Claims Analyst Specialist
7 days ago
We are looking for a skilled Claims Analyst Specialist to join our team at MedPOINT Management. The successful candidate will possess expertise in healthcare financial recovery, medical claims analysis, and process improvement.
Main Responsibilities:- Review and analyze retro eligibility term reports to identify potential overpayments.
- Develop and implement plans to initiate refund requests for identified overpayments.
- Collaborate with internal departments to resolve provider dispute resolutions efficiently.
- Utilize EZ Cap software to track capitation deductions and ensure accurate reconciliation.
- Communicate effectively with stakeholders to provide updates on recovery progress.
- 3+ years of experience in claims processing, collections, or a related field.
- AA degree or equivalent combination of education and experience required.
- Excellent knowledge of medical terminology and healthcare regulations.
- Proven ability to work in a fast-paced environment with multiple priorities.
Estimated Salary: $70,000 - $90,000 per year.
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Insurance Claims Analyst Trainee
2 weeks ago
Los Angeles, California, United States Sedgwick Claims Management Services Full time**Job Overview:**Sedgwick Claims Management Services is seeking a detail-oriented Insurance Claims Analyst Trainee to join our team. In this role, you will work closely with experienced claims professionals to analyze workers compensation, general liability, or disability claims.As an Insurance Claims Analyst Trainee at Sedgwick, you will have the...
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Los Angeles, California, United States Sedgwick Claims Management Services Full time**Job Description:**Sedgwick Claims Management Services is seeking a highly skilled General Liability and Disability Claims Specialist to join our team. In this role, you will work closely with our claims professionals to analyze general liability and disability claims.As a General Liability and Disability Claims Specialist, you will apply your knowledge of...
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Claims Analyst
2 weeks ago
Los Angeles, California, United States Elevance Health Full timeJob 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...
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Medical Claims Analyst
3 days ago
Los Angeles, California, United States MedPOINT Management Full timeJob DescriptionThe Medical Claims Analyst will be responsible for daily creation and submission of 837 files, correcting errors, and accurately reconciling submitted encounter data. Additionally, this role involves attending meetings, reviewing standard operation procedures, and performing other duties as assigned by management.
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Professional Claims Analyst
4 days ago
Los Angeles, California, United States Regal Medical Group Full timeAre you a motivated and organized individual looking for a challenging role in the healthcare industry? As a Healthcare Claims Specialist at Regal Medical Group, you will play a critical part in ensuring that claims are processed and released efficiently and accurately. With a focus on process improvement and customer satisfaction, you will work...
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Investigative Claims Specialist
3 days ago
Los Angeles, California, United States Delta Group Full timeKey ResponsibilitiesThe Investigative Claims Specialist will be responsible for:Conducting thorough investigations into questionable insurance claims, including recorded statements and interviews of claimants, witnesses, and employers.Providing timely status updates to case managers and clients.Maintaining accurate and detailed documentation of claim...
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Medical Claims Project Coordinator
3 days ago
Los Angeles, California, United States Regal Medical Group Full timeJob Summary We are seeking a skilled Medical Claims Project Coordinator to join our team at Regal Medical Group. As a key member of our staff, you will be responsible for processing and releasing professional claims according to established policies and procedures. This role requires strong analytical and problem-solving skills, as well as excellent...
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Liability Claims Specialist
2 days ago
Los Angeles, California, United States JBA International Full timeWe are seeking a Liability Claims Specialist to join our team at JBA International.Job DescriptionThe ideal candidate will have experience in negotiation / reduction of liens with medical providers and third-party payers upon resolution of injured party's claim. Additionally, they will be responsible for preparing client disbursement agreements, compiling...
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Compensation Claims Specialist
3 days ago
Los Angeles, California, United States Elite Sourcing LLC Full timeJob OverviewElite Sourcing LLC is partnering with a leading law firm to seek a skilled Compensation Claims Specialist. This role involves representing clients in workers' compensation matters, providing expert legal counsel and support throughout the claims process.
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Claims Audit Specialist
3 days ago
Los Angeles, California, United States MedPOINT Management Full timeAbout the Role:We are seeking a skilled Claims Audit Specialist to join our team at MedPOINT Management. As a key member of our recovery services team, you will be responsible for reviewing and disputing capitation deductions received from various health plans. Your expertise will also be required to analyze retro eligibility term reports, identify...
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Healthcare Claims Specialist
3 days ago
Los Angeles, California, United States MedPOINT Management Full timeJob SummaryA Healthcare Claims Specialist is needed at MedPOINT Management to resolve medical claims efficiently and accurately. The ideal candidate will have strong analytical and communication skills.About the Role:Review and adjust medical claims according to established guidelines and protocols.Work collaboratively with healthcare providers and insurance...
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Liability Claim Specialist
3 days ago
Los Angeles, California, United States JBA International Full timeJob OverviewAs a Liability Claim Specialist at JBA International, you will play a crucial role in the negotiation and settlement of medical liens. Your primary responsibility will be to reduce liens with medical providers and third-party payers upon resolution of injured parties' claims.The ideal candidate will have excellent negotiation skills, a strong...
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Claims Management Specialist
2 weeks ago
Los Angeles, California, United States Ascendion Full timeRole 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...
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Claims Investigation Specialist
3 days ago
Los Angeles, California, United States JBA International Full timeJob OverviewJBA International is seeking a skilled Claims Investigation Specialist to join our team.About the Position:Draft and respond to written and phone communication with insurance providersRequest and file medical recordsThe ideal candidate will have experience with personal injury claims and processes, as well as strong analytical skills.Salary and...
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Medical Claims Specialist
7 days ago
Los Angeles, California, United States MedPOINT Management Full timeJob OverviewMedPOINT Management is a leading provider of IPA services. We're committed to delivering exceptional value to our Members and Providers through our dedicated teams and innovative solutions.In this role, you'll have the opportunity to work closely with our IPA department to ensure seamless communication and resolution of issues. Your expertise...
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Compensation Claims Specialist
4 weeks ago
Los Angeles, California, United States JBA International Full timeWe 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...
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Dental Claims Specialist
1 week ago
Los Angeles, California, United States Dental Office Full timeWe are seeking a skilled Dental Claims Specialist to join our team at the Dental Office in Los Angeles, CA. As a key member of our front office team, you will be responsible for managing patient accounts, collecting and posting payments from insurance companies, and monitoring dental claim reports.The ideal candidate will have experience with Dentrix...
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Senior Injury Claim Specialist
5 days ago
Los Angeles, California, United States Vaziri Law Group Full timeJob Title: Senior Injury Claim SpecialistVaziri Law Group, a leading Plaintiff Personal Injury Firm in Los Angeles, is seeking an experienced Senior Injury Claim Specialist to join our team.The estimated salary for this role is $80,000 - $120,000 per year, depending on experience.Key Responsibilities:Assemble and analyze client medical bills and records to...
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Personal Injury Claims Specialist
3 days ago
Los Angeles, California, United States Frish Law Group, APLC Full timeJob Title: Personal Injury Claims SpecialistWe are seeking a highly skilled Personal Injury Claims Specialist to join our team at Frish Law Group, APLC. As a key member of our personal injury team, you will play a vital role in assisting clients who have suffered injuries due to various incidents such as car crashes, slips/trips, and...
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Medical Claims Recovery Specialist
7 days ago
Los Angeles, California, United States MedPOINT Management Full timeJob OverviewWe are seeking a skilled Medical Claims Recovery Specialist to join our team at MedPOINT Management. The successful candidate will research and identify complex overpayments on previously processed claims for multiple product lines, assist in DOFR implementation projects, and review claim refunds and capitation deductions from various...