Medicare & Medicaid Claims Examiner
WelbeHealth
WelbeHealth is seeking a Claims Examiner to ensure timely processing of claims for specialty provider partners. This role involves assessing claims appropriateness, maintaining processing rules, and assisting partners with claims inquiries. The ideal candidate has at least three years of claims processing experience, strong knowledge of Medicare and Medicaid, and proficiency in Microsoft Office. Join us to help transform senior care in Los Angeles. #J-18808-Ljbffr WelbeHealth
- ...ensures excellent care delivery for participants, and the Claims Examiner plays a pivotal role in the timely and efficient processing... ...complex managed care environment In-depth experience with Medicare and Medicaid claims processing Demonstrated skills within Microsoft...SuggestedWork at office
- ...Workers Compensation Claims Examiner Primary Purpose: To analyze complex or technically difficult workers' compensation claims to determine... ...Second Injury Fund excess recoveries and Social Security and Medicare offsets. Reports claims to the excess carrier; responds to...SuggestedWork at officeLocal areaRemote work
- ...Job Title: Claims Examiner ILocation: Encino, CAReports to: Claims ManagerEmployment Type: Full timeJob Req ID: 2026Req Begin Date: 6 /12/2026About TMHCCTokio Marine HCC (TMHCC) brings 50 years of service to the specialty insurance industry, today offering over 100 products...SuggestedWork at officeWorldwide
$77.5k
...Job Summary Carl Warren & Company is seeking a skilled Senior Claims Examiner, Public Entity to manage property damage and bodily injury claims for public entity clients from assignment through resolution. In this role, you will apply your expertise in litigated auto and...SuggestedTemporary workFor subcontractorWork at office$84.24k - $126.36k
...Medical Malpractice Claims Examiner Huntington Hospital Employee Login Expectations: The Medical Malpractice Claims Examiner is responsible for the investigation, evaluation, and resolution of professional liability claims involving alleged medical negligence. This role...SuggestedFull timeShift work- ...Position Title: Department: Reports To: FLSA Status: Non-Exempt Job Grade: 12 Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative...Full timeWork at officeLocal areaImmediate startRemote workMonday to FridayFlexible hours1 day per week
- ...The Claims Examiner will be responsible for researchingand resolving pending claims, reviewing claim denials requiring manualreview, and ensuring timely processing in compliance with policies,procedures, and regulatory guidelines. The role involves determiningclaim payments...
$28 - $32 per hour
...Monterey Park, CA 91754 Department: Ops - Claims Ops Compensation: $28.00 - $32.00 / hour Description Job Title: Claims Examiner III Department: Ops - Claims Ops What You'll... ...and company policies and procedures Process Medicare member claims based on DMHC and DHS...Hourly payFull timeWork at office$34 per hour
...Claims Examiner III Location: Pasadena, CA (Hybrid considered after training once performance expectations are consistently met) Schedule... ...Health plan contracts and benefits CMS guidelines Medicare and commercial claims Medical policies and coding guidelines...Hourly payPermanent employmentTemporary workMonday to Friday$80k - $110k
...Senior Claims Examiner Build a brilliant future with Hiscox Bring your passion and enthusiasm to our team! We are a fun, innovative and growing Claims team where you'll get the opportunity to learn multiple insurance products and interact with business leaders across...Temporary workWork at office2 days per week$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$28 - $30 per hour
...To evaluate and determine the appropriate path and to assist in the expedited processing of all claims, special projects and escalated reconsiderations originating from various internal and external sources and to serve as the first level of telephonic and written response...Hourly payContract workCasual workWork at officeRelocation packageFlexible hours- Sedgwick Claims Management Services Ltd is seeking a Claims Examiner - Property to analyze and process complex personal and commercial line property claims. Responsibilities include managing documentation, vendor coordination, and communication with clients. An ideal candidate...Remote jobFlexible hours
$80k - $90k
Claims Examiner - Workers Compensation (HYBRID - West Hills, CA / 3 Days Remote) PRIMARY PURPOSE OF THE ROLE To analyze Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations...Remote jobFlexible hours- HCC Service Company, Inc. is looking for an Associate Claims Examiner to join their team in Los Angeles, California. This on-site role involves investigating and analyzing surety bond claims to ensure effective communication of claim determinations. The ideal candidate...
