Medical Claims Specialist — Complex Claims Processing
Providence
Providence in Anaheim, California, is seeking a Medical Claims Processor responsible for handling complex medical claims and inquiries. This role involves processing claims, reviewing adjustments, and interacting with various stakeholders. Candidates should have recent HMO claims processing experience in a managed care environment. Providence offers unique benefits aimed at supporting employee well-being and professional growth, emphasizing a culture of care and mutual respect. #J-18808-Ljbffr Providence
- Responsible for processing medical claims. Resolves complex, difficult or non-routine claims requiring special handling in accordance with established policy guidelines. Reviews and authorizes payment and final disposition of claims requiring adjustment and claims benefit...Suggested
- ...Claims Specialist Our client is seeking a Claims Specialist to manage medical malpractice claims for their Orange County office. This role involves... ...responsibilities for highly complex claim files, participating in litigation processes, and providing guidance and...SuggestedWork at office
$64.97k - $104.06k
...a Property Field Inspection Claim Specialist and showcase your expertise... ...help them through the claims process while providing Remarkable service... ...Experience in handling complex or high-value claims... ...a high deductible plan. All medical plans provide 100% coverage...SuggestedWork experience placementWork at officeLocal areaRemote workWork from homeFlexible hours$54k - $103k
...within defined authority limits, to manage commercial claims with moderate to high complexity and exposure for a specific line of business. Responsibilities... ...individuals with disabilities in the recruitment process. To request an accommodation, please contact leaveadministration...SuggestedWork experience placementWork at officeLocal area- ...experienced Behavioral Health Claims Follow-Up Specialist to join our Revenue Cycle... ...: • Claims Processing: Review and process incoming... ...established guidelines, reviewing medical records, police reports,... ...and Resolution: Investigate complex claims, including fraud...Suggested
$43 - $48 per hour
...Have: ~1+ years of experience in workers' compensation claims management. ~ Strong verbal and written communication skills... ...with stakeholders. Responsibilities: Analyzes and processes complex or technically difficult workers' compensation claims by...- ...Job Title: Claims Examiner - Workers Compensation 3+ Months... ...PRIMARY PURPOSE : To analyze complex or technically difficult workers' compensation... ...and RESPONSIBILITIES ~ Analyzes and processes complex or technically difficult workers...Hourly pay
$85k - $105k
...Financial Services & Insurance Claims Examiner- Workers... ...and experience to adjudicate complex customer claims in the context... ...RESPONSIBILITIES Analyzing and processing claims through well-developed... ...benefits offering including medical, dental vision, 401K on day one...Work at officeRemote workFlexible hours- ...Job 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...
- ...Claims Specialist Orange, California, United States Responsibilities Essential Duties and Responsibilities: Manage medical malpractice claims, including the assignment, direction, and... ...Agreement. Manage increasingly complex cases with larger financial...
$85k - $105k
...Claims Examiner – Workers Compensation | Brea, CA (Hybrid) By joining... .... Primary Purpose To analyze complex or technically difficult... ...Responsibilities Analyzing and processing claims through well-developed... ...benefits offering including medical, dental, vision, 401K on day...Flexible hours$27.69 per hour
...Financial Services & Insurance Claims Representative (IAP) -... ...how to investigate and resolve complex situations for employees and... ...professional needs including medical, dental, vision & 401k. PRIMARY... ...supervision, which includes: Processing and responding to incoming mail...TraineeshipWork at officeFlexible hours- ...Claims Examiner - Workers Compensation Brea, CA 92821 3... ...Description: To analyze complex or technically difficult workers... ...Analyzes and processes complex or technically difficult... ...containment principles including medical management practices and Social...Contract workWork at office
$27.69 per hour
...Financial Services & Insurance Claims Representative (IAP) -... ...how to investigate and resolve complex situations for employees and... ...professional needs including medical, dental, vision & 401k. PRIMARY... ...supervision, which includes: Processing and responding to incoming mail...TraineeshipWork at officeFlexible hours- ...Required Experience: • CA workers' compensation claims experience Position Overview: To analyze complex or technically difficult workers' compensation... ...negotiate settlements. Job Duties : • Analyzes and processes complex or technically difficult workers'...
