We have other current jobs related to this field that you can find below
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Temporary - Claims Administrative Analyst
4 weeks ago
Santa Ana, United States Kaiser Permanente Full timeJob 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...
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Claims Assistant
19 hours ago
Santa Ana, United States Kelly Full timeWe’re seeking a Claims Assistant to work at a premier client in Santa Ana, CA. Sound good? Salary/Pay Rate/Compensation: $23 an hour. Why you should apply to be a Claims Assistant: • Competitive pay rate of $23 an hour • Monday-Friday schedule, 8:30AM-5:30PM • Room for growth and advancement within the company • Opportunity to work with a...
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Compensation Administration Lead
3 days ago
Santa Ana, California, United States Camber Corporation Full timeJob OverviewCamber Corporation, a prominent entity in the Real Estate sector, is seeking a dedicated and experienced Payroll Manager. The ideal candidate will be a proactive individual who thrives in a dynamic work environment.Key Responsibilities:Manage the bi-weekly payroll processing for over 500 employees across various properties.Generate and prepare...
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Administrative Assistant
3 weeks ago
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Warranty Claims Coordinator
3 days ago
Santa Monica, California, United States LAcarGUY Full timeJoin the dynamic team at LAcarGUY as we seek a dedicated Warranty Administrator. This role presents a remarkable chance to contribute to our operations and ensure the seamless processing of warranty claims.Key Responsibilities:Efficiently manage warranty claims, ensuring all submissions adhere to manufacturer and dealership standards.Conduct thorough...
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Administrative Assistant
2 weeks ago
Santa Ana, United States Innovative Career Resources & Staffing Full time $27 - $31Job DescriptionJob DescriptionWe are partnering with a reputable and professional Commercial Property Management firm in Santa Ana to find an Administrative Assistant for a direct hire position. The ideal candidate will possess exceptional attention to detail, polished communication skills, and the ability to work independently with a proactive approach. In...
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Claims Processing Specialist
3 days ago
Santa Monica, California, United States LAcarGUY Full timeJoin the dynamic team at LAcarGUY as we seek a dedicated Warranty Administrator. This role is pivotal in managing warranty claims and ensuring compliance with both dealership and manufacturer standards.Key Responsibilities:Efficiently process warranty claims while adhering to factory guidelines.Maintain accurate records and reconcile warranty schedules to...
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Workers' Comp. Defense Attorney
3 months ago
Santa Ana, United States GLENN L. SILVERII & ASSOCIATES, APC Full timeJob DescriptionJob DescriptionWorkers’ Comp. Defense Attorney Growing workers’ compensation defense firm seeks experienced attorneys for Orange County and Los Angeles offices. Competitive salary, excellent benefits and work environment. At least 5 years of experience. Company DescriptionThe law firm of Glenn L....
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Medical Claims
2 weeks ago
Anaheim-Santa Ana-Garden Grove, United States SCUFCW Trust Fund Full time $24Job DescriptionJob Description***This position is located in Cypress, CASouthern California United Food & Commercial Workers Unions & Food Employers Joint Benefit Funds Administration, LLC (The Funds) were created more than 40 years ago as a result of collective bargaining between the Southern California Retail Food Employers and the Southern California UFCW...
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Office Support Specialist
3 days ago
Santa Ana, California, United States Frontline Resources LLC Full timeJob OverviewFrontline Resources LLC is seeking a dedicated Office Support Specialist to assist in various administrative functions. This role is crucial for maintaining operational efficiency and supporting the team during a temporary staffing gap.Compensation: $22-25 per hourKey Responsibilities:Financial Management: Utilize QuickBooks for vendor bill...
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Associate Attorney
3 weeks ago
Santa Ana, United States Dietz Gilmor & Chazen Full timeJob DescriptionJob DescriptionDietz, Gilmor & Chazen, an established California workers’ compensation defense law firm, is seeking to hire an experienced Attorney for our Corporate office in San Diego. The attorney will be responsible for ensuring quality representation of employers, insurers, and third-party administrators in the defense of workers'...
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Intake Client Services
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Santa Ana, United States Royalty Medical Solutions Full timeJob DescriptionJob DescriptionAs an Intake Client Services with Personal Injury Experience at Royalty Medical Solutions, you will be responsible for facilitating the intake process for personal injury cases. You will be the first point of contact for clients and will help gather necessary information to initiate the claims process.Key responsibilities...
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Warranty Administrator
2 weeks ago
Santa Rosa, United States Hansel Auto Group Full timeHansel Ford Lincoln of Santa Rosa is seeking a Warranty Administrator to help us maintain our exceptional customer service ratings. Business is booming and we're looking for the best! Job Purpose To enhance the customer experience by communicating with the customer, the service staff, and the manufacturer to ensure timely service, confirming that all...
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CalAIM Nonprofit Administrative Coordinator
3 days ago
Santa Cruz, California, United States Housing Matters Full timePosition OverviewCalAIM Nonprofit Administrative SupportHousing Matters is dedicated to collaborating with individuals and families to forge pathways out of homelessness into stable housing. As a prominent organization in the mission to eradicate homelessness, we seek individuals who are passionate about making a positive impact and are committed to our...
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Risk Management Analyst
1 month ago
Santa Ana, United States City of Santa Ana Full timeThe City of Santa Ana is looking for individuals who are results-oriented, possess great attitude, demonstrate creativity and innovation, work efficiently, show a record of success and have a passion for public service. Having the best employees provides the best service to the community. Performs complex and varied technical, analytical, professional, and...
