- UCLA Health (Los Angeles, CA)
- …to the next level. You can do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned ... to the auditor. You will review claims (paid, pending, and denied) for accuracy, appropriate application of benefits, authorization for services, contract… more
- PennyMac (Moorpark, CA)
- …aspirations of homeownership through the complete mortgage journey. A Typical Day The Quality Assurance (QA) Claims Processor will perform QA reviews in ... required by the applicable investor and insurer servicing guidelines. The QA Claims Processor will : + Reconcile servicing expenses/corporate advances as required by… more
- WelbeHealth (Sacramento, CA)
- …corrections + Provide feedback to the Oversight & Monitoring Manager on claims processing errors, quality improvement opportunities, and configuration change ... Services team helps ensure excellent care delivery for our participants, and the Claims Audit Analyst plays a pivotal role in ensuring timely and accurate… more
- Sedgwick (Brea, CA)
- …and documentation standards. + Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead (Supervisor) - Workers Compensation | Hybrid...Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +… more
- Sedgwick (Sacramento, CA)
- …and documentation standards. + Providing technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for ... Fortune Best Workplaces in Financial Services & Insurance Assistant Claims Team Lead - Workers Compensation Are you looking...Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +… more
- Cedars-Sinai (CA)
- …to all CMS and DMHC guidelines. Investigate and complete open or pended claims . Meet production and quality standards. Job Duties and Responsibilities: + ... **Job Description** The Claims Examiner is responsible for accurately and consistently...preferred. **About Us** Cedars-Sinai is a leader in providing high- quality healthcare encompassing primary care, specialized medicine and research.… more
- Sedgwick (San Diego, CA)
- …Compiles reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead - Workers Compensation **PRIMARY PURPOSE:** To...contract requirements, and quality standards. + Acts as second level of appeal… more
- Travelers Insurance Company (Irvine, CA)
- …negotiating and resolving assigned General Liability Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle ... manage staff. **What Will You Do?** + Directly handles assigned severity claims . + Provides quality customer service and ensures file quality and timely… more
- Travelers Insurance Company (San Diego, CA)
- …negotiating and resolving assigned Specialty Liability Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle ... manage staff. **What Will You Do?** + Directly handles assigned severity claims . + Provides quality customer service and ensures quality and timely coverage… more
- Elevance Health (Los Angeles, CA)
- …at least one of the following: AA/AS or minimum of 15 years of experience in claims auditing, quality assurance, or recovery auditing. + Requires at least one of ... Coding Auditor Principal** is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case… more