - Revenue Cycle Management HATHAWAY-SYCAMORES CHILD AND FAMILY SERVICESClaiming Analyst - Revenue Cycle ManagementLos Angeles, CA$23–$26 / hourUse internal communication to track admissions across all programs, in order to accurately create and open consumers financial profile in both EHRS and IBHIS. In collaboration with Claiming and Revenue Manager, claim, track and monitor invoice/EDI claims to other funding entities to ensure timely submission.
Claim Examiner- WC TPI Global (formerly Tech Providers, Inc.)Claim Examiner- WCBrea, CAEstablish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost-effective manner and ensuring timely issuance of disbursements. Duties:Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted.
NewSr Claim Examiner- WC TPI Global SolutionsSr Claim Examiner- WCbrea, CARemoteEstablish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost-effective manner and ensuring timely issuance of disbursements. Duties: Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted.
Analyst, Configuration Oversight COB (Edit Reviews)/Claims/QNXT/ Root Cause analysis Molina Healthcare IncAnalyst, Configuration Oversight COB (Edit Reviews)/Claims/QNXT/ Root Cause analysisCAThis includes but not limited to; deep dive contract review and targeted claim audits related to accurate and timely implementation and maintenance of critical information on all claims and provider databases, validate data housed on databases and ensure adherence to business and system requirements of stakeholders as it pertains to provider contracting, network management, credentialing, benefits, prior authorizations, fee schedules, and other business requirements critical to claim accuracy. Experience independently reviewing and processing simple to moderately complex High dollar claims and knowledge of all claim types of reimbursements not limited to payment methodologies such Stoploss, DRG, APC, RBRVS, FFS applicable for HD Inpatient, Outpatient and Professional claims.
Litigation Insurance Adjuster (Remote: Pacific Time Zone) TruStage Financial Group IncLitigation Insurance Adjuster (Remote: Pacific Time Zone)CARemote$93,100–$139,700 / yearClaim Litigation Consultant II will provide credit unions with superior claims service, building and solidifying a strong partnership through proactive professional consultation and delivering optimal solutions to meet their needs on third-party litigated claims. Collaborate with other claims and product experts to ensure the consistent handling of commercial insurance claims and will be accountable for decision-making regarding the appropriate use of investigators, experts and outside legal counsel.
Bilingual Triage Specialist Argo Group International Holdings IncBilingual Triage SpecialistLos Angeles, CA$26.76–$30.80 / hourOur Adjusters and Managers are empowered to exercise their independent discretion and, within broad limits and authority, be creative in developing solutions and treat each case as the unique situation it is. Ability to develop and maintain productive relationships with clients, business partners and organizational peers with a focus on timely and meaningful exchanges of information.
Legal Counsel ReservLegal CounselCAThis is a unique opportunity to join a fast-moving, venture-backed insurtech at an exciting stage of growth - and to gain broad, hands-on experience across transactional, commercial, and operational legal matters. Founded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022.
Appraisal Specialist Mercury Insurance CompanyAppraisal SpecialistCA$32,363–$56,701 / yearUpon completion of our comprehensive training program, and with ongoing guidance and support, the Appraisal Specialist takes the lead in researching vehicle values and negotiating total loss settlements accurately, efficiently and with excellent customer service. Essential Job Functions: Research actual cash value of vehicles by gathering and analyzing current market information to reach an equitable settlement of damages for losses due to theft and collision, while maintaining good customer service and shop relations.
Client Accounting Coordinator Davies Group LtdClient Accounting CoordinatorCalifornia, CARemote$45,000–$54,000 / yearThe coordinator partners closely with clients, claims management, banking partners, and internal teams to ensure loss fund activity is accurate, timely, well-documented, and aligned with client expectations, internal controls, and insurance claims processing requirements. Manage program accounting from cradle to grave, including coordinating new bank account openings, supporting program setup in the CRM, maintaining accurate client and program data, and ensuring required documentation is complete.
Medical Assistant/Cast Specialist - Manhattan Beach-BCO Ortho Clinic- Full Time 8 Hour Days (Non-Exempt) (Non-Union) University of Southern CaliforniaMedical Assistant/Cast Specialist - Manhattan Beach-BCO Ortho Clinic- Full Time 8 Hour Days (Non-Exempt) (Non-Union)Manhattan Beach, California$29–$45.20 / hourWhen extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations. Escorts patients to x-ray and exam rooms, monitors patient flow, assists physicians with minor clinical procedures including staple removal, suture removal, and wound care.
