Provider Claims & Appeals Specialist II
IEHP
IEHP is seeking a Claims Specialist II – Provider Claims to support appeals, provider disputes, and call center tasks in a fast-paced managed care setting. You will perform complex claim adjustments, root cause analysis, and cross-train staff while ensuring accuracy and regulatory compliance with Medi-Cal/Medicare requirements. The role emphasizes collaboration across units, Lean process improvements, and quality program goals such as HEDIS, CAHPS, and NCQA Accreditation. #J-18808-Ljbffr IEHP
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Provider Claims & Appeals Specialist II in Rancho Cucamonga, CA vacancy
$27.43 - $35.66 per hour
...human spirit” and to pivot from a “job” opportunity to an authentic experience! The Claims Specialist II - Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are...SuggestedHourly payTemporary workWork at office$25.9 - $33.02 per hour
...authentic experience! Under the direction of the Provider Claims Resolution & Recovery Supervisor, the Claims Specialist I - Provider Claims is responsible for... ...for evaluating and resolving provider disputes & appeals, issuing resolution letters, and processing adjustment...SuggestedHourly payContract workTemporary workWork at officeFlexible hours- Join IEHP as a Claims Specialist I - Provider Claims, responsible for evaluating and processing institutional and professional medical claims under the direction of the Provider Claims Resolution & Recovery Supervisor. Your role includes resolving provider disputes, issuing...Suggested
$25.48 - $41.09 per hour
...Description Job Description The Liability Claims Specialist manages non-complex and non-problematic... ...at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may... ...Place to Work® Company, is a national provider of industry-leading risk management solutions...SuggestedHourly payMinimum wageFull timeWork at officeLocal areaRemote workFlexible hoursCorVel Enterprise Claims, Inc.
Rancho Cucamonga, CA14 days ago$25.48 - $41.09 per hour
...Description The Workers’ Compensation Claims Specialist floater manages within company best practices... ...at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may... ...Place to Work® Company, is a national provider of industry-leading risk management solutions...SuggestedHourly payMinimum wageFull timeWork at officeLocal areaRemote workFlexible hoursCorVel Enterprise Claims, Inc.
Rancho Cucamonga, CA2 days ago- The Senior Liability Claims Specialist managesmid to complexAuto and/or General Liability claims,... ...modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may... ...Place to Work® Company, is a national provider of industry-leading risk management solutions...Minimum wageFull timeWork at officeLocal areaRemote workFlexible hours
$16.74 - $26.92 per hour
...The Workers’ Compensation Medical Only Claims Specialist manages non-complex and non-problematic,... ...modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may... ...Place to Work® Company, is a national provider of industry-leading risk management...Hourly payMinimum wageFull timeWork at officeLocal areaRemote workFlexible hoursCorVel Enterprise Claims, Inc.
Rancho Cucamonga, CAa month ago$23.5 per hour
...First (1st) Administrative Assistant II At DHL, you will play a part in one of the world's most essential industries. As the world's leading contract logistics provider, we believe in doing the right thing, growing together, and delivering the difference. At DHL you...Hourly payWeekly payFull timeContract workWork at officeMonday to FridayFlexible hoursShift workDeutsche Post Und Dhl
Bloomington, CA2 days ago- ...The Workers’ Compensation Claims Supervisor is responsible for supervising a team of direct... ...(subject to managerial approval) Provides technical and jurisdictional guidance to... ...modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may...Minimum wageFull timeWork at officeLocal areaRemote workFlexible hoursNight shift
CorVel
Rancho Cucamonga, CA3 days ago - ...an exciting opportunity for you as an Administrative Assistant I-II (DOQ) (Confidential)! IEUA is seeking a proactive, detail... ...Board and Administrative Services Department. This key position provides essential support to the department’s day-to-day operations and...Hourly payContract workWork at officeLocal areaVisa sponsorshipWork visa
$29.83 per hour
...difference. Position Title Position Title Administrative Associate II Position Control Number Position Control Number 999618 Type of... ...overall mission and accreditation. The Administrative Associate provides administrative and secretarial support to the Chair of the...Hourly payFull timeWork experience placementWork at officeLocal areaMonday to FridayFlexible hoursWeekend workAfternoon shift- CorVel is a national provider of risk management solutions for workers' compensation, auto, health and disability management. The Senior Liability Claims Specialist will manage mid to complex Auto and General Liability claims, including bodily injury and property damage...Remote job
- CorVel, a national risk-management solutions provider, seeks a Senior Workers’ Compensation Claims Specialist to manage complex claims, coordinate with case managers and attorneys, and oversee subrogation and settlements. You will ensure the best outcomes while meeting...Remote job
$29.35 - $47.28 per hour
...Description Job Description The WC Senior Claims Specialist handles complex and high-profile Workers... ...at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may... ...Place to Work® Company, is a national provider of industry-leading risk management...Hourly payMinimum wageFull timeWork at officeLocal areaRemote workFlexible hours$61.86k - $108.2k
...passionate about helping people restore their lives when the unexpected happens to their homes and providing the best customer experience, then our Mercury Insurance Property Claims team could be the place for you! Upon completion of the training program, ideal candidates...Seasonal workLocal areaFlexible hours- ...evaluates and manages liability, property, auto, general liability claims, and employment claims in compliance with state regulations.... ...legal hearings, settlement conferences, and mediations to provide testimony and monitor proceedings. Maintains claims files and...
