Current jobs related to Claims Processing Specialist - Los Angeles, California - Preferred IPA of California
-
Medical Claims Specialist
1 week ago
Los Angeles, California, United States Volt Full timeJob Title: Medical Claims SpecialistVolt is seeking a highly skilled Medical Claims Specialist to join our team. As a Medical Claims Specialist, you will play a critical role in ensuring timely and accurate payment of medical claims.Key Responsibilities:Review and analyze medical claims to identify potential issues and discrepancies.Communicate with payors...
-
Medical Claims Specialist
2 days ago
Los Angeles, California, United States Medix Full timeJob SummaryAt Medix, we are seeking a highly skilled Medical Claims Specialist to join our team. As a Medical Claims Specialist, you will play a critical role in ensuring the accuracy and efficiency of our claims processing operations.Key ResponsibilitiesReview claims for accuracy and completeness, ensuring that all necessary information is included.Expedite...
-
Claims Processing Supervisor
1 week ago
Los Angeles, California, United States Crystal Stairs Full timeClaims Processing SupervisorWe are seeking a qualified candidate for the Claims Processing Supervisor position. The Claims Processing Supervisor will oversee the receipt, processing, calculation, payment and reporting of monthly claims submitted by providers in compliance with contractual requirements, regulations, and agency policies and procedures.The...
-
Claims Processing Supervisor
4 days ago
Los Angeles, California, United States Crystal Stairs Full timeJob SummaryCrystal Stairs, Inc. is seeking a highly skilled Claims Processing Supervisor to oversee the receipt, processing, calculation, payment, and reporting of monthly claims submitted by providers in compliance with contractual requirements, regulations, and agency policies and procedures.The successful candidate will have a strong background in claims...
-
Insurance Claims Specialist
3 weeks ago
Los Angeles, California, United States Trigent Software Full timeJob Title: Insurance Billing SpecialistWe are seeking a highly skilled Insurance Billing Specialist to join our team at Trigent Software in Los Angeles, CA. This is a 6-month contract position with possible extension.Job Summary:The Insurance Billing Specialist will be responsible for processing and managing insurance claims, ensuring accurate and timely...
-
Insurance Claims Specialist
4 weeks ago
Los Angeles, California, United States Trigent Software Full timeJob Title: Insurance Billing SpecialistWe are seeking a highly skilled Insurance Billing Specialist to join our team at Trigent Software in Los Angeles, CA. This is a 6-month contract position with possible extension.Job Summary:The Insurance Billing Specialist will be responsible for processing and managing insurance claims, ensuring accurate and timely...
-
Insurance Claims Specialist
2 weeks ago
Los Angeles, California, United States Prosum Full timeJob Summary:A skilled Billing Specialist is required to maintain a current understanding of billing and coding guidelines to ensure claims are consistently billed properly. The primary accountability for this role is to support Soarian Financials Billing Edits and Billing Processes for the company.Key Responsibilities: Review and resolve claim edits in the...
-
Claims Administrative Specialist
2 weeks ago
Los Angeles, California, United States Zenith Full time{"title": "Claims Administrative Specialist", "description": "Job SummaryZenith Insurance Company is seeking a highly skilled Claims Administrative Specialist to join our team. In this role, you will provide administrative support to our claims team, ensuring the efficient processing of claims and excellent customer service.Key ResponsibilitiesIssue timely...
-
Insurance Claims Specialist
2 weeks ago
Los Angeles, California, United States Prosum Full timeJob SummaryA Billing Specialist plays a crucial role in maintaining the organization's billing and coding practices to ensure accurate and timely claims processing. The ideal candidate will have a strong understanding of billing guidelines and regulations, as well as excellent analytical and problem-solving skills.Key ResponsibilitiesReview and resolve claim...
-
Medical Claims Specialist
2 weeks ago
Los Angeles, California, United States MedPOINT Management Full timeJob SummaryThe Medical Claims Specialist is responsible for the accurate and timely adjustment of hospital risk claims, ensuring compliance with regulatory requirements and contractual obligations. This role involves researching and reviewing claims, collaborating with providers and other departments to resolve issues, and suggesting process improvements to...
-
Insurance Claims Specialist
2 weeks ago
Los Angeles, California, United States TEKsystems Full timeAbout the RoleWe are seeking a highly skilled Insurance Claims Specialist to join our team at TEKsystems. As a key member of our revenue cycle team, you will be responsible for verifying insurance information, following up on claims, and communicating with insurance companies to resolve issues and facilitate prompt payment of claims.Key...
-
Workers' Compensation Claims Specialist
2 weeks ago
Los Angeles, California, United States Zenith Insurance Company Full timeJob SummaryZenith Insurance Company is seeking a skilled Workers' Compensation Claims Specialist to join our team. As a key member of our claims department, you will be responsible for investigating, analyzing, and determining the extent of company liability concerning claims and attempting to effect settlement with claimants.Key ResponsibilitiesInvestigate...
