Managed Care Claims Examiner: Precise Adjudication
Nahse
Nahse is seeking a Claims Examiner in Los Angeles, CA. The role involves accurately adjudicating claims following company guidelines and ensuring compliance with CMS and DMHC regulations. Candidates should have three years of experience in medical claims processing, especially in specialty claims like Chemotherapy and Dialysis. The position requires familiarity with claims processing systems, ideally Epic Tapestry, and a commitment to quality and efficiency standards. #J-18808-Ljbffr Nahse
- Academy of Managed Care Pharmacy is hiring a Claims Examiner in Los Angeles, CA. The ideal candidate will have three years of experience in medical claims... ..., and specialty claims. Responsibilities include adjudicating claims per company policies, meeting production standards...Suggested
- ...Job Description The Claims Examiner is responsible for accurately and consistently adjudicating claims in accordance with policies, procedures and guidelines as outlined by the company policy. Process claims according to all CMS and DMHC guidelines. Investigate and...SuggestedContract work
- MedPOINT Management is seeking a Claims Examiner to adjudicate claims in accordance with health plan regulations and contractual obligations. This role involves reviewing Provider claims, resolving issues, and assisting staff in claims research. The ideal candidate is a...SuggestedRemote job
- ...difference in people’s lives. It takes empathy, precision, and a strong sense of partnership—and... ..., and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes...SuggestedFull timeLive outWork at officeLocal areaRemote workFlexible hours
- General Liability Claims Adjuster MUST Reside in California & MUST have California General Liability Claims Experience. General Liability... ...resources through pro‑active and aggressive claims and managed care solutions in support of our clients’ objectives. Innovative processes...Suggested
- ...prominent healthcare institution in Los Angeles is seeking a Claims Examiner to adjudicate medical claims accurately while adhering to company... ...timely processing. This position is critical for maintaining quality standards in claims management. #J-18808-Ljbffr Cedars-Sinai
$28 - $30 per hour
...Claims Processor To evaluate and determine the appropriate path... ...on-going updates to Claims management. Assist in the processing... ...Supervisor regarding claims adjudication issues discovered in audit or... ...adjudication experience in a managed care setting. Knowledge of CPT-...Hourly payFull timeContract workCasual workWork at officeRelocation packageFlexible hours- 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...
$23 - $26 per hour
...Claiming Analyst Sycamores provides a spectrum of equitable mental health services through... ...agency focuses primarily on providing care to low-income, high at-risk youth. The... ...collaboration with Claiming and Revenue Manager, claim, track and monitor invoice/EDI claims...Hourly payWork experience placementLocal area- A healthcare organization is seeking a Claims Examiner in Los Angeles, California. The role involves adjudicating medical claims in compliance with company policies, ensuring accuracy, and maintaining productivity standards. Candidates should have three years of experience...
$85k - $100k
...AvonRisk Claims Specialist AvonRisk is the nation's leading specialty risk manager for self-insured organizations, uniting respected regional leaders in workers' compensation, liability, managed care, and risk management across 32 states. With nearly 700 professionals...- ...Worker Compensation Claims Adjuster We're seeking an experienced and motivated Workers' Compensation Claims Adjuster to assist... ...technological resources through pro-active and aggressive claims and managed care solutions in support of our clients' objectives. Innovative...
$70k - $120k
...Senior Claims Specialist, Workers' Compensation BITCO Corporation... ...is guided by core values. We care deeply about our people, partners... ...promises with integrity and precision, and we strive to make a... ...Position Summary: This role manages California Workers' Compensation...Temporary workWork at officeRemote workFlexible hoursNight shift$80k - $98k
...A leading claims management company is seeking a Workers Compensation Claims Examiner to analyze and adjudicate complex customer claims. The role is remote for applicants in Central Valley, California. A successful candidate should have at least 5 years of claims management...Remote workFlexible hours- NOTE THIS ROLE IN AN ONSITE POSITION IS DOWNTOWN LA Job Title Claims Adjuster, Public Entity Department Claims Services Job Summary Carl... ...Company is seeking a skilled Claims Adjuster, Public Entity to manage property damage and bodily injury claims for public entity...Temporary workFor subcontractorWork at office
- ...Health & Services is looking for a Senior Claims Specialist based in Los Angeles,... ...involves processing complex claims and adjudication while ensuring compliance with regulations... ...comprehensive benefits package, including health care and a 401(k) plan with employer matching...
