Claims Specialist

Overview: We are seeking a highly organized and detail-oriented Claims Specialist to join our team. As a Claims Specialist, you will be responsible for processing and managing insurance claims, ensuring accuracy and compliance with relevant regulations and policies. This is a vital role in our organization, as you will play a key part in facilitating the...

Job DescriptionJob DescriptionThe Senior EDI Claims Specialist is responsible for overseeing the retrieval, processing, validation, and posting of electronic claim data files into MPM’s core system, EZ-CAP®. Serving as a subject matter expert, the Senior EDI Claims Specialist will support the EDI Claims Team through training, monitoring of workflows,...

***This is a fully remote role but you must live IN CALIFORNIA Must Haves: 3+ years’ experience with handling Indemnity Claims in CA Experience handling Workers Compensation Claims Bilingual (English/Spanish) – highly preferred for their client!!! Plusses: Bachelor’s degree Self-Insured Certificate and State Certification Day to Day: Insight Global is...

Job DescriptionJob DescriptionPosition: Medical Claims Review SpecialistLocation: 10920 Wilshire Blvd, Los Angeles, CA 90024Duration: 24 week contractSHIFT: M-F 8-5Note: This position is 99% remote, with only the orientation and occasional meetings requiring onsite presence.Job Summary:We are seeking a skilled Revenue Integrity Analyst / Claims Review...

Salary Range:  $77,265.00 (Min.) - $100,445.00 (Mid.) - $123,625.00 (Max.)   Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million...

Salary Range: $77, Min.) - $100, Mid.) - $123, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...

Job DescriptionJob DescriptionOverviewA Medical Billing Specialist plays a crucial role in a healthcare organization, as they are responsible for accurately billing patients and insurance companies for medical services rendered. This role is essential for ensuring that the organization receives proper compensation for the care provided and maintains...

Coordination of Benefits Validation Specialist II **Job Category**:Administrative, HR, Business Professionals**Department**:Claims Integrity**Location**:Los Angeles, CA, US, 90017**Position Type**:Full Time**Requisition ID**:11187**Salary Range**: $50,216.00 (Min.) - $62,770.00 (Mid.) - $75,324.00 (Max.)- Established in 1997, L.A. Care Health Plan is an...

Job Description Would you like to be part of an organization that is committed to delivering the highest quality of medical care to our patients? Cedars Sinai was awarded the National Research Corporation's Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. News & World Report has named us one of America's...

The Clinical Authorization Specialist will take the lead in securing medical authorizations from third party payers (commercial and government) for outpatient clinic, inpatient admission, ancillary services and/or chemotherapy and other infused treatments as needed in assigned service line. The Specialist will be instrumental in obtaining written...

Salary Range: $50, Min.) - $62, Mid.) - $75, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...

Job DescriptionJob DescriptionJob Summary:The Billing and Collection Specialist will be responsible for performing a variety of complex billing and collection functions. The duties include but not limited to maintaining and resolving third party billing and collection, reviewing patients’ accounts, verifying eligibility, and reprocessing all outstanding...

Job DescriptionJob DescriptionThe Work Justice Firm handles employment and workers' compensation claim. We are seeking an experienced intake specialist to join our growing firm. The intake specialist must have a working understanding of the law, speak Spanish fluently and be able to turn potential cases into clients. This position requires at least 1...

Loss Control Specialist (Hybrid in Baton Rouge, LA) page is loaded Loss Control Specialist (Hybrid in Baton Rouge, LA) Apply remote type Hybrid locations Baton Rouge, LA (USA) time type Full time posted on Posted 8 Days Ago job requisition id R3169 Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at...

Job DescriptionJob DescriptionCustomer Care Specialist* Speak with customer by phone, in person.& * Provide information about products and services& * Take and recorded orders& * Cancel accounts& * Receive and processed incoming phone calls from customer or client base& * Record details of customer transactions, interactions, inquiries, complaints,...

Job DescriptionAlign yourself with an organization that has a reputation for excellence! Cedars-Sinai was awarded the National Research Corporation’s Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company’s Workplace of the Year. This annual award recognizes...

Salary Range:  $50,216.00 (Min.) - $62,770.00 (Mid.) - $75,324.00 (Max.)   Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million...

DescriptionAs the Credit and Refunds Specialist, you will be responsible for: • Reviewing inpatient and outpatient claims/balances to ensure maximum collection dollars by providing appropriate follow-up and documenting actions taken • Reviewing and processing refunds/credit balances in each liability bucket regardless of the services line and...

Description As the Credit and Refunds Specialist, you will be responsible for: * Reviewing inpatient and outpatient claims/balances to ensure maximum collection dollars by providing appropriate follow-up and documenting actions taken * Reviewing and processing refunds/credit balances in each liability bucket regardless of the services line and responding to...

Loss Control Specialist (Hybrid in Baton Rouge, LA) page is loaded Loss Control Specialist (Hybrid in Baton Rouge, LA) Apply remote type Hybrid locations Baton Rouge, LA (USA) time type Full time posted on Posted 8 Days Ago job requisition id R3169 Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at...