Complex Claim Research Specialist

4 days ago


Los Angeles, California, United States UnitedHealth Group Full time

Job Summary

">

We're seeking an experienced Claims Representative Senior to join our team at UnitedHealth Group. In this role, you'll be responsible for conducting complex research, analysis, and evaluations of claims data to resolve disputes and discrepancies.

">

Responsibilities

">
  • ">
  • Conduct thorough research and analysis of claims data to identify discrepancies and disputes.">
  • Develop and implement effective solutions to resolve claims issues.">
  • Communicate regularly with internal teams and external stakeholders to gather information and provide updates.">
">

Requirements

">

To be successful in this role, you'll need:

">
  • ">
  • A bachelor's degree in a relevant field, such as business, healthcare, or a related field.">
  • At least 5 years of experience in claims processing or a related field.">
  • Strong analytical and problem-solving skills, with the ability to think critically and develop creative solutions.">
  • Excellent communication and interpersonal skills, with the ability to build strong relationships with internal and external stakeholders.">
">

Working Conditions

">

This is a remote-based role, with occasional travel required to meetings and training sessions.

">

Other Benefits

">

We offer a comprehensive benefits package, including medical, dental, and vision coverage, as well as 401(k) matching and paid time off.



  • Los Angeles, California, United States Swyft Staffing Full time

    Job Title: Accident Claims Specialist Los AngelesAbout the Role:We are seeking a skilled Accident Claims Specialist to join our team at Swyft Staffing in Los Angeles. As an Accident Claims Specialist, you will be responsible for assisting attorneys with various duties assigned to them.Key Responsibilities:The ideal candidate will have excellent communication...


  • Los Angeles, California, United States Murphy Research Full time

    Expand Your HorizonsMurphy Research, a leader in custom market research, is seeking an experienced Research Account Growth Specialist to join our team. In this role, you will drive business growth by identifying new business opportunities, growing existing client relationships, and delivering exceptional results that meet and exceed client expectations.Your...


  • Los Angeles, California, United States AXA Group Full time

    AXA XL is seeking a highly skilled Large Loss Claims Specialist to join our Construction Defect Claims team.We deliver on our claims promise by having the best systems, the best people, and the best partnerships in place. Our team handles complex construction defect claims, requiring the right balance of knowledge and skills. In claims, experience matters,...


  • Los Angeles, California, United States Ascendion Full time

    Role OverviewWe are seeking an experienced Claims Management Specialist to join our team at Ascendion. As a Claims Management Specialist, you will be responsible for managing all aspects of personal injury cases, from intake to resolution. This includes gathering and reviewing medical records, coordinating with medical providers and insurance adjusters, and...


  • Los Angeles, California, United States JBA International Full time

    We are seeking an experienced Compensation Claims Specialist to oversee and negotiate bodily injury claims for Plaintiffs' side cases in the Mid-Wilshire area. As a key member of our team, you will be responsible for negotiating personal injury cases against insurance companies, supervising a team, and reviewing demand packages.Our ideal candidate will have...

  • Claims Investigator

    3 weeks ago


    Los Angeles, California, United States Sedgwick Full time

    We are seeking a highly skilled Claims Examiner to join our team at Sedgwick. As a Claims Examiner, you will play a critical role in analyzing complex claims and determining benefits due.Our ideal candidate will have five years of experience in claims management, with expertise in general liability claims. They will be subject matter experts in insurance...


  • Los Angeles, California, United States Volt Workforce Solution Full time

    Volt Workforce Solutions is currently seeking a Medical Claims Specialist to join their team in the SFV area.This role offers a competitive salary of $21-25 per hour, providing an excellent opportunity for individuals looking to excel in a dynamic and fast-paced environment.


  • Los Angeles, California, United States Murphy Research Full time

    We're Murphy Research, a custom market research firm that's dedicated to delivering exceptional research insights. As a Data Insights Specialist, you'll play a vital role in analyzing complex data sets, developing PPT report charts, and working with vendors to ensure project success.About You:You have a strong background in data analysis, preferably with...


