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claims adjuster in Los Angeles

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  1. Actuary (Fortune 100 Healthcare Leader)

    Actuary (Fortune 100 Healthcare Leader) Woodland Hills, CA, USA $105,000 - $130,000    + Bonus  Must be ASA ASA required from the Society of Actuaries (SOA)  We are currently looking for a Medicaid Associate Actuary. The Associate Actuary will complete the most diverse and complicated projects and performs highly complex actuarial studies. Primary duties may include, but are not limited to: •Develop historical and projected trends •Evaluate the impact of proposed legislation •Manage required ...

  2. CPC/CCS Risk Adjustment Coder

    We are currently searching for CPC's or CCS's with at least 2 years of HCC or Risk Adjustment experience in the Long Beach, CA area. Position Responsibilities: • Perform review of high dollar claims for accuracy. • Work collaboratively with Finance Department to determine appropriateness of pricing. • Work collaboratively with Medical Management Department to resolve any issues with medical review notes that affect claim pricing • Serve as a technical resource / coding subject matter expert for ...

  3. CPC/CCS Risk Adjustment Coder

    We are currently searching for CPC's or CCS's with at least 2 years of HCC or Risk Adjustment experience in the Long Beach, CA area. Position Responsibilities: • Perform review of high dollar claims for accuracy. • Work collaboratively with Finance Department to determine appropriateness of pricing. • Work collaboratively with Medical Management Department to resolve any issues with medical review notes that affect claim pricing • Serve as a technical resource / coding subject matter expert for ...

  4. Bodily Injury Claims Adjuster (4189)

    The CKM Recruitment team is seeking an experienced Bodily Injury Claims Adjuster in the San Fernando Valley Area. The Bodily Injury Claims Adjuster is responsible for handling 1st and 3rd party property damage and bodily injury claims from commencement to settlement.  Desired candidate will be knowledgeable and competent in coverage determinations and California legal matters as they pertain to automobile accidents.   REQUIRED SKILLS AND EXPERIENCE: 4+ years prior experience handling property ...

  5. Home Based Nurse Case Manager in Workers Compensation

    DIRECT HIRE OPPORTUNITY for stellar Nurse Case Managers in the Southern California area working with a Regional Workers Compensation Case Management company.  This role combines the best of both worlds combining telephonic and field work together to offer variety in this position.  In this role as a Nurse Case Manager, you will engage in case review and audits working directly with members and primary care physicians to ensure care plans are established, managed and members receive the highest ...

  6. Infertility Billing Manager

    Infertility Billing Manager Billing Manager will be responsible for directing and coordinating the overall functions of the Billing Office to ensure maximization of cash flow while fostering patient, physician and our program relations. Required qualifications to be considered include at least two years demonstrated experience and working knowledge of fertility office procedures and insurance referral process. The ideal candidate will have excellent attention to detail and a strong desire to ...

  7. CPC/CCS Risk Adjustment Coder

    We are currently searching for CPC's or CCS's with at least 2 years of HCC or Risk Adjustment experience in the Long Beach, CA area. Position Responsibilities: • Perform review of high dollar claims for accuracy. • Work collaboratively with Finance Department to determine appropriateness of pricing. • Work collaboratively with Medical Management Department to resolve any issues with medical review notes that affect claim pricing • Serve as a technical resource / coding subject matter expert for ...

  8. Auto Claims Adjuster

      Essential Duties and Responsibilities include the following. Other duties may be assigned.   Handles newly assigned and existing files to their conclusion. Responsible for all aspects of handling claims on injury and non-injury files. Confirms and determines coverage and investigates all coverage issues. Investigates and determines liability. Evaluate bodily injury, BI, MP, and UM claims. Negotiates settlements within authority. Directs independent appraisers, investigators and defense ...

  9. Claims Supervisor

    Claims Supervisor A large non-profit corporation established to administer benefits for employees in a union environment in the south-western region of the US, is seeking a driven and dedicated team member who can provide leadership as a Claims Supervisor. Key Role: The Claims Supervisor under the direction of the Claims Manager would be responsible for promoting, implementing and overseeing the day-to-day operations involved in the claims processing for a staff size of approximately 14 – 20 ...

  10. Property Adjuster

      ~~TITLE:  Property Adjuster POSITION PURPOSE:  Handle first party homeowner and mobile home property claims. ESSENTIAL FUNCTIONS: 1) Verifies coverage on new losses; determines if coverage applies and amount of policy limits. 2) Contacts insured promptly, verifies property location and basic facts of loss. 3) Directs Property Field Adjusters on issues involving fact gathering and evaluation of damages. 4) Hires contractors and other experts when necessary. 5) Keeps abreast of and complies with ...