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Program Assistant
3 weeks ago
Santa Ana, United States JFCS of Long BeachWest Orange County Full timeAbout the role We are seeking someone who is collaborative, detail-oriented, proactive, and organized — able to operate effectively in a fast-changing environment. This person will need to be a self-starter who values effective communication to ensure cohesion across the team and someone able to zoom in and out to prioritize the big and specific details...
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Program Assistant
3 weeks ago
Santa Ana, United States JFCS of Long BeachWest Orange County Full timeAbout the role We are seeking someone who is collaborative, detail-oriented, proactive, and organized able to operate effectively in a fast-changing environment. This person will need to be a self-starter who values effective communication to ensure cohesion across the team and someone able to zoom in and out to prioritize the big and specific details of...
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Program Assistant
3 weeks ago
Santa Ana, United States JFCS of Long BeachWest Orange County Full timeAbout the role We are seeking someone who is collaborative, detail-oriented, proactive, and organized — able to operate effectively in a fast-changing environment. This person will need to be a self-starter who values effective communication to ensure cohesion across the team and someone able to zoom in and out to prioritize the big and specific details...
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CalAIM Nonprofit Administrative Coordinator
3 days ago
Santa Cruz, California, United States Housing Matters Full timePosition OverviewCalAIM Nonprofit Administrative SupportHousing Matters is dedicated to partnering with individuals and families to forge pathways out of homelessness into stable housing. As a leader in the effort to eliminate homelessness, we are seeking individuals who are passionate about making a positive impact and are committed to our vision that...
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Program Support Specialist
3 days ago
Santa Ana, California, United States JFCS of Long BeachWest Orange County Full timePosition OverviewThe JFCS of Long Beach/West Orange County is in search of a dedicated and detail-oriented individual who thrives in a dynamic work environment. The ideal candidate will possess strong organizational skills, proactive communication abilities, and a collaborative spirit. This role requires a self-motivated individual who can adeptly navigate...
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Claims Administrative Analyst_
2 months ago
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 Medical Center physicians, Administration, Outside Providers and members in order to process and partner with the Medical Centers, Outside Providers and Claims Administration. Essential Responsibilities: + Reviews physicians requests for outside medical services. + Verifies patient eligibility and contacts both outside facility and patient regarding billing procedures and appointment scheduling. + Reviews and processes billings received from outside medical providers. + Verifies authorized services prescribed, determines accuracy and appropriateness of charges. + Determines whether questionable billings received are to be considered for payment through the outside medical referral system and reroutes billings. + Follows up on referral compliance. + Sets up and maintains files on all outside referral patients. + Educates community hospital personnel, physicians and billing services regarding Kaiser Outside Medical referral and reimbursement policies and practices, covered benefits and authorized services. + Interprets SCPMG, KFH and KFHP policies and answer inquiries from Kaiser Members, physicians and other involved personnel and support staff. + Acts as liaison between Regional Offices and local Outside Referral desk to coordinate and implement all Outside Medical Systems for SCPMG associated with use of non-Kaiser facilities for the purposes of: in and out patient referrals, supplemental bed and pre-scheduled surgeries. + Provide accurate information to outside providers and members to help facilitate most appropriate route of health care. + Interpret and implement necessary procedures regarding contractual agreements between Kaiser Permanente and Community Hospitals and physicians. + Performs other administrative duties as required. + Follows cost avoidance policies and procedures by requesting LOAs on non-contracted referrals, Check passport, check W/C database, Check for CCS, and OIC information prior to processing referrals. + Process and initiates NONC in accordance with plan rules and benefits. + Performs daily review of I-file inquiries. + Analyzes referrals and claims information for accuracy according to established guidelines and provides education/feedback and reports as applicable. + Assists Claims Auditor with tracing sources of inaccuracies; reports and proposes remedial action to appropriate manager. + Prepares detailed analysis of claims activity and submits reports/findings as requested. + Carries out and maintains records of special processing payment adjustments/check requested. + Works with Finance Department and others as resource regarding all aspects of Outside Medical Claims; researches and provides reports as requested. + Reviews processing of outside medical payments on a continuous basis. + Ensures safeguarding of assets through the verification of documentation, approvals and accurate coding of provider service and accounting data. + Monitors and coordinates special transactions such as check adjustments and credits. + Performs analysis of data entered for outside medical payments for the purpose of performance feedback. + Performs special comprehensive reports as indicated or requested by management. + Reviews, audits medical claims submitted by non-plan providers to ensure accuracy and appropriateness of charges submitted. + Consults with clinical staff to determine medical necessity of procedures performed or care provided by a non-plan provider. + Responds to provider appeals as it relates to disputed claims payment and authorized services. + Determines if care provided corresponds to the charges submitted. + Reviews appropriateness of CPT/ICD-9 coding. + Identifies and coordinates contracting opportunities with problematic providers to decrease potential erroneous billing and promotes controlled outside medical cost. Basic Qualifications: Experience + Minimum one (1) year of related work experience. Education + Bachelors degree in a health care related field OR four (4) years of experience in a directly related field. + High School Diploma or General Education Development (GED) required. License, Certification, Registration + N/A Additional Requirements: + Familiarity with medical terminology required. + Strong negotiation, conflict resolution and excellent interpersonal skills required. + Proficient with software applications such as Word and Excel. + Strong analytical skills, excellent oral and written communication skills required. + Proficiency in analyzing problems. + Must have knowledge of regulatory requirements, policies and procedures development, and general expertise in areas that affect referral and claims processing. + Must be able to work in a Labor/Management Partnership environment. Preferred Qualifications: + Proficient with EPIC/Health and other software applications such as Word and Excel. + Knowledge in Access database a plus. COMPANY: KAISER TITLE: Claims Administrative Analyst LOCATION: Santa Ana, California REQNUMBER: 1290980 External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.