Claims jobs in Long Beach, CACreate job alerts

Your Role The Clinical Services Coordinator (CSC) will report directly to the Supervisor of Promise Medi-Cal Care Management. This individual will interact telephonically and electronically with members and providers as per established protocol or direction to ensure that members are effectively...

Your Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and re...

Your Role The Facility Compliance Review team reviews post service prepayment facility claims for contract compliance, industry billing standards, medical necessity and hospital acquired conditions/never events. The Utilization Management Nurse, Senior will report to the Senior Manager, Facility...

Your Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and re...

Your Role The Risk Adjustment Provider Partnership team supports all functions within the risk adjustment program, working with cross-functional teams at Blue Shield and Provider Groups. The Risk Adjustment Consultant, reporting to the Manager, will work with operational and clinical leaders to ...

About RulaRula is a comprehensive behavioral health solution that works with a network of licensed clinicians to deliver high-quality care to individuals, couples, and families. By taking care of all the new client marketing and administrative heavy-lifting, we allow providers at Rula to focus on...

About RulaRula is a comprehensive behavioral health solution that works with a network of licensed clinicians to deliver high-quality care to individuals, couples, and families. By taking care of all the new client marketing and administrative heavy-lifting, we allow providers at Rula to focus on...

About RulaRula is a comprehensive behavioral health solution that works with a network of licensed clinicians to deliver high-quality care to individuals, couples, and families. By taking care of all the new client marketing and administrative heavy-lifting, we allow providers at Rula to focus on...

About RulaRula is a comprehensive behavioral health solution that works with a network of licensed clinicians to deliver high-quality care to individuals, couples, and families. By taking care of all the new client marketing and administrative heavy-lifting, we allow providers at Rula to focus on...

About RulaRula is a comprehensive behavioral health solution that works with a network of licensed clinicians to deliver high-quality care to individuals, couples, and families. By taking care of all the new client marketing and administrative heavy-lifting, we allow providers at Rula to focus on...

*About Us* Telemynd is a leading national mental health platform dedicated to providing accessible and high-quality care to individuals, couples, and families. We prioritize the well-being of our clients and are committed to supporting our providers in delivering exceptional care. Our mission is...

Claims processing to ensure quality (in/out patient hospital claims, Medi-cal, Commercial, and Medi-care claims). Review and process hospital claims and complicated claims to assist claims examiners I, and II. Extensive knowledge of claims processing and claims data analysis.

ADP is hiring a Claims Lead Examiner. Perform regular reviews of claims by specified criteria on diary. Possesses professional communication, both written and verbal to facilitate exceptional customer service and resolution for client complaints and issues.

Claims Manager - Remote - California. Are you a dedicated claims professional looking to find a growth opportunity? A top insurance agency in the Bay Area wants to add a Claims Manager to its growing team! In this role, you will develop new strategies to minimize risk and improve the claims proce...

To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication...

Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client. To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clie...

PRIMARY PURPOSE: To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements. Manages workers compensation cla...

Our client is expanding their Workers' Compensation department and seeking to add a Workers' Compensation Claims Supervisor to their Inland Empire claims operation. Supervise Workers' Compensation Claims Adjusters handling minor to complex indemnity claims. This position would be responsible for ...

To analyze mid-level Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. Workers Compensation Claims Adjuster | Long Bea...

TRISTAR Risk Management is seeking a seasoned Workers Compensation Claims Examiner III to manage all aspects of indemnity claims handling from inception to conclusion. Workers Compensation Claims Examiner III Intro:. Ability to manage very complex claims independently. Experienced in handling a l...

The Medical Claims Processor is primarily responsible for accurately and thoroughly processing claims and referrals in a timely manner in accordance with specific plan benefits provisions and guidelines, exclusions and limitations. Identifies any issues or concerns regarding any claims and refers...

Our client is expanding their Workers' Compensation Department and seeking to add Workers' Compensation Claims Adjusters to their California operations. These positions would be responsible for handling California Workers' Compensation Indemnity claims from inception to close. Handle moderate to ...

Commercial and/or Personal Lines Property & Casualty insurance experience – specifically claims management in retail broker environment. ...

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 ...