- Providence (Mission Hills, CA)
- **Description** The Senior Claims Specialist is responsible for the processing of complex institutional claims (stop loss, contracted, non-contracted, ... adjudication and claims research when necessary. Senior Claims Specialist must have knowledge of compliance...have knowledge of compliance issues as they relate to claims processing and ability to identify and… more
- Providence (Mission Hills, CA)
- …best people, we must empower them. **Required qualifications:** + 2 years HMO claims processing experience in a managed care environment, preferably PMG/IPA ... Full time **Job Shift:** Day **Career Track:** Admin Support **Department:** 7520 CLAIMS PROCESSING CA HERITAGE SERVICES **Address:** CA Mission Hills 11165… more
- Crawford & Company (Brea, CA)
- …members of the medical profession and other persons pertinent to the investigation and processing of claims . + Verifies policy coverage for submitted claims ... is not a job post. Position Summary Administers and resolves non-complex short term claims of low monetary amounts, including medical only claims . Documents and… more
- Robert Half Accountemps (Costa Mesa, CA)
- Description We are looking for a Medical Collections Specialist to join our team in Costa Mesa, California. The role will focus on working with insurance companies, ... and accounts. The successful candidate will be responsible for evaluating claims , initiating appeals for underpayments, reviewing and completing payor and patient… more
- Social Security Administration (Whittier, CA)
- …benefits, insurance benefits, health benefits and/or social service programs; developing, processing , or authorizing claims ; explaining benefit related programs ... by SSA; and use state of-the-art technology to access and update claims information. Requirements Conditions of Employment Qualifications Applicants must have 52… more
- Conduent (Los Angeles, CA)
- …overpaid claims . + Possess strong analytical skills, medical billing or claims processing knowledge and collections background. + Basic knowledge of ... procedures, working with insurance carriers, Medicare, and Medicaid. + Required to have claims processing knowledge so they can speak to providers in medical… more
- LA Care Health Plan (Los Angeles, CA)
- …Degree Experience Required: 1 year of experience in healthcare insurance coordination, claims processing , or data validation. Experience in Customer Service. ... experience in Managed Health Care. Skills Required: Solid understanding of standard claims processing , COB guidelines and data analysis. Must have knowledge… more
- Robert Half Accountemps (Covina, CA)
- …managing CMS1500 forms, working on claim edits, submitting, and following up on claims . The Medical Billing Specialist must have experience with claims ... Description The role of the Medical Billing Specialist will include handling day-to-day medical billing procedures,...in the healthcare system and ensure accurate and timely processing of claims . Responsibilities: * Handle claim… more
- Robert Half Accountemps (Baldwin Park, CA)
- …managing CMS1500 forms, working on claim edits, and ensuring accurate and timely processing of claims . Responsibilities: * Handle claim edits, investigate denied ... Description We are seeking a Medical Billing Specialist in the healthcare industry located in Baldwin... claims , and resubmit claims as needed. * Submit claims timely… more
- City National Bank (Los Angeles, CA)
- …CLAIM SPECIALIST ** **WHAT IS THE OPPORTUNITY?** The Payment Claims Specialist is responsible for the investigation and processing of payment fraud ... email to discuss claim decisions, obtain additional details or follow-up on existing claims within the regulatory defined guidelines, as well as, the banks policies… more
- TORKLAW (Los Angeles, CA)
- …Experience in property damage or a related field + Familiarity with insurance claims processing and requirements + Excellent communication and negotiation skills ... those in need? Join us at TorkLaw! We're seeking a standout Property Damage Specialist , who thrives on challenges, excels in organization, and never loses sight of… more
- LA Care Health Plan (Los Angeles, CA)
- …incentives or any additional service needs according to specific program guidelines. Uses claims processing and care management software to look up member ... Care Management Specialist II Job Category: Clinical Department: Care Management...predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other… more
- Blackstone Consulting (Los Angeles, CA)
- …Agile, ability to work in a fast-paced, deadline or + Responsible for the timely processing of all LOA/FMLA claims . + Ensures all unemployment claims are ... Description/Job Summary Job Description-Human Resources Specialist The HR Specialist (HRS) with...time limits proscribed by each State. + Manages unemployment claims and leave of absence logs. + Provides assistance… more
- The County of Los Angeles (Los Angeles, CA)
- CREDENTIALING SPECIALIST Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3476028) Apply CREDENTIALING SPECIALIST Salary $63,840.00 - ... typically report to a higher-level manager and are responsible for processing and maintaining credentialing documentation for review by the credentialing review… more
- The County of Los Angeles (Los Angeles, CA)
- ENVIRONMENTAL HEALTH SPECIALIST III Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3049497) Apply ENVIRONMENTAL HEALTH SPECIALIST III ... class receive administrative and technical lead from a Chief, Environmental Health Specialist and may receive technical lead from an Environmental Health … more
- LA Care Health Plan (Los Angeles, CA)
- …Excel and Power Point. Requires strong knowledge of regulatory standards and claims processing ; strong analytical, oral, written and presentation skills, able ... Customer Solution Center Appeals and Grievances Specialist II Job Category: Customer Service Department: CSC...complaint and appeals issues, including eligibility, access to care, claims , benefit, and quality of care concerns. Experience working… more
- Cedars-Sinai (Torrance, CA)
- …Duties include but are not limited to, reviewing and submitting claims to payors, performing account follow-up activities, updating information on patient ... account, reviewing and processing credits, posting payments, and account reconciliations. Positions at...cycle functions and provide back-up coverage. The Revenue Cycle Specialist III: + Independently responds timely and accurately to… more
- Cedars-Sinai (Los Angeles, CA)
- …collections. Duties include but not limited to, reviewing and submitting claims to payors, performing account follow-up activities, updating information on patient ... account, reviewing and processing credits, posting payments, and account reconciliations. Positions at this level require expert knowledge, skill and proficiency in… more
- Cedars-Sinai (Los Angeles, CA)
- …may include preparing, indexing, and posting payments, performing daily reconciliation, processing payment transfers, reviewing and submitting claims to payors, ... department and properly using activity codes. + Accurately billing multispecialty claims within established timelines and initiating dialog with payors, patients and… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Training Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, ... Job Summary The Customer Solutions Center Appeals and Grievances (A&G) Training Specialist II is primarily responsible for the overall training strategy across the… more