- A healthcare organization in Los Angeles is seeking a Claims Examiner responsible for researching and resolving claims, reviewing denials, and ensuring compliance with regulations. The ideal candidate will analyze claims, identify process improvements, and assist in reporting...
- Sedgwick in Los Angeles is seeking a Claims Analyst to analyze Workers Compensation claims for its clients. The role involves processing claims, negotiating settlements, and ensuring compliance with industry standards. The ideal candidate should possess at least 5 years...
- Job Description Intro: Are you an experienced Claims Examiner looking for a new opportunity with a prestigious healthcare company? Do you... ...payment methodologies such as Medi-Cal, RBRVS, DRG and other Medicare reimbursements Additional Information If you are interested,...Contract work
- 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...
$77.5k
CWC01 Carl Warren & Company LLC is searching for a skilled Senior Claims Examiner in Los Angeles. The successful candidate will handle property damage and bodily injury claims for public entity clients, ensuring compliance with client guidelines and delivering exceptional...$72.91k - $85k
Claims Examiner - Workers Compensation | Glendale, CA - Hybrid page is loaded## Claims Examiner - Workers Compensation | Glendale, CA - Hybridlocations: Glendale, CAtime type: Full timeposted on: Posted Todayjob requisition id: R72176By joining Sedgwick, you'll be part...Work at officeFlexible hours- ...Claims Adjuster - Workers Compensation Location: Los Angeles, CA. Hybrid-3 days in office Tuesday/Wed/Thursday, Flexible upon performance. Job Hours-8:00 am-4:30 am Duration: 6 months Job description Summary: The main function of a Claims Adjuster is to investigate...Work at officeFlexible 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...
- Tokio Marine HCC is looking for an Associate Claims Examiner to join their Los Angeles team. This role involves investigating and analyzing surety bond claims while ensuring effective communication and customer service. Candidates should have strong analytical and writing...
$85k - $100k
Sedgwick is looking for a Claims Examiner in Los Angeles, CA, to analyze and adjudicate complex workers' compensation claims. You'll be part of a global leader, applying your expertise to help clients and manage high exposure claims. This role requires a Bachelor's degree...Flexible hours$29.44 - $40.46 per hour
Job Overview Claims Examiner Tokio Marine HCC - Surety Group, a member of the Tokio Marine Group of Companies, has an exciting opportunity for an Associate Claims Examiner position on-site at our office in Los Angeles, California. Responsibilities The primary responsibilities...Hourly payWork experience placementWork at officeLocal areaRemote work- Elite Tek Services, Inc. is seeking a Senior Claims Examiner to adjust workers’ compensation claims throughout California. The role includes establishing contact with employers, responding to inquiries, and negotiating settlements. Candidates need a High School Diploma,...
- Position Details Position Title: Senior Claims Examiner Department: Workers’ Compensation California Reports To: Claims Supervisor Position Summary COMPANY has an immediate need for a Senior Claims Examiner to support our workers compensation offices and can be located...Work at officeImmediate startMonday to Friday
$29.44 - $40.46 per hour
## Associate Bond Claims ExaminerApplylocations: California - Los Angelestime type: Full timeposted on: Posted Yesterdayjob requisition id: 2026-613**Claims Examiner**Tokio Marine HCC - Surety Group, a member of the Tokio Marine Group of Companies, has an exciting opportunity...Hourly payWork experience placementWork at officeLocal areaRemote work$44 - $48 per hour
A staffing and consulting firm in Los Angeles is seeking a Workers' Compensation Specialist/Senior Claims Examiner. This position involves overseeing claims from start to finish ensuring timely administration of benefits and compliance with statutory regulations. The successful...Hourly pay
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