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Medical Claims Specialist Jobs in Irvine, California

37 jobs

Company Confidential
Summary: Responsible for the accurate and timely adjudication of all claims in accordance with applicable contracts, state and federal regulations and health plan requirements. Job Duties and Essential Functions: Must demonstrate proficiency in the operation of the Company’s software and hardware systems for claims adjudication. Must have an excellent understanding of health and managed care c...

Based in Orange County, CA, URAC-accredited, Independent Review Organization is seeking a professional teamplayer for the Medical Review Department. TO BE CONSIDERED Candidate MUST MEET EITHER of the two requirements: Certified Professional Coder (CPC, CCP or CCS) with minimum 1-2 year medical coding experience Professional candidate with significant experience in medical coding, health claim p...

Bodily Injury Claims Specialist - Aliso Viejo, CA-65245 Description Advance your career at Liberty Mutual Insurance - A Fortune 100 Company! Are you looking for an opportunity to join a claims team with a responsible company that has consistently outpaced the industry in year over year growth? Liberty Mutual Insurance has an excellent claims opportunity available. As a Bodily Injury Claims Spe...

At Gallagher Bassett Services, Inc. (GB) we are constantly seeking skilled professionals who are up for a challenge and take exceptional performance to heart. The professionals we hire help us maintain our reputation as one of the most progressive property/casualty third party claims service organizations in our industry and throughout the world. Gallagher Bassett provides services to Fortune 1000...

Claims Property Field Adjuster - Orange, CA-65587 Description Advance your career at Liberty Mutual Insurance - A Fortune 100 Company! Are you looking for an opportunity to join a claims team with a responsible company that has consistently outpaced the industry in year over year growth? Liberty Mutual Insurance has an excellent claims opportunity available. A Field Property Claims Specialist ...

Medical Billing Support Specialist I Americas employees are responsible for proactive follow-up on outstanding third party payor claims; excellent customer service to patients and clients; and providing key revenue cycle operations services. This is accomplished in a team environment and requires attention to detail, effective collection and time management skills, knowledge of medical insurance b...

Prospect Medical is searching for a qualified: Medical Coding Specialist (DRG Coder) SUMMARY Under general supervision, this position evaluates hospital medical records to ensure completeness, accuracy, and compliance with the International Classification of Diseases Manual - Clinical Modification (ICD-9-CM), and the American Medical Association's Current Procedural Terminology manual (CPT) for...

POSITION SUMMARY The Field Case Manager is responsible for assessing and analyzing an injured employee to evaluate the medical and vocational needs required to facilitate the patients appropriate and timely return to work. Acts as a liaison with patient/family, employer, provider(s), insurance companies, and healthcare personnel. This position will provide flexibility! It will require 75%-100% t...

POSITION SUMMARY The Field Case Manager is responsible for assessing and analyzing an injured employee to evaluate the medical and vocational needs required to facilitate the patients appropriate and timely return to work. Acts as a liaison with patient/family, employer, provider(s), insurance companies, and healthcare personnel. This position will provide flexibility! It will require 75%-100% t...

POSITION SUMMARY The Field Case Manager is responsible for assessing and analyzing an injured employee to evaluate the medical and vocational needs required to facilitate the patients appropriate and timely return to work. Acts as a liaison with patient/family, employer, provider(s), insurance companies, and healthcare personnel. This position will provide flexibility! It will require 75%-100% t...

POSITION SUMMARY The Field Case Manager is responsible for assessing and analyzing an injured employee to evaluate the medical and vocational needs required to facilitate the patients appropriate and timely return to work. Acts as a liaison with patient/family, employer, provider(s), insurance companies, and healthcare personnel. This position offers flexibility and life/work balance! It will re...

Under direction of the Billing Director, the Billing Claims Specialist will assess the requisition and supporting documentation, and accurately data enter patient demographics, insurance information, and test information, thereby, ensuring that all claims submitted for payment are completed without errors and in a timely manner. Essential Responsibilities Review requisition and supporting document...

Senior EH&S Specialist US-CAE165-18275 We are seeking a Sr. EH&S Specialist with oversight responsibility for the Occupational Health, Safety, Environmental and Security management systems, in alignment with the company’s National Platform for Environmental, Health and Safety management. The EH&S Sr. Specialist works with the EH&S Manager and all levels of management and hourly employees to ensu...

Prospect Medical is searching for a qualified: Benefit Configuration Specialist (Health Plan Benefits/DOFR) SUMMARY Under minimal supervision, this position is responsible for creating, updating and maintaining vendor contracts, fee schedules, reading and interpreting contracts and/or contract summaries, and assigning fee schedules to providers. Responsible for creating, updating and maintainin...

Everest National Insurance, a member of the Everest Re Group, LTD, a worldwide Reinsurance Company, is looking for an outstanding Managed Care Specialist to fill a position in our Claim Department in Orange or Oakland CA office, position may also be based out of our Liberty Corner, NJ office. PRIMARY PURPOSE: Analyze complex or technically difficult managed care issues to positively impact overa...

Overview: Under general guidance, implements the agency’s workers’ compensation claims program and oversees and administers the workers’ compensation third party administrator (TPA). Assists in the development and implementation of workers’ compensation program goals, objectives, priorities, and policies. This position is in Salary Grade P: Min $61,838.40 – Mid $76,772.80 – Max $91,707.20 per ho...

Prospect Medical is searching for a qualified: Provider Information Specialist SUMMARY Under minimal supervision, this position is responsible for creating, updating and maintaining vendor contracts, fee schedules, reading and interpreting contracts and/or contract summaries, and assigning fee schedules to providers into the IDX system. Responsible for creating, updating and maintaining capitat...

Everest National Insurance, a member of the Everest Re Group, LTD, a worldwide Reinsurance Company, is looking for an outstanding Managed Care Specialist to fill a position in our Claim Department in Orange or Oakland CA office, position may also be based out of our Liberty Corner, NJ office. PRIMARY PURPOSE:Analyze complex or technically difficult managed care issues to positively impact overall...

Description We are currently seeking and interviewing ambitious and team-oriented, analytically-minded individuals who enjoy problem-solving and researching in a fast-paced and FUN work environment! DaVita is currently looking for a Patient Account Specialist. Individuals who excel in this role are highly ambitious, results driven, and comfortable thinking "outside the box". In this role you wil...

Description We are currently seeking and interviewing ambitious and team-oriented, analytically-minded individuals who enjoy problem-solving and researching in a fast-paced and FUN work environment! DaVita is currently looking for a Patient Account Specialist. Individuals who excel in this role are highly ambitious, results driven, and comfortable thinking "outside the box". In this role you wil...