Lead Claims Examiner - Hybrid, Healthcare Quality & Compliance
Astrana Health
Astrana Health in Monterey Park, CA is seeking a Lead - Claims Examiner to report to the Sr. Manager - Claims. This hybrid role combines in-office work at 1600 Corporate Center Dr. with home-based flexibility, supporting claims quality and process improvements. You will mentor staff, monitor audits, drive compliance with CMS and coding standards (ICD-10, CPT, HCPCS), and coordinate cross-functional efforts with Accounting and Network Management to minimize overpayments and optimize performance. #J-18808-Ljbffr Astrana Health
- Astrana Health in Monterey Park, CA is seeking a Lead - Claims Examiner to oversee quality across claims processing and drive compliance. The role reports to Sr. Manager - Claims and operates in a hybrid setting, combining in-office collaboration with remote work each...SuggestedWork at officeRemote work
$130k - $135k
A high-growth healthcare organization is seeking an AR Manager to oversee a team of billers... ...billing operations while ensuring quality and compliance. This role offers a base salary of $13... ...35,000 plus bonuses and operates in a hybrid work environment. The company values innovation...Suggested- A leading healthcare venture firm is seeking a Managing Director for their New Ventures team in Los Angeles. This hybrid position involves fostering partnerships, creating healthcare companies from clinical insights, and driving investment strategies. Candidates should...Suggested
$27 - $32 per hour
...Department: Ops - Claims Ops Location: 1600... ...highly motivated Lead - Claims Examiner. This role will report... ...to scale in the healthcare industry. This is a hybrid role where the... ...work of all Claims Quality, Appeals and Recovery... ...and to ensure compliance with department quality...SuggestedContract workWork experience placementWork at office$105k - $120k
...assist in scaling operations within the healthcare sector. This position involves maintaining... ...financial statements, and ensuring compliance with internal control policies. The ideal... ...in Microsoft Excel. This role offers a hybrid work model and a compensation range of $...Suggested- A healthcare management firm located in California is seeking a Cash/Claims Processor with at least 3 years of vision billing experience. The role involves managing cash... ...payment application. This position offers a hybrid work model and provides opportunities for continuous...
- ...in Rosemead, CA is seeking a Manager, Corporate Security PMO to lead a portfolio of construction and security technology projects, aligning... ...and results orientation in a high-visibility, deadline-driven environment, with hybrid work #J-18808-Ljbffr Southern California EdisonFor contractors
$86.03k - $98.94k
...an Assistant Program Director for its Teen Line. This is a hybrid position based in Los Angeles. The successful candidate will lead program operations, supervise clinical staff, and ensure delivery of quality mental health services. Requirements include a minimum of two...$70k - $83k
A leading healthcare organization is seeking a highly motivated Senior Claims Auditor in Monterey Park, CA. This role involves auditing... ...health plan claims, ensuring compliance with CMS regulations, and... ...and the ability to work in a hybrid setting. The compensation ranges...- ...drive the identification, building, and scaling of transformative healthcare companies. You will engage with external partners and... ...leveraging your 5-7 years of experience in consulting or research. This hybrid opportunity blends strategic insight with operational...Work at office
- ...Edison (SCE) is hiring a Regulatory Affairs and Compliance Senior Advisor to manage external regulatory audits... ...with regulatory rules, develops strategies, and leads reporting and supporting cross‑functional teams. Hybrid work, California residence required, with a strong...
- Prosper Services LLC is seeking a Quality Improvement Coordinator in Los Angeles, CA. This... ...quality initiatives and ensuring compliance with federal and state standards. The ideal... ...of relevant experience, preferably in a healthcare setting, and must be bilingual in English...
- A leading restaurant company is seeking a Manager, HR Compliance to oversee compliance with I-9/E-Verify and other HR policies. The role involves managing a team,... ...five years of HR experience. This position offers a hybrid work schedule and various benefits including 401K...
