Senior Claims Quality & Compliance Lead
$78.5k - $163.6kDirect Jobs
Direct Jobs is seeking a Claims Quality Supervisor in Los Angeles to lead audit and quality assurance initiatives across the claims operations. This position requires a minimum of 5 years of claims experience and 2 years of supervisory experience. Key responsibilities include developing quality assurance monitoring systems, overseeing audits, and managing the customer service team. The role demands excellent communication skills and proficiency in managed care software. The salary range is $78,500 - $163,600 annually. #J-18808-Ljbffr Direct Jobs
$116.3k - $264.6k
...hospital billing operations in Los Angeles, California. This role is pivotal in ensuring accurate claims submissions to various payers, including Medicare and Medi-Cal, while leading a team focused on optimizing revenue cycle performance. The ideal candidate will have...SeniorClaims- Argo Group is seeking a Senior Construction Defect Technical Claims Specialist Team Lead to manage complex claims and supervise a small team in Los Angeles or remotely. The role requires a minimum of seven years in claims adjudication and focuses on providing outstanding...SeniorClaimsRemote job
$78.5k - $163.6k
The Academy of Managed Care Pharmacy is seeking a Claims Resolution and Reconciliation Supervisor in Los Angeles, California, to oversee... ...operations. The role entails supervising staff, ensuring compliance with CMS and DMHC regulations, and monitoring operational metrics...SeniorClaims- A leading telehealth organization is seeking a Claims Follow-Up Lead for a fully remote position. The ideal candidate will resolve denials, manage accounts receivable, and support workflow execution within a mission-driven team. Candidates should have 3-5+ years in behavioral...SeniorClaimsRemote jobFlexible hours
- ...least 7 years of experience in employment law, with substantial work on wage and hour class actions, PAGA claims, and arbitration matters Proven ability to lead legal teams and supervise junior attorneys Practical experience handling high-volume or mass arbitration...SeniorClaims
- Los Angeles Metro is seeking a Senior Analyst to perform workers’ compensation functions in line with California regulations, mentor staff... ...the Transitional Duty Program. The role involves handling claims, processing medical bills, and working closely with legal personnel...SeniorClaims
$78.5k - $163.6k
UCLA Outpatient Clinics is seeking a Claims Quality Supervisor to lead audit and quality assurance initiatives in Los Angeles. This position requires... ...oversight of quality monitoring systems, management of compliance and performance audits, and leadership of the customer...Claims- Gannett Fleming, Inc. is seeking a Senior Railroad Construction Manager to join our Construction Services group in Los... .... The candidate will inspect construction work, perform quality control, and ensure compliance with plans and specifications, while traveling 90% of the...Senior
$78.5k - $163.6k
Academy of Managed Care Pharmacy is seeking a Claims Quality Supervisor in Los Angeles. This role involves leading audit and quality assurance initiatives to ensure compliance with regulations and operational efficiency. The ideal candidate will have over 5 years of claims...ClaimsWork at office- Archinect is seeking a Senior Architect / Project Architect in Los Angeles to lead complex architectural projects. The role requires 8+ years of... ...manage project teams, oversee documentation quality, and ensure project compliance. This position offers the opportunity to...SeniorLocal area
- A leading healthcare provider in California seeks a Senior Inpatient Coder responsible for accurately coding inpatient and emergency room encounters.... ...essential in this role that aims for the highest quality of coding compliance in a supportive healthcare environment. #J-188...Senior
- .... They are seeking a Senior Office Engineer Maintenance... ...activities and leading the administrative functions... ..., accurately, and in compliance with District... ...change orders. Support claims management efforts through... ...documentation. Quality Assurance & Compliance...SeniorClaimsFull timeContract workFor contractorsWork at office
$100k - $110k
InterMed Cost Containment Services in Glendale, California, is seeking a Claims Manager responsible for overseeing a claims unit. This role involves coaching specialists and ensuring compliance with the Labor Code concerning workers’ compensation claims. Ideal candidates...SeniorClaims$200k - $250k
...Do: GFT is seeking a Senior Construction Manager/ Resident... .... This position will lead construction management... ..., Construction Quality Assurance, Construction... ...Control, Environmental Compliance Monitoring and Public Outreach... ...Dispute Resolution and Claims Analysis. Support...SeniorClaimsFull timeContract workFor contractorsRemote workFlexible hours$117k - $195k