  • Los Angeles, California, United States Wake Research Full time

    At Wake Research, an M3 company, we are seeking a highly skilled Clinical Research Coordinator to join our team.The successful candidate will be responsible for managing, supporting, facilitating, and coordinating daily clinical trial activities, working under the guidance of the clinical research site management and Principal Investigator (PI).The Clinical...


  • Los Angeles, California, United States La-Z-Boy Full time

    La-Z-Boy Incorporated is a leading manufacturer of comfort-related products. We are committed to fostering an environment in which all employees feel valued, included, and empowered to do their best work.About the RoleThis position plays a crucial role in ensuring customer satisfaction by resolving escalated warranty claims. As a Senior Warranty Claims...


  • Los Angeles, California, United States Software Placement Group Full time

    About the Opportunity:This is a fantastic opportunity for an experienced Senior Product Liability Practice Attorney to join our top-tier international law firm. Based in Los Angeles or San Diego, this position offers competitive compensation, a comprehensive benefits package, and a collaborative environment with a lower billable hour requirement.Job...


  • Los Angeles, California, United States Cedars-Sinai Full time

    Job Summary:Cedars-Sinai invites applications for the position of Research Development Specialist. This role involves working closely with researchers to design, conduct, and analyze experiments.Key Responsibilities:Develop and execute complex experiments, collaborating with researchers to develop new techniques and protocols.Maintain precise records of...

  • Claims Analyst

    4 days ago


    Los Angeles, California, United States Elevance Health Full time

    Job OverviewElevance Health is seeking a skilled Claims Analyst to support the Payment Dispute process across all lines of business. This role is responsible for investigating provider requests and resolving payment appeals.The ideal candidate will have experience in claims research and/or issue resolution, as well as knowledge of reimbursement methodologies...


  • Los Angeles, California, United States Cornerstone Research Full time

    **About Us:** At Cornerstone Research, we provide expert economic and financial consulting services to clients worldwide. Our team of experienced professionals works closely with academics and industry experts to deliver high-quality analysis and expert testimony.**Estimated Salary:** Based on location and experience, the estimated salary for this role is...


  • Los Angeles, California, United States Career Consulting Partners Full time

    Job OverviewCareer Consulting Partners, a boutique law firm in Century City, California, is seeking a skilled Settlement Negotiator to join our team.Key ResponsibilitiesNegotiate with insurance firms to secure equitable compensation for clients' personal injury claims.Conduct thorough research to determine the value of cases and assess settlement offers.


  • Los Angeles, California, United States West Coast Trial Lawyers Full time

    West Coast Trial Lawyers, a renowned law firm in Downtown Los Angeles, is seeking an experienced Personal Injury Claims Specialist to join their dynamic team. With a strong background in personal injury matters and proficiency in Microsoft Office and Outlook, the ideal candidate will be responsible for interacting with adjusters and medical providers,...


  • Los Angeles, California, United States destinationone Consulting Full time

    Job Title: Accounting Expert for Complex IssuesWe are seeking an experienced Accounting Expert to join our team at destinationone Consulting. As a Technical Accounting Specialist, you will provide expertise on complex accounting issues, ensuring compliance with regulatory standards.About the Role:We are committed to building a robust talent databank,...


  • Los Angeles, California, United States Prosum Full time

    Job OverviewProsum is seeking a highly skilled Insurance Billing and Claims Specialist to join our team. This role plays a crucial part in ensuring seamless billing processes, maintaining compliance with industry guidelines, and fostering exceptional relationships with clients.Key ResponsibilitiesReview and resolve claim edits in the billing scrubber for...


  • Los Angeles, California, United States Larson Maddox Full time

    Salary Range: $250,000 - $400,000 per annumAbout the Role:Larson Maddox is seeking a highly skilled Labor and Employment Attorney to join our team in California. As a Labor and Employment Specialist - Complex Litigation, you will be responsible for handling complex employment litigation matters from start to finish.Key Responsibilities:Draft pleadings,...


  • Los Angeles, California, United States CEDARS-SINAI Full time

    OverviewCedars-Sinai is a leading healthcare organization that prioritizes medical advancements and patient care.SalaryThe estimated annual salary for this position is $54,435 - $91,628.Job DescriptionWe are seeking a skilled Medical Research Specialist II to join our Urology department. The successful candidate will be responsible for performing complex...