Director of Claims Operations

We are seeking a highly skilled and strategic Director of Claims Operations to lead our claims department and ensure the precise and efficient processing of healthcare claims. The ideal candidate will have a strong background in claims management, revenue cycle management, and healthcare operations, with a proven track record of implementing process...

Job DescriptionJob DescriptionRole InsightsThis role of the Claims Examiner III is considered an essential position within the organization as well as the Claims Department. The Claims Examiner is responsible for collaborating with the Claims Team to meet productivity goals as well as ensure quality. This candidate should possess claims knowledge,...

Job DescriptionJob DescriptionRole InsightsThis role of the Claims Examiner III is considered an essential position within the organization as well as the Claims Department. The Claims Examiner is responsible for collaborating with the Claims Team to meet productivity goals as well as ensure quality. This candidate should possess claims knowledge,...

Job DescriptionJob DescriptionRole InsightsThis role of the Claims Examiner III is considered an essential position within the organization as well as the Claims Department. The Claims Examiner is responsible for collaborating with the Claims Team to meet productivity goals as well as ensure quality. This candidate should possess claims knowledge,...

Job DescriptionJob DescriptionRole InsightsThis role of the Claims Examiner III is considered an essential position within the organization as well as the Claims Department. The Claims Examiner is responsible for collaborating with the Claims Team to meet productivity goals as well as ensure quality. This candidate should possess claims knowledge,...

Insurance Claims Support SpecialistAt Automobile Club of Southern California, we take pride in being a leader in the insurance sector, renowned for our commitment to exceptional customer service and the welfare of our members. We are currently looking for an entry-level Insurance Claims Support Specialist to assist in our auto claims operations. This...

Claims Loss Reporting SpecialistAt AAA – Auto Club Enterprises, we pride ourselves as a leader in the insurance industry, recognized for our dedication to legendary customer service and our commitment to the well-being of our members. We are currently seeking an entry-level Claims Loss Reporting Specialist to support our auto claims operations. This role...

Job DescriptionJob DescriptionPOSITION SUMMARY Strong background on Medi-Cal, Commercial, and Medicare benefits, including coordination of benefits. Works closely with all departments necessary to ensure that processes, programs and services are accomplished in a timely and efficient manner in accordance with AMM policies and procedures and in compliance...

Claims and Insurance Coordinator As Mount Sinai grows, so does our legacy in high-quality health care. Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across...

Opportunity for a Warranty AdministratorAudi Long Beach is in search of a dedicated Warranty Administrator to enhance our operations. In this pivotal role, you will be responsible for managing warranty claims, ensuring adherence to manufacturer standards, and processing claims with precision.What We Offer:Comprehensive health, dental, and vision...

Job OverviewAs a Clinical Review Nurse, you will leverage your clinical expertise to assess documentation for medical necessity and the appropriate level of care. Your role will involve utilizing MCG/InterQual guidelines, state and federal regulations, billing and coding standards, and Molina policies to validate medical records and claims submitted,...

Job DescriptionJOB DESCRIPTIONJob Summary Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and claim submitted support correct coding...

Job DescriptionJob Description POSITION SUMMARY Like the look of this opportunity Make sure to apply fast, as a high volume of applications is expected Scroll down to read the complete job description. Strong background on Medi-Cal, Commercial, and Medicare benefits, including coordination of benefits. Works closely with all departments necessary to ensure...

Job DescriptionJob DescriptionPOSITION SUMMARY Strong background on Medi-Cal, Commercial, and Medicare benefits, including coordination of benefits. Works closely with all departments necessary to ensure that processes, programs and services are accomplished in a timely and efficient manner in accordance with AMM policies and procedures and in compliance...

Job DescriptionJob DescriptionPOSITION SUMMARY Strong background on Medi-Cal, Commercial, and Medicare benefits, including coordination of benefits. Works closely with all departments necessary to ensure that processes, programs and services are accomplished in a timely and efficient manner in accordance with AMM policies and procedures and in compliance...

Claims and Insurance Coordinator As Mount Sinai grows, so does our legacy in high-quality health care. Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across...

This position will be a remote position. Must have a California SIP (Workers Compensation - Sr. Work Comp Claims Adjuster) Must be Bilingual (English/Spanish)POSITION SUMMARY: Under minimal supervision manages all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines. DUTIES AND RESPONSIBILITIES: ...

This position will be a remote position. Must have a California SIP (Workers Compensation - Sr. Work Comp Claims Adjuster) Must be Bilingual (English/Spanish)POSITION SUMMARY: Under minimal supervision manages all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines. DUTIES AND RESPONSIBILITIES: ...

Claims Service Representative III - SIUAAA has a constantly growing membership; we are always welcoming dedicated professionals looking to challenge themselves and build a career within our dynamic organization.  You will find that being part of a very successful team is extremely rewarding. If you are a career-minded, service-driven professional looking...

The Department of Energy, Environment, and Climate Change (DEECA) is seeking a dedicated and experienced professional to join the Conservation Regulator as the Director of Regulatory Operations. This leadership role is vital for overseeing state and regional intelligence, education, compliance, and enforcement programs within the Conservation Regulator. ...