...certificates, and making and following through with claims against insurance policies. Facilitates... ...with OAI. Responsibilities Leads the identification, assessment, and prioritization... ...brokers, ensuring timely resolution, compliance with policy terms, and root‑cause...SeniorClaimsContract workLocal areaShift work$98.44k - $147.66k
...seeking an Associate Director of Special Education in Los Angeles to lead special education initiatives across multiple schools. This role requires strong leadership to ensure instructional quality, compliance with educational standards, and effective support for students...Senior$183.7k - $230k
A leading construction firm is seeking a skilled Preconstruction Manager to oversee complex projects in California. This role involves leadership in project management, ensuring quality, safety, compliance, and mentorship of teams. Ideal candidates will have 15+ years of...Senior- Suffolk, based in Los Angeles, is seeking a Superintendent to oversee daily job site activities and ensure superior quality and safety compliance. The ideal candidate will have a bachelor's degree and over 4 years of relevant construction experience. You will manage team...Senior
- A leading insurance provider in California seeks a Senior Claims Specialist to manage various insurance claims. The ideal candidate will possess 6-10 years of relevant... ...include handling claims, ensuring compliance with regulations, and providing customer service....SeniorClaims
$100k
...services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities... .... Job Description Business Title(s): Senior Construction Defect Technical Claims Specialist Team Lead Employment Type: Full-Time FLSA Status: Exempt...SeniorClaimsFull timeLocal areaRemote work$110k - $230k
A leading insurance firm is looking for a Financial Lines Claims Counsel in Los Angeles. The successful candidate will manage complex claims including Directors & Officers and Financial Institutions Liability from inception to resolution. The role requires strong communication...SeniorClaims- ...extensive experience in forensics, insurance loss, environmental claims management, and be adept at recognizing hazards. This position... ...investigations, providing expert witness support, and ensuring compliance with industry standards. Excellent communication and analytical...SeniorClaims
- Eminent, Inc. is looking for a Senior Technical Designer to join our team in Los Angeles, CA. In this full-time role, you will evaluate garment samples for quality compliance and lead fit sessions to ensure the perfect fit for our fashion lines. You will collaborate with...SeniorFull time
- Westfield Specialty in Los Angeles is seeking an experienced insurance claims manager to handle public and private D&O, E&O, and EPL claims. The ideal candidate will have 6-10 years of relevant experience, a Juris Doctor degree, and must possess strong communication skills...SeniorClaimsLocal area
- Aon is seeking a Complex Construction Claims Strategic Lead based in Los Angeles to lead claims strategies across multi-line construction programs. You will work closely with high-profile clients, providing expert guidance in navigating complex claims issues. The successful...Claims
$115.44k - $148.15k
A leading health organization is seeking a Senior Manager for Claims Delegation Audit in Monterey Park, CA. The role involves management of Claims Delegation Audits, strategy development, and ensuring compliance with regulations for Medicare and Medicaid. Candidates should...SeniorClaims- ...Claims Team Manager In order to deliver an exceptional customer experience, a... ...opening for a Claims Team Manager who will lead a team of Claims Specialists who... ..., negotiating and settling claims in compliance with Claims Quality Standards. Creates a high performing...ClaimsWork at officeImmediate start
$125k - $140k
Astrana Health Management is looking for a Senior Manager for Claims Delegation Audit in Monterey Park, CA. As a key leader, you will oversee claims audits and ensure compliance with Medicare, Medicaid, and other regulations. This role requires a Bachelor's degree and...SeniorClaims- ...oversee daily revenue cycle operations, including: Medical billing Claims submission Payment posting Accounts Receivable (AR) follow-up... ...claim rate Days in AR Denial rates Collection rates Ensure compliance with HIPAA, payer guidelines, and healthcare regulations...Claims
$225k - $365k
...Mid- to Senior-Level Labor & Employment Associate Direct Counsel is representing an Amlaw 100 firm seeking a... ...representing employers on both individual and class claims, including: Wage and hour compliance Employment discrimination and harassment claims...SeniorClaimsFull time
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