- CDM Smith (San Diego, 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...potential fraud, and ensure the integrity and fairness of claim settlements. By applying advanced accounting, auditing, and investigative… more
- The County of Los Angeles (Los Angeles, CA)
- …Angeles County, CA Job Type Full time Job Number P5456C-R Department MEDICAL EXAMINER Opening Date 01/16/2025 Closing Date Continuous + Description + Benefits + ... met and is subject to closure without prior notice. About the Medical Examiner : The Department of Medical Examiner investigates and determines the circumstances,… more
- LA Care Health Plan (Los Angeles, CA)
- …reporting and corrective action plans monitoring of financial solvency and claims processing compliance for specialty health plans and vendors. These audits ... responsible for the Department of Managed Health Care (DMHC) claims data submissions for LA Care and its Plan...liaison for Centers for Medicare and Medicaid Services (CMS) claim audit section of LA Care delegates. Reviews and… more
- Travelers Insurance Company (San Jose, CA)
- …equipment breakdown, and overall insurability. Investigate less complex Equipment Breakdown claims as requested by the claim department. Evaluate elements ... recommending corrective actions. Work cooperatively with Boiler and Machinery underwriting and claim groups, in support of helping them make informed decisions to… more
- The County of Los Angeles (Los Angeles, CA)
- …+ A validCalifornia Ambulance Driver Certificate*. + A valid Medical Examiner 's Certificate* . + A validCalifornia Emergency Medical TechnicianCertificate*. + A ... steps to view correspondence, and we will not consider claims of missing notices to be a valid reason...Not Applicable 05 Do you have a valid Medical Examiner 's Certificate? If Yes, you MUST attach a legible… more
- City of Long Beach (Long Beach, CA)
- …and consultant contracts, including analyzing and negotiating contract changes, evaluating claims and reviewing and processing progress payments; and performs other ... Technologist Certification from the California Water Environment Association; Plans Examiner certification from the International Code Council (ICC), Certified… more
- UCLA Health (Los Angeles, CA)
- …reviewing treatment progress, recommending medical treatment interventions to the third-party claims examiner , and ensuring compliance with applicable workers' ... Compensation Analyst and department manager, you will manage workers' compensation claims by supporting employees who have experienced work-related injuries or… more
- LA Care Health Plan (Los Angeles, CA)
- …data by delegates on a monthly basis to assign the annual claim processing and financial solvency audits, adherence to regulatory requirements. Manages complex ... Internal Auditor (CIA) Certified Management Accountant (CMA) Certified Fraud Examiner (CFE) Physical Requirements Light Additional Information Salary Range… more
- Highmark Health (Sacramento, CA)
- …**Required** + None **Preferred** (any of the following) + Certified Fraud Examiner (CFE) + Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) ... (AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must have… more