- Southern California Edison is seeking a Compliance Investigations Senior Advisor to lead the most complex internal investigations across regulatory requirements... ...and strategic input on regulatory challenges, with a hybrid work mode and relocation not #J-18808-Ljbffr...Relocation
- ...their lifecycle. The role involves managing hardware and software compliance and ensuring integration with ServiceNow. The ideal candidate... ...experience with ServiceNow. This full-time position offers a hybrid work schedule and comprehensive benefits. #J-18808-Ljbffr Panda...Full time
$27 - $33 per hour
...reviews and collaboration with health providers to enhance quality care and compliance with HEDIS standards. Ideal candidates have a strong... ...systems and able to work independently. The position includes a hybrid work model, with a pay range of $27.00 - $33.00 per hour....Hourly pay- ...Edison (SCE) is seeking an Employee Communications Senior Advisor to lead a wide range of employee communications, campaigns and events.... ...on best practices to elevate the employee experience. The role is Hybrid in California. #J-18808-Ljbffr Southern California EdisonRemote job
$180k - $220k
HOK is seeking a Healthcare Practice Leader to join our team in Los Angeles, supporting project initiatives and managing staff. In this role, you'll oversee strategic planning, business development, and mentorship to project managers. An ideal candidate will have 15+ years...Remote workFlexible hours- A leading healthcare provider in Northridge is seeking a Full-Time Therapy Manager to oversee rehabilitation services in their skilled... ...is preferred. The Therapy Manager will ensure high-quality care, compliance with regulations, and effective operation of rehabilitation...Full time
- ...professionals. This role involves overseeing coding quality, productivity, and compliance while supporting staff development. The ideal... ...understanding of relevant coding guidelines and healthcare regulations. Join us to lead our efforts in providing accurate coding...
- A prestigious healthcare company is seeking an experienced Claims Examiner to join their team. In this role, you will conduct claims analyses, adjudicate medical claims, and verify patient eligibility. The ideal candidate has 2-5 years of claims examining experience, a...
$28 - $30 per hour
...across Los Angeles County through high-quality programs and compassionate care. Our goal... ...and families in Southern California to lead fulfilling lives. Position Overview The Claims Specialist - Quality Assurance and Compliance (QAC) manages client information and funding...Hourly payContract workWork at officeWorldwide- ...Edison is seeking a Senior Workers' Compensation Claims Adjuster in California to manage a complex... ...supports injuried workers while ensuring regulatory compliance and high-quality care. The position operates in a hybrid mode, requiring presence at an SCE facility on some...Remote workRelocation
$28 - $33 per hour
...We Are Kerry Kerry is the world's leading taste and nutrition company for the food... ...highest standards of food safety, quality, regulatory compliance, and operational excellence. This role... ...of scams online or from individuals claiming to represent us. A Kerry employee will...Hourly payFull timeWork at office$85k - $100k
Kyo Autism Therapy in Los Angeles is seeking BCBA professionals to lead individualized ABA programs across home, school, and community settings. The role offers a hybrid delivery model with both telehealth and in-person service options and flexible scheduling for part-...Full timePart timeFlexible hours- ...in California is seeking a Board Certified Behavior Analyst (BCBA) to lead a select caseload and deliver high-quality ABA therapy for 7-10 clients, with emphasis on individualized planning. This hybrid role combines in-person school and home-based supervision with...Work from homeFlexible hours
$116k - $165k
...in insuring Allied Healthcare Providers,... ...Malpractice focused Complex Claims Consultant... ...company protocols, quality and customer service... ...enjoys a flexible, hybrid work schedule and... ...handling protocols.Leads focused investigation... ...and ensures compliance with state/local regulatory...Full timeWork experience placementWork at officeLocal areaFlexible hoursShift work$124k - $199.8k
...will have over 5 years of underwriting experience in Auto Liability, Workers’ Compensation, and General Liability. This role offers a hybrid work arrangement, allowing flexibility in the workplace. You will engage with internal and external partners to ensure underwriting...- ...Title Admission Team Lead Job Description... ...procedures to meet data quality goals, comply with department... ...development, compliance with department and CSMC... ...Four (4) years of healthcare experience working in... .... This position is hybrid eligible after successful...Full time
- Autism Learning Partners is expanding a BCBA-led team in a hybrid role across in-person and telehealth supervision. Earn a strong base salary with performance bonuses and rich onboarding. Enjoy professional growth through CEUs, an in-house conference, and research opportunities...Flexible hours
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