- Sedgwick is seeking a Claims Examiner in Los Angeles, CA, to manage complex auto and commercial claims. The role demands at least 5 years of Auto Liability claims experience, including oversight of claims and ensuring timely resolution while maintaining compliance. The...Flexible hours
$80k - $105k
A leading claims management company in California is seeking a Workers Compensation Claims Examiner to analyze and manage complex claims. The ideal candidate will have at least five years of experience and in-depth knowledge of California's workers compensation laws. This...Flexible hours$80k - $98k
Sedgwick Claims Management Services Ltd is hiring a Claims Examiner for their location in West Hills, CA, or remote work. The ideal candidate will analyze Workers Compensation claims, ensuring timely adjudication while adhering to industry best practices. Qualifications...Remote jobFlexible hours- A leading claims management firm is seeking a Claims Examiner in Glendale, CA for a hybrid role. The successful candidate will analyze and adjudicate workers' compensation claims while ensuring timely resolution and excellent customer service. Required qualifications include...
- A leading insurance provider is seeking a Claims Specialist to investigate and manage claims in Los Angeles. The role involves reviewing first reports, establishing action plans, and negotiating settlements within specified limits. The ideal candidate will possess strong...Local areaRemote work
$120k - $190k
...Join our Construction & Infrastructure claims team as a Construction Claims Consultant based... ...primary point of contact for clients, managing and coordinating liability claims with a... ...disability, health savings account, health care and dependent care reimbursement accounts...Full timeTemporary workPart timeWork at officeLocal areaImmediate startNight shift- A prestigious academic institution in Los Angeles is seeking a Commercial Collections Representative to manage inpatient and outpatient claims. The role involves conducting account reviews, communicating with payers, and ensuring timely resolution of claims. Candidates...
- ...Wellness resources Summary The claims examiner is responsible for the adjudication of claims, in accordance with... ...Suggests process improvements to management and is a resource of information... ...Abilities · Experience in a managed care environment preferred. · ICD-10...Remote work
$72.91k - $85k
...career with us, experience our caring culture, and enjoy work-life... ...Services & Insurance Claims Examiner - Workers Compensation | Glendale... ...knowledge and experience to adjudicate complex customer claims in... ...: 5 years of claims management experience or equivalent combination...Work at officeFlexible hours$28 - $30 per hour
...Claims Specialist - Quality Assurance and Compliance (QAC) For over 100 years, Vista... ...developing a culture of healing, community care, and creating a sense of belonging. Our actions... ...- Quality Assurance and Compliance (QAC) manages client information and funding...Hourly payContract workWork at officeWorldwide- ...Claims Management Position Directly handle, manage and/or oversee commercial and financial lines Public and Private D&O, Financial Institutions E&O, EPL, Fiduciary and Crime/Fidelity claims. Handle claims in accordance with Claim Handling Best Practices in all phases...Work at office
$68k - $80k
...reimagining the way we help customers to manage risk. Join us as a an Underwriter, Environmental... ...exposures, special or common hazards, claims experience and appropriate controls.*... ...clients alike.**Enjoy benefits that take care of what matters**At AIG, our people are our...Work at office- ...Quality: (50%)* Apply appropriate account selection, coverage, risk management, aggregate management, reinsurance and pricing techniques... ...risk financing programs, insurance products, risk engineering and claims management services that enable our clients to effectively and...For contractorsLocal area
$120k - $200k
ANV Group Holdings Ltd. (“ANV”) is a leading managing general agency platform which writes a diversified mix of specialty, affinity and wholesale insurance products in the United States, United Kingdom, and Europe. With deep industry experience and a history of profitable...Work experience placement
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