- ...Workers Compensation Claims SpecialistPomona Corporate Temco - Pomona, CA 91766OverviewSalary... ...seeking a Workers' Compensation Claims Specialist to join our growing Claims Department.... ...within the Claims Department to provide a more consistent employee experience, stronger...Hourly payFull timeTemporary work
Temco Logistics
Pomona, CA4 days ago $50k - $70k
...Agent is seeking an organized and efficient specialist to fulfill administrative duties and... ...follow up with customers, as needed. Provide prompt, accurate, and friendly customer... ..., coverages, policy changes, transfers, claim submissions and billing clarification....For contractorsWork at officeDaevon Parks - State Farm Agent
Rancho Cucamonga, CA2 days ago$30k - $110k
...Agent is seeking an organized and efficient specialist to fulfill administrative duties and... ...follow up with customers, as needed. Provide prompt, accurate, and friendly customer... ..., coverages, policy changes, transfers, claim submissions and billing clarification....For contractorsWork at officeDaevon Parks - State Farm Agent
Rancho Cucamonga, CA2 days ago- ...unmatched opportunities, our goal is to provide a unique experience for our contractors... ...interpreting our client's eligibility, capitation, claims and quality reports Liaise with... ...Visit Primary Care Physicians, Specialists, BHS's and Vision providers on a somewhat...Contract workFor contractorsWork at officeLocal areaImmediate start
- ..., backed by the power, resources, and trust of a well-known and reputable brand. And you’ll have the personal reward of helping to provide financial security and added peace of mind to clients when they experience a covered health event. Prior Sales experience is welcome...Full timePart timeInternshipLocal areaMonday to Friday
Aflac
Ontario, CA14 days ago $17.5 - $19 per hour
...Customer Service Representative II Take your career further with McLane! The McLane team is the driving force behind our success... ...routine customers and issues while achieving customer satisfaction by providing accurate, timely, and consistent information and solutions. This...Hourly payWork at officeImmediate start- DHL Supply Chain in the United States is hiring an Administrative Assistant II to support management with clerical and secretarial duties, maintain records, and handle payroll-related tasks. This is a full-time role with a Monday-Friday schedule and hourly pay. The ideal...Hourly payFull timeWork at officeMonday to Friday
- CorVel is seeking a Liability Claims Specialist to manage non-complex medical and minor liability claims under supervision, ensuring optimal outcomes for CorVel and our clients. This is a remote role with responsibilities from intake to reserving and client communication...Remote job
- ...moderate supervision of Management, the Claims Supervisor performs the essential functions... ...Representatives and Claims Support Specialists. Ensure that the team meets service standards... .... · Make handling recommendations and provide directions to subordinates. · Ensure...Work experience placementShift work
Aspire General Insurance Company
Rancho Cucamonga, CAa month ago - CorVel is seeking a Workers’ Compensation Claims Specialist to manage low-complexity WC claims under supervision, supporting a claims team. The role is remote and requires strong written and verbal communication, plus Excel proficiency. The candidate should have a Bachelor...Remote job
- Western University of Health Sciences in Pomona, CA, seeks an Administrative Associate II to support the Chair of the Department of Pharmacy Practice and Administration. This role ensures day-to-day activities run smoothly and allows administrators and faculty to focus...
- ...Company and Aspire General Insurance Services, we're dedicated to providing affordable specialty auto insurance while delivering... ...repairs ~ Total loss evaluations ~ Complex vehicle damage claims ~ Strong working knowledge of estimating platforms such as CCC...
Aspire General Insurance Company
Rancho Cucamonga, CA18 days ago - ...Claims Examiner Seeking a Claims Examiner to analyze complex or technically difficult workers' compensation claims to determine benefits... ...to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background...Full timeWork at office
Synectics
Ontario, CA1 day ago - ...degree of physical damage to vehicles for first and third party claims; complete detailed summary of damage and estimate cost of... ...damage, explain relevant procedures, respond to customer inquiries; provide complete, courteous and timely customer service. # Keep abreast...Work experience placementWork at office
Aspire General Insurance Company
Rancho Cucamonga, CAa month ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Provider Claims & Appeals Specialist II. Be the first to apply!
Related searches
- remote medical claims processor Rancho Cucamonga, CA
- medical claims auditor Rancho Cucamonga, CA
- veterans claims Rancho Cucamonga, CA
- claims processing Rancho Cucamonga, CA
- claims analyst work from home
- medical claims assessor
- insurance claims handler
- warranty claims processor
- claims assistant workers compensation
- claims benefit specialist