- ...to dealers in coordinating and validating customer returns and claims. With guidance, responsibilities include: Reviews customer... ...any account-specific guidelines. Investigates basic, less complex cases (e.g., late title claims, basic condition report claims,...
$63.4k - $90k
...A leading claims management company is seeking a Claims Examiner to analyze and process complex workers' compensation claims in a remote position. The role involves negotiating... ...along with comprehensive benefits including medical, dental, vision, and 401k. #J-18808-Ljbffr...Remote work$72k - $141k
...contributor role operates under broad authority to manage commercial claims of high complexity and exposure within the Commercial Auto line(s) of business... ...for coordinating all aspects of the claim resolution process in accordance with company guidelines, while consistently...Work experience placementWork at officeFlexible hours$27.69 per hour
...limit to what you can achieve. Claims Representative (IAP) -... ...how to investigate and resolve complex situations for employees and... ...professional needs including medical, dental, vision & 401k. Primary... ...supervision, which includes: Processing and responding to incoming mail...TraineeshipWork at officeFlexible hours- ...Claims Adjuster, Public Entity Job Title: Claims Adjuster, Public... ...team of experts and industry specialists partners with clients to manage... ...Party Administration (TPA), Complex Claims Management,... ...through the decision‑making process, ensuring all relevant stakeholders...Temporary workFor subcontractorWork at officeFlexible hours
$63.4k - $90k
## Claims Examiner Workers Compensation I NE Jurisdiction I RemoteBy... ...PURPOSE**: To analyze complex or technically difficult workers... ...RESPONSIBILITIES*** Analyzes and processes complex or technically... ...containment principles including medical management practices and Social...Work at officeLocal areaRemote workFlexible hours$90k - $110k
...knowledge and experience to adjudicate complex customer claims in the context of an energetic culture... ...subrogation opportunities and manages process. Attends and participates in... ...comprehensive benefits offering including medical, dental vision, 401K on day one. As...Local areaFlexible hours$49 per hour
...Information Name Claims Examiner - Workers Compensation... ...purpose: To analyze complex or technically difficult workers... ...Analyzes and processes complex or technically difficult... ...containment principles including medical management practices and Social...Full timeTemporary workWork at officeLocal areaRemote workShift work$105k - $118k
...Financial Services & Insurance Claims Team Lead (Supervisor) -... ...and experience to adjudicate complex customer claims in the context... ...issues, and opportunities for process improvement; advises management... ...benefits offering including medical, dental vision, 401K on day one...Work at officeRemote workFlexible hours$85k - $105k
...Services & Insurance Workers Compensation Claims Examiner | CA Jurisdiction Knowledge... ...and experience to adjudicate complex customer claims in the context of an energetic... ...days onsite) PRIMARY PURPOSE : To process future medical workers compensation claims to...Contract workWork at officeRemote workFlexible hours$20 - $25 per hour
...of our benefit offerings include: ~ Medical, Dental, and Vision Insurance ~ Life... ...About The Position The Insurance Claims Specialist will be responsible for servicing auto... ...state, and local laws/regulations. Process and file physical damage, total loss, and...Hourly payTemporary workWork at officeLocal areaFlexible hours$85k - $95k
...Overview Workers' Compensation Claim Specialist Location: Irvine, CA (... ...clients to solve their most complex risk management challenges,... ...success. We don't just process claims-we support people. As... ...compensability, managing medical treatment through maximum medical...Remote work$19 - $21 per hour
...Insurance Workers Compensation Claims Assistant | Brea, CA (Onsite)... ...system as instructed. Processes payments. Processes mail;... ...initiates telephone calls, sets up medical appointments, and may provide... ...for the rapidly changing and complex risk landscape. For more, see...Work at officeFlexible hours$19.9 - $29.81 per hour
...quickly and efficiently. The Arbitrator I will learn to investigate claims, determine compliance with Manheim's National Arbitration... ...with policies and account‑specific guidelines. Investigate less complex cases such as late title claims, condition reports, vehicle availability...Hourly pay$76.83k - $142.21k
...Property Claims Field Adjuster II If you're passionate about helping people restore... ...and resolve Homeowners claims of moderate complexity in a timely and efficient manner.... ...bonus, and performance-based bonus) ~ Medical, dental, vision, life, and pet insurance...Seasonal workLocal areaFlexible hours
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