Claims Review Specialist

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...

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,...

Job DescriptionJob DescriptionSummaryThe claims adjuster is responsible for the adjusting of claims, in accordance with outside regulations and the contractual obligations of the Health Plans and/or the IPAs. Researches, reviews and contacts provider services for problem claims and issues, as needed. Suggests process improvements to management and is a...

Job DescriptionJob Description Summary:Accurate review, input and adjudication of provider specialty claims, including UB04s, in accordance with outside regulations, internal production standards and the contractual obligations. Knowledge of medical terminology necessary. Strong knowledge of Commercial, Medicare and Medi-Cal codes. Basic PC knowledge with...

Job DescriptionJob DescriptionSummaryResponsible for accurate review and input of claims in accordance with outside regulation, internal production standards and contractual obligations of the organization. Duties and Responsibilities1. Accurately review all incoming claims to verify if required fields are populated.2. Process claims information into the...

Administer claims inclusive of receiving, reviewing, and approval of claims as submitted from claimants and/or distributors for payment. Identify liable carrier, filing of claim, collection of funds, and file maintenance. Interact with claimants, dis Claims Analyst, Claims, Marine, Analyst, Insurance

Administer claims inclusive of receiving, reviewing, and approval of claims as submitted from claimants and/or distributors for payment. Identify liable carrier, filing of claim, collection of funds, and file maintenance. Interact with claimants, dis Claims Analyst, Claims, Marine, Analyst, Insurance

Job DescriptionJob DescriptionThe claims examiner is responsible for the adjudication of claims, in accordance with outside regulations and the contractual obligations of the Health Plans and/or the Hospital Client. Researches, reviews and contacts provider services for problem claims and issues, as needed. Suggests process improvements to management and is...

Manager, Claims Job Category: Claims Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 11073 Salary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of...

Salary Range: $102, Min.) - $132, Mid.) - $163, 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 Summary The Manager, Claims directs the efforts of others in the achievement of the strategic, regulatory and operational objectives of the Health Plan. Provides direct supervision to a team of claims examiners, data entry clerks and claims assistants and continuously monitors department for compliance with regulatory requirements. Ensures all work...

Job DescriptionJob DescriptionJob SummaryThe Claims Examiner is key in the daily operations and processing of medical claims. The Examiner is responsible for the review and accurate payment of PPO health claims under the Health and Welfare Plan.This is a full-time position based in Pasadena, CA. Essential job functions include but are not limited to:Accurate...

**Job Summary**: The purpose of this position is to provide support to the Outside Medical Services department, Responsible for Coordinating and Processing Referrals in accordance with regulatory and organizational referral processing guidelines.Under direct supervision, Responsible for coordinating, resolving and communicating problems and issues between...

Salary Range:  $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (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...

Job Summary: The purpose of this position is to provide support to the Outside Medical Services department, Responsible for Coordinating and Processing Referrals in accordance with regulatory and organizational referral processing guidelines.Under direct supervision, Responsible for coordinating, resolving and communicating problems and issues between...

Residuals Claims Rep The Residuals Department of the Writers Guild of America, West, is currently seeking qualified applicants for the position of Claims Representative. This position is a full time, non-exempt (hourly) position with excellent comprehensive benefits package. Compensation is commensurate with experience. The WGAW is an activist union...

Salary Range: $55, Min.) - $69, 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 DescriptionOne of Los Angeles' premier Hospitals is in the immediate need of a Hospital Medical Collections Specialist for its Central Business Office. The Hospital Medical Collections Specialist will be directly supporting the organization by conducting insurance billing and insurance follow up for its many Acute Medical Facilities....

Job DescriptionJob DescriptionSummary:To serve as a liaison between IPA and its Members and Providers. Ensures that all Members and Providers receive a level of service that exceeds their expectations. Respond to and resolve questions and problems from current Providers/Members, or their representative and other appropriate parties.Duties and...

Salary Range:  $45,760.00 (Min.) - $47,823.00 (Mid.) - $55,818.00 (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 members in...