- Elevance Health (Los Angeles, CA)
- …Coding Auditor Principal** is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including ... case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, and its clients.… more
- Medtronic (Los Angeles, CA)
- …connected, compassionate world. **A Day in the Life** The Principal Insurance and Claims Management role is a newly created expert and highly specialized position ... at all levels to gather information for insurance placement, facilitates claims resolution between internal and external stakeholders, provides transparency and… more
- Ventura County (Ventura, CA)
- …floating holiday. Description Under direction of assigned attorney or manager , provides specialized secretarial, complex clerical and advanced technical support ... representatives, effectively communicating professionally to provide general procedural and case information while distinguishing between sensitive and public information.… more
- Ventura County (Ventura, CA)
- …Management and/or Quality Assurance in a Managed Health Care Plan. + Experience working as a case manager in a health plan case managing complex cases. + ... Senior Medical Management Nurse is responsible for performing utilization review, case management, and quality improvement functions to ensure that members receive… more
- CDM Smith (Walnut Creek, CA)
- …Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial data related ... to disaster-related claims , including property damage, business interruption, and other loss...Smith Placement Agreement from the CDM Smith Recruitment Center Manager to receive payment for your placement. Verbal or… more
- Travelers Insurance Company (Walnut Creek, CA)
- …Unit and/or Subrogation Unit. + Identifies and refers claims with Major Case Unit exposure to the manager . + Performs administrative functions such as ... is intended to develop skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. Provides quality claim… more
- Sedgwick (West Hills, CA)
- …from some of the world's most respected brands + A **dedicated mentor and manager ** to guide you every step of your career journey + **Career development and ... and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Establishes FMLA claims ; tracks and codes documentation in accordance with internal workflow… more
- The County of Los Angeles (Los Angeles, CA)
- …undercover, as well as participate in covert investigations and raids; prepare the case for legal proceedings and/or testify in court proceedings; report facts and ... steps to view correspondence, and we will not consider claims of missing notices to be a valid reason...as participate in covert investigations and raids; prepare the case for legal proceedings and/or testify in court proceedings;… more
- University of Southern California (Los Angeles, CA)
- …accurate records of interactive processes, track and report accommodation data, prepare case summaries upon request for senior leadership, and respond to requests ... may substitute for minimum education) + 5 years in leave administration, claims management, or ADA accommodations Preferred Qualifications + Master's degree in a… more
- LA Care Health Plan (Los Angeles, CA)
- …Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements Light ... to develop and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service… more