NewProperty Adjuster Mid Loss Mercury Insurance CompanyProperty Adjuster Mid LossLos Angeles, CA$110,468.25–$135,016.75 / yearEstablish reserve amounts within prescribed settlement authority limit and negotiates settlement of claims; recommends claims which exceed personal authority limit to supervisor for approval. Ability to use advanced video technology to collaborate with onsite vendors and insureds to identify damage and write a damage estiate from a virtual setting when needed.
Sr California Workers Comp Adjuster The Hanover Insurance Group IncSr California Workers Comp AdjusterCalifornia, CARemotePOSITION OVERVIEW: The Senior Workers Compensation Adjuster is responsible for managing moderate to complex and high-value casualty claims with minimal supervision. Compensation: The target hiring range for this role may vary based on geographic location and other factors, including merit or performance, demonstrated proficiency, skills for the role, education, travel requirements, and experience.
Sr California Workers Compensation Adjuster The Hanover Insurance Group IncSr California Workers Compensation AdjusterLos Angeles, CARemotePOSITION OVERVIEW: The Senior Workers Compensation Adjuster is responsible for managing moderate to complex and high-value casualty claims with minimal supervision. Compensation: The target hiring range for this role may vary based on geographic location and other factors, including merit or performance, demonstrated proficiency, skills for the role, education, travel requirements, and experience.
Controller Broekema GroupControllerLos Angeles, CARun the monthly, quarterly, and annual close cycles, reviewing financial statements, general ledger activity, reconciliations, journal entries, accruals, and supporting schedules so reporting stays accurate and on schedule. The role manages a team that includes Assistant Controllers, Property Accountants, and the accounts receivable, accounts payable, and collections groups, and it works closely with senior leadership.
NewSurveillance Investigator Allied UniversalSurveillance InvestigatorLos Angeles, CA$20–$24 / hourThe Surveillance Investigator will perform discreet mobile and stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an insurance claim. RESPONSIBILITIES: Conduct independent investigations of insurance claims across a range of coverage types, including workers' compensation, general liability, property and casualty, and disability.
Casualty Desk Adjuster - RGA Sedgwick Claims Management Services, Inc.Casualty Desk Adjuster - RGACA$100,000–$120,000 / 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. Eight (8) years of related experience to include experience in personal lines claims, evaluating coverage and drafting coverage letters to include both reservation of rights and coverage denials, or equivalent combination of education and experience required.
Coordinator Scheduling - Beverly Hills - IM Endo Cl - Full Time 8 Hour Days (Non-Exempt) (Union) University of Southern CaliforniaCoordinator Scheduling - Beverly Hills - IM Endo Cl - Full Time 8 Hour Days (Non-Exempt) (Union)Beverly Hills, CA$22–$37.40 / hourHe/She closely monitors patients throughout various phases to assure completion of required testing and services, validating financial clearance for services being scheduled, providing stellar customer service when interfacing with patients in person and over the phone to establish appointments, alerting clinicians when patient testing is complete or when patients are non-compliant in completing medical services, coordinating collection of testing results and provider notes, coordinating care with ancillary departments as needed. Process new referrals in a timely manner; this includes obtaining required outside medical records, entering demographic information into computer systems, provides medical records to physician / multidisciplinary team for review, provides insurance information to financial counselor for patient to be financially cleared, and schedule patient in clinic.
(Hiring) Personal Injury (Settlement) Negotiators (Onsite) Viper Staffing Services(Hiring) Personal Injury (Settlement) Negotiators (Onsite)Los Angeles, California$25–$50 / hourIn this role, you will be responsible for managing and negotiating claims related to personal injury cases, ensuring fair and efficient resolution for clients and insurance providers. Communicate effectively with clients, legal representatives, and internal teams to provide updates and clarify claim details.
Billing Specialist West Coast AmbulanceBilling SpecialistBurbank, CaliforniaYour role will involve accurately processing and managing medical billing claims, ensuring timely reimbursements, and helping to maintain our financial stability. We are looking for a full-time and if you're a dedicated Billing Specialist ready to contribute to the success of a leading healthcare provider, we want to hear from you!