- LA Care Health Plan (Los Angeles, CA)
- Manager, Claims Quality Assurance Job Category: Claims Department: Claims Data and Support Services Location: Los Angeles, CA, US, 90017 Position Type: ... the safety net required to achieve that purpose. Job Summary The Manager, Claims Quality Assurance (QA) is responsible for managing and leading the operational … more
- 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
- LA Care Health Plan (Los Angeles, CA)
- …and recommends quality assurance protocols to ensure accuracy across the claims ecosystem. The Manager manages and leads staff who research and remediate complex ... enterprise readiness during regulatory reviews, inquiries, or settlements. Partners with Claims Administration and Quality Assurance (QA) in the development… 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
- 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
- LA Care Health Plan (Los Angeles, CA)
- …Configuration, Payment Integrity, and related operational areas. The Director oversees enterprise claims quality auditing, claims compliance oversight, issue ... Field Experience Required: At least 7 years of deep experience in claims quality , claims compliance, auditing, or related managed care administrative… more
- Sedgwick (Sacramento, 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