-
Senior Claims Specialist
2 weeks ago
Los Angeles, California, United States AXIS Company Defunct Full timeJob Title:Senior Claims Specialist - Management Liability Claims HandlerAbout the Role:AXIS is seeking a highly skilled and experienced Senior Claims Specialist to join our North America Claims team. The successful candidate will report to the Head of Management Liability Liability Claims and will be responsible for handling and managing a wide variety of...
-
Personal Injury Claims Specialist
4 days ago
Los Angeles, California, United States The Accident Guys Full timeJob Title: Personal Injury Claims SpecialistAbout the Role:We are seeking a highly skilled Personal Injury Claims Specialist to join our team at The Accident Guys. As a Personal Injury Claims Specialist, you will be responsible for managing a high volume of cases, providing exceptional customer service, and working closely with clients to ensure their claims...
-
Medicare Claims Appeals Specialist
3 days ago
Los Angeles, California, United States Med National Staffing Inc. Full timeJob DescriptionWe are seeking a detail-oriented Medicare Claims Appeals Specialist with a comprehensive understanding of Medicare claims processing, including provider contracts, Division of Financial Risk (DOFR), explanation of benefits, and claim edits.Key Responsibilities:Review and process Medicare provider appeals cases for California clients, adhering...
-
Claims Examiner
4 weeks ago
Los Angeles, California, United States Preferred IPA of California Full timeJob SummaryThe Claims Examiner position is a critical role within our organization, responsible for ensuring the accurate and timely adjudication of paper and/or electronically formatted claims received in the CMS 1500 and/or UB-04 format. This position requires a strong understanding of Medicare and Medi-Cal regulatory guidelines, contract provisions, and...
-
Medical Claims Specialist
1 week ago
Los Angeles, California, United States MedPOINT Management Full timeJob SummaryMedPOINT Management is seeking a highly skilled Medical Claims Specialist to join our team. As a Claims Examiner, you will be responsible for the accurate and timely adjudication of claims, ensuring compliance with regulatory requirements and company policies.Key Responsibilities:Review and verify incoming provider claims for accuracy and...
-
Personal Injury Claims Specialist
7 days ago
Los Angeles, California, United States Frish Law Group, APLC Full timeJob DescriptionFrish Law Group, APLC is seeking a skilled Personal Injury Claims Specialist to join our team. As a key member of our personal injury team, you will work closely with clients who have been injured in various accidents, including car crashes, slip/trip and falls, bike crashes, motorcycle crashes, and other personal injuries. This is a hybrid...
-
Healthcare Claims Specialist
2 weeks ago
Los Angeles, California, United States MedPOINT Management Full timeJob SummaryWe are seeking a skilled Healthcare Claims Specialist to join our team at MedPOINT Management. As a key member of our claims department, you will be responsible for the accurate and timely adjudication of claims, ensuring compliance with regulatory requirements and contractual obligations.Key Responsibilities:Review and analyze incoming claims to...
-
Bilingual Property Damage Claims Specialist
7 days ago
Los Angeles, California, United States Wilshire Law Firm Full timeProperty Damage Specialist Role At Wilshire Law Firm, we are seeking a skilled Property Damage Specialist to join our Personal Injury PreLitigation department. As a key member of our team, you will have the opportunity to assist clients in resolving their property damage claims. Key Responsibilities: Communicate with clients regarding their property damage...
Claims Processing Specialist
2 months ago
The Claims Processing Specialist is tasked with ensuring the precise and prompt evaluation of claims submitted in CMS 1500 and/or UB-04 formats. This role involves managing all claims and related correspondence in compliance with Medicare and Medi-Cal regulations, contractual obligations, and established operational protocols.
The Specialist is expected to consistently achieve the accuracy and productivity benchmarks set forth in the department's performance metrics.
ESSENTIAL SKILLS
- A minimum of 4 years of experience in medical claims processing within a managed care environment.
- In-depth knowledge of Medicare and Medi-Cal claims processing standards and compliance requirements.
- Familiarity with CPT-4, ICD-10CM, RBRVS, ASA, and HCPCS, along with a comprehensive understanding of Medicare and Medi-Cal guidelines related to Coordination of Benefits (COB) and Medicare Secondary Payer (MSP) scenarios.
- Extensive experience in determining plan benefits, co-payment responsibilities, and financial liability, as well as in claims policy and adjudication processes.
- Strong analytical skills in reviewing claims with respect to NCCI guidelines.
- Proficient understanding of reimbursement methodologies for professional claims, including those involving injectable medications.
The ideal candidate will be detail-oriented, organized, and capable of following established procedures independently. They must also be able to meet deadlines while upholding departmental quality standards.
Excellent interpersonal skills are essential for effective communication with providers regarding claim statuses, as well as for fostering a collaborative environment with colleagues and supervisors.
Strong professional ethics and a commitment to quality service are required, along with intermediate proficiency in Microsoft Word, Excel, and internet navigation.
ABOUT PREFERRED IPA OF CALIFORNIA
Preferred IPA of California is dedicated to delivering exceptional care management, coordination, and claims processing services. We collaborate with a network of participating physicians to ensure seamless patient care throughout the provider network, striving to offer superior healthcare services to our members.