  11. Sales Agent/Representative

    Sales Agent/Representative Benefit Together, Inc., America's health care discount provider, is seeking commission only Sales Agents. Benefit Together provides pre-negotiated discounts on a variety of health and wellness services and products. Benefit Together is not an insurance company or insurance plan. Members save between 20% and 75% on their current health and wellness needs, with no claims forms and one low price to cover the entire family. Commissioned Sales Agents are responsible for selling ...

  12. Hospital Medical Billing Specialist (PPO, HMO, Medi-Medi,W/C, Comm.)

    Position:    Medical Biller-Hospital (HMO, PPO, Commercial, Medi-Cal, MediCare, Workers' Comp.) Schedule:  Monday-Friday  Location:   Long Beach Area Salary:      Competitive Salary, depending on experience   Immediate position available for a well seasoned Medical Biller.  Must be well versed in Hospital billing (in-patient/out-patient) and all types of insurance products.  Minimum seven to ten years of CONSECUTIVE medical billing experience required.   QUALIFICATIONS: Minimum 7 years ...

  13. Insurance and Financial Sales Services - NY Life - Benefits + Bonuses

    Welcome to New York Life Insurance Company. For over a century and a half, New York Life's mission remains the same: to be here for our customers when they need us. That's why we're known as "The Company You Keep."   Our People: Central to our success is our New York Life agents, who are widely recognized as the best-trained professionals in the industry. Our team of skilled, dedicated men and women are committed to being the best and understand what it means to be a part of the New York Life team.   ...

  14. CPC/CCS Risk Adjustment Coder

    We are currently searching for CPC's or CCS's with at least 2 years of HCC or Risk Adjustment experience in the Long Beach, CA area. Position Responsibilities: • Perform review of high dollar claims for accuracy. • Work collaboratively with Finance Department to determine appropriateness of pricing. • Work collaboratively with Medical Management Department to resolve any issues with medical review notes that affect claim pricing • Serve as a technical resource / coding subject matter expert for ...

  15. Director of Medicare Services /paid relo to Cincinnati, OH - fzsmarLA

     We are looking for someone that has supervisory or management experience with hospital based Medicare claims experience. Position Summary:   The Director of Medicare Services is primarily responsible for leadership and management of the daily workflow of the Medicare Advantage, Traditional Medicare and Post Discharge Review Departments. Essential Duties and Responsibilities: Interview, hire, train, audit and review team members Lead, supervise, motivate and monitor team members to ensure ...

  16. Human Resource Manager

     Position Summary: The Human Resources Manager provides strategic recommendations and directs/coordinates functional Human Resources activities, such as employment, compensation, employee relations, benefits, training, safety/workers' compensation and employee services company-wide.  The position will be located at our headquarter office in Torrance, CA. ESSENTIAL DUTIES AND RESPONSIBILITIES – Other duties may be assigned based on business requirements. • Develops and administers various Human ...

  17. Homeowner Property Field Adjuster (3926)

    The CKM Recruitment Team is looking for an experienced Property Field Claims Specialist. The territory is from Ventura into the San Fernando Valley. In this role you will be investigating, evaluating and settling complex homeowner and property claims by conducting outside scene investigations, contacting the involved parties and assessing the extent of damage and loss. 50% of the time will be spent traveling in the territory. Our client offers a competitive salary, advancement opportunities, and a ...

  18. CLAIMS RECOVERY

    ESSENTIAL DUTIES AND RESPONSIBILITIES MUST HAVE CLAIMS RECOVERY EXPERIENCE Maintain current knowledge of all ICD-9, CPT, HCPC codes and their changes, general billing procedures for health care providers and institutions, Medicare and Medi-Cal reimbursement guidelines. Maintain knowledge of Company policies and procedures. Adjudication of more complex claims requiring additional research or problem solving. Alerts management or auditor of issues that impact claims production, i.e. incorrect ...

  19. Sr Workers' Compensation Examiner

    You must have these minimum qualifications: 5+ years of California WC claims handling experience Prior experience handling complex and litigated claims Must have experience with claim reviews and client relations Experienced Adjuster Designation (current on required training hours) And although not a requirement we would prefer you to have: Bachelors Degree Self Insured Certificate (SIP) About the Job:  Our clients have immediate openings for Workers' Compensation Claims Examiners ...