California Work Comp Claims Examiner

Job SummaryWe are seeking a highly skilled Claims Management Specialist to join our team at CorVel Enterprise Comp, Inc. in this remote position.This role is ideal for individuals with a strong background in claims management and a passion for delivering exceptional results under the guidance of senior professionals.About the RoleAs a Claims Management...

Reporting to the Manager, Claims, the Claims Examiner is responsible for claims processing, adjudication, and research. You will stay current on claim processing procedures, produce a quality work product, and assist Claims Management with special projects. You will have claims processing experience with the ability to maintain high qualitative and...

Reporting to the Manager, Claims, the Claims Examiner is responsible for claims processing, adjudication, and research. You will stay current on claim processing procedures, produce a quality work product, and assist Claims Management with special projects. You will have claims processing experience with the ability to maintain high qualitative and...

Job Title: Claims ExaminerAt Maltos Law Firm PLLC, we are seeking a highly skilled Claims Examiner to join our team.About the Role:We are looking for an experienced Claims Examiner to manage and maintain client cases in our Case Management Software. The successful candidate will be responsible for preparing and sending letters of representation, obtaining...

Get To Know Us! WebTPA, a GuideWell Company, is a healthcare third-party administrator with over 30+ years of experience building unique benefit solutions and managing customized health plans. Key position details: This is a Full time in office position: 19100 Ridgewood Pkwy San Antonio, TX 78259 What is your impact? As a Claim Examiner, you will handle...

Job DescriptionGet To Know Us! WebTPA, a GuideWell Company, is a healthcare third-party administrator with over 30+ years of experience building unique benefit solutions and managing customized health plans. Key position details: This is a Full time in office position: 19100 Ridgewood Pkwy San Antonio, TX 78259 What is your impact? As a Claim Examiner, you...

We are seeking a highly skilled Claims Adjuster - Workers' Compensation Specialist to join our team at Republic Indemnity. This is an exciting opportunity for a motivated individual to work with us in managing Workers' Compensation costs for businesses in the western U.S.The ideal candidate will have 6-10 years of experience handling California workers' comp...

Shared Services: Risk Management- (Full-Time, Day Shift) - Job Summary: The Claims Examiner-HP Enrollment role coordinates all aspects of eligibility and enrollment for the health plans administered by Risk Management. Performs other duties as needed.Education and Experience: High School Diploma or GED required. Associate‘s Degree preferred. Minimum two...

About OptumOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best.Here, you will find a culture guided by diversity and...

At Republic Indemnity, we've been helping businesses in the western U.S. manage their Workers' Compensation costs for over 50 years. Headquartered in Calabasas, California with additional offices in San Francisco and San Diego, we write workers compensation primarily in CA with significant business in AK, AZ, NV, and other western states. Whether it's...

At Republic Indemnity, we’ve been helping businesses in the western U.S. manage their Workers’ Compensation costs for over 50 years. Headquartered in Calabasas, California with additional offices in San Francisco and San Diego, we write workers compensation primarily in CA with significant business in AK, AZ, NV, and other western states. Whether it’s...

About the RoleAre you looking for a challenging and rewarding career in medical claims processing? Optum is seeking a Senior Claims Examiner to join our team. This role offers a unique opportunity to grow your career while making a positive impact on people's lives.Job DescriptionWe are responsible for providing claims support to our teams in reviewing,...

Description: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation To ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of...

POSITION SUMMARY/RESPONSIBILITIES Performs adjudication of medical (HCFA) or hospital (UB92) claims for Medicaid, Commercial, and CHIP (Children’s Health Insurance Program) according to departmental and regulatory requirements. Maintains audit standards as defined by the Department. EDUCATION/EXPERIENCE A high school diploma or GED equivalent is...

POSITION SUMMARY/RESPONSIBILITIES Performs adjudication of medical (HCFA) or hospital (UB92) claims for Medicaid, Commercial, and CHIP (Children’s Health Insurance Program) according to departmental and regulatory requirements. Maintains audit standards as defined by the Department. EDUCATION/EXPERIENCE A high school diploma or GED equivalent is...

Shared Services: Risk Management- (Full-Time, Day Shift) - Job Summary: The Claims Examiner-HP Enrollment role coordinates all aspects of eligibility and enrollment for the health plans administered by Risk Management. Performs other duties as needed. Education and Experience: High School Diploma or GED required. Associate's Degree preferred. Minimum two...

POSITION SUMMARY/RESPONSIBILITIES Performs adjudication of medical (HCFA) or hospital (UB92) claims for Medicaid, Commercial, and CHIP (Children’s Health Insurance Program) according to departmental and regulatory requirements. Maintains audit standards as defined by the Department. EDUCATION/EXPERIENCE A high school diploma or GED equivalent is...

About the RoleWe are seeking a highly skilled Complex Claims Examiner to join our team at Heritage MGA LLC.Job SummaryThe Complex Claims Examiner will analyze and review claims for accuracy, completeness, and eligibility. This role requires a strong ability to investigate losses, calculate and negotiate settlements, and prepare reports and records for...

Job OverviewAt University Health, we are seeking a skilled Medical Claims Examiner to join our team. This role involves performing adjudication of medical claims for Medicaid, Commercial, and CHIP according to departmental and regulatory requirements. ResponsibilitiesAdjudicate medical claims accurately and efficientlyMaintain audit standards as defined by...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion,...