Workers Compensation Claims Adjuster III
4 weeks ago
Form a partnership with the medical case manager to maximize early return to work potential thereby reducing the need for extended disability payments, vocational rehabilitation, and other protracted claims costs.Initiate the referral to the SIU of cases with suspected fraud.Aggressively pursue subrogation from culpable third parties, contributions on multiple defendant cases, and apportionment when there is pre-existing disability.Review and approve all vocational rehabilitation plans.Review all medical bills for appropriateness prior to referral to InterMed for payment and posting to the claim file.Requires a working knowledge of the Labor Code of the State of California as it pertains to workers compensation claims and the legal requirements for handling them.Litigation management - Direct, manage, and control the litigation process.Requires a high degree of claims handling expertise to include a minimum of at least five years experience managing indemnity cases, many with complex or high potential subrogation, rehabilitation, medical management, and/or legal issues & possess an SIP certificate.
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Senior Workers Compensation Claims Adjuster
3 days ago
Fresno, California, United States Intercare Insurance Full timeJob OverviewPosition: Workers Compensation Adjuster IIISummary:This role reports directly to the Claims Supervisor and may provide technical support in their absence. The Adjuster is responsible for managing a portfolio of claim files, which may involve complex cases or unique challenges, in compliance with relevant laws and company policies.Key...
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Senior Workers Compensation Claims Adjuster
5 days ago
Fresno, California, United States Intercare Insurance Full timeJob OverviewPosition: Workers Compensation Adjuster IIISummary:This role reports directly to the Claims Supervisor and may involve providing technical support in their absence. The Adjuster is responsible for managing a portfolio of claims, including those of significant complexity or unique circumstances, in compliance with relevant regulations and company...
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Claims Management Supervisor
2 weeks ago
Fresno, California, United States Zenith Full timeThis position offers the opportunity to engage in Zenith's flexible hybrid work model, allowing for a blend of remote and in-office work as per the established schedule by regional leadership. Essential Qualifications: Applicants must possess experience in Workers' Compensation and hold the necessary state certifications. Under general oversight, this role...
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Claims Management Supervisor
1 week ago
Fresno, California, United States Zenith Full timeThis position is eligible for Zenith's hybrid work model, allowing flexibility to work remotely on designated days based on the in-office schedule set by regional leadership. Essential Qualifications: Must possess experience in Workers' Compensation and hold the necessary state certifications. Under general oversight, this role involves supervising a Claims...
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Medical Claims Specialist III
7 days ago
Fresno, California, United States CEDARS-SINAI Full timeJob SummaryCedars-Sinai is seeking a highly skilled Medical Claims Specialist III to join our team. As a key member of our Patient Financial Services department, you will play a critical role in ensuring accurate and timely reimbursement for medical services provided by our clinicians.Key Responsibilities:Coding and Compliance: Provide coding and educational...
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Lead Claim Investigator
1 week ago
Fresno, California, United States Crawford & Company Full timeCommitment to Excellence in Every InteractionPosition OverviewFlexible Work-from-Home OpportunityLooking for professionals experienced in managing California Workers Compensation claimsSIP certification is mandatoryPotential for Bonus IncentivesVarious Employee Discounts AvailableConduct thorough investigations and resolve intricate, high-value claims...
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Senior Claims Analyst
1 week ago
Fresno, California, United States Crawford & Company Full timeCommitment to Excellence in Every InteractionPosition OverviewFlexible Remote Work OpportunityIdeal candidates will have experience handling California Workers Compensation claimsSIP certification is mandatoryPotential for Bonus IncentivesVarious Employee Discounts AvailableConduct thorough investigations and resolve intricate, high-value claims efficiently...
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Insurance Claims Specialist
2 weeks ago
Fresno, California, United States Relation Insurance Inc Full timePRIMARY RESPONSIBILITIESHandles all incoming inquiries related to commercial insurance claims.Collects all necessary details regarding the claim from the producer and/or client.Maintains neutrality regarding coverage decisions for claims.Identifies relevant coverage and policy details related to the claim and completes the necessary ACORD...
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Claims Management Supervisor
6 hours ago
Fresno, California, United States Zenith Full timeJob SummaryZenith is seeking a highly skilled Claims Management Supervisor to oversee the supervision and management of a Claims unit. The ideal candidate will have extensive experience in workers' compensation indemnity claims, including settlement negotiation of litigated claims.Key ResponsibilitiesDirect and control the Claims unit, providing technical...
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Insurance Claims Specialist
2 weeks ago
Fresno, California, United States Relation Insurance Inc Full timeKEY RESPONSIBILITIESHandles all incoming inquiries related to commercial insurance claims.Collects all necessary details regarding the claim from the client or producer.Does not imply or deny any claim coverage.Identifies relevant coverage and policy details associated with the claim and completes the necessary ACORD documentation.Processes daily...
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Medical Claims Examiner
5 days ago
Fresno, California, United States TEKsystems Full timeJob SummaryWe are seeking a highly skilled Medical Claims Examiner to join our team at TEKsystems. As a Medical Claims Examiner, you will be responsible for processing medical claims in a computerized environment, ensuring accurate and timely processing of claims.Key ResponsibilitiesMaintain multiple groups and process CMS-1500 and UB-04 claimsProcess...
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Medical Claims Examiner
7 days ago
Fresno, California, United States TEKsystems Full timeJob SummaryWe are seeking a highly skilled Medical Claims Examiner to join our team at TEKsystems. As a Medical Claims Examiner, you will be responsible for processing medical claims in a computerized environment, ensuring accurate and timely processing of claims.Key ResponsibilitiesMaintain multiple groups and process CMS-1500, UB-04, and high dollar...
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Insurance Claims Service Representative Assistant
24 hours ago
Fresno, California, United States DiBuduo & DeFendis Insurance Brokers, LLC Full timeJob Summary:We are seeking a highly skilled and detail-oriented Insurance Claims Service Representative Assistant to join our team at DiBuduo & DeFendis Insurance Brokers, LLC. As a key member of our claims team, you will be responsible for providing exceptional customer service and ensuring seamless claims processing.Key Responsibilities:Claims Processing:...
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Clinical Revenue Coordinator III
7 days ago
Fresno, California, United States CEDARS-SINAI Full timeJob SummaryCedars-Sinai is seeking a highly skilled Medical Claims Specialist III to join our team. As a key member of our Patient Financial Services department, you will play a critical role in ensuring accurate and timely reimbursement for medical services provided by our clinicians.Key Responsibilities:Coding and Compliance: Provide coding and educational...
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HVAC Service Technician
7 days ago
Fresno, California, United States Mark III Construction Full timeJob SummaryMark III Construction is seeking a skilled Journeyman HVAC Technician to join our team in the Fresno area. As a key member of our team, you will be responsible for installing, troubleshooting, and repairing heating and air conditioning systems to industry standards.Key ResponsibilitiesEstablish and maintain positive relationships with customers to...
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Compensation Analyst
1 week ago
Fresno, California, United States Denham Resources Full timeAre you seeking a fulfilling role in a supportive environment? Denham Resources, a reputable family-owned business, is dedicated to making a positive impact in the community, and your contributions will play a vital role in this mission.We are currently in search of a skilled Payroll Specialist with expertise in certified and union payroll processes.Key...
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Billing and Collections Specialist
2 weeks ago
Fresno, California, United States Sante Health Full timeJob OverviewSante Health System is seeking a dedicated full-time Accounts Receivable / Insurance Follow-Up / Medical Collections Agent. This role is pivotal in managing insurance claims and patient balance inquiries, generating aging reports, and delivering exceptional customer service.REQUIREMENTSHigh school diploma or equivalent required.Preferred two...
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Medical Billing Specialist
2 weeks ago
Fresno, California, United States Sante Health Full timeJob OverviewSante Health System is seeking a dedicated full-time Accounts Receivable / Insurance Follow-Up / Medical Collections Agent to manage patient and insurance follow-ups, oversee aging reports, and provide exceptional customer service.REQUIREMENTSHigh school diploma or equivalent required.Preferred two years of experience in medical billing, with...
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Compensation and Benefits Coordinator
2 weeks ago
Fresno, California, United States Vie Del Full timeJob OverviewVie-Del is a leading manufacturer of fruit concentrates, spirits, and wines. We are on the lookout for skilled individuals to become part of the Vie-Del Family. We provide a competitive salary along with a comprehensive benefits package in a supportive and rewarding workplace.POSITION SUMMARY: The Payroll Administration Specialist will work under...
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Billing and Collections Specialist
2 weeks ago
Fresno, California, United States Sante Health Full timeJob OverviewSante Health System is seeking a dedicated full-time Accounts Receivable / Insurance Follow-Up / Medical Collections Agent to manage insurance and patient balance follow-ups, aging reports, and provide exceptional customer service.REQUIREMENTSHigh school diploma or GED certificate is mandatory.Preferred two years of experience in medical billing,...