• Manager, Claims Quality Assurance

    LA Care Health Plan (Los Angeles, CA)
    …readiness for regulatory audits. Oversees audits across the entire operational claims lifecycle including claim intake, data entry, adjudication, pricing, ... QA audit methodology, including sampling standards, audit frequency, scoring tools, examiner scorecards, and quality thresholds. Co-leads claims components of… more
    LA Care Health Plan (01/16/26)
    - Related Jobs

  • Senior Manager, Claims Adjustments

    LA Care Health Plan (Los Angeles, CA)
    …contractual requirements. The position functions as the operational leader for all claim adjustments that exceed routine examiner responsibilities and require ... Senior Manager, Claims Adjustments Job Category: Management/Executive Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time… more
    LA Care Health Plan (01/16/26)
    - Related Jobs

  • Director, Claims Administration

    LA Care Health Plan (Los Angeles, CA)
    Director, Claims Administration Job Category: Management/Executive Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... net required to achieve that purpose. Job Summary The Director, Claims Administration, governs enterprise outcomes and risk controls, introducing a preventative… more
    LA Care Health Plan (01/16/26)
    - Related Jobs

  • Claims Operations Lead

    HCA Healthcare (Nashville, TN)
    … claims , with at least two years of claims examiner experience. Physician Services Group (https://careers.hcahealthcare.com/pages/physician-services) is ... LIMITED TO:** Adjudicates and distributes work assignments including complex claims , resolving all system edits and audits...ICD-10, CPT, HCPCS, and revenue coding. Ability to analyze claim issues and "trouble shoot" claims problems.… more
    HCA Healthcare (01/11/26)
    - Related Jobs

  • Claims Manager

    CHS (Clearwater, FL)
    **Overview** ** Claims Manager** **Servicing** **Health Insurance Policies or Benefits** **Summary:** Premier Administrative Solutions (PAS) is a Third-Party ... organizations, insurance marketing organizations, and employers. One core service, claims administration, is where submissions for payment/reimbursement/sharing from medical… more
    CHS (11/06/25)
    - Related Jobs

  • Claims Coordinator

    Access Dubuque (Dubuque, IA)
    …As a Claims Coordinator, you will be responsible for maintaining and updating our claims system . You will make a direct impact on a daily basis by carrying ... + Provide administrative support to the team + Input claim data into the software system +...Managed Solutions Group Client Coordinator Cottingham & Butler/ SISCO Claims Examiner Cottingham & Butler/ SISCO Education… more
    Access Dubuque (01/10/26)
    - Related Jobs

  • Supervisor, Claims

    LA Care Health Plan (Los Angeles, CA)
    …or Healthcare Related Field Experience Required: At least 3 years of experience as claims examiner working with medical facility claims and high dollar ... Supervisor, Claims Job Category: Claims Department: ...regulations. This position will manage new program implementations and/or system implementations. This position must maintain an up-to date… more
    LA Care Health Plan (12/27/25)
    - Related Jobs

  • Claims Assistant

    Access Dubuque (Dubuque, IA)
    …Assistant Sedona Staffing Services Administrative Assistant Kunkel & Associates, Inc. Claims Examiner Cottingham & Butler/ SISCO Dental Assistant Crescent ... FUNCTIONS and RESPONSIBILITIES** + Sets up and enters new claims into claims management system ....and learning resources that focus on our culture, procedures, systems and performance expectations. We evaluate the educational needs… more
    Access Dubuque (12/03/25)
    - Related Jobs

  • Workforce Absence Team Lead

    Access Dubuque (Dubuque, IA)
    …and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on ... projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles,...claim status; and provides written resumes of specific claims as requested by client. + Assures that direct… more
    Access Dubuque (12/20/25)
    - Related Jobs

  • Sr. Risk Data and Systems Analyst

    First Student (Cincinnati, OH)
    …as the third party liability claims administrator (GLICRS) and the technical examiner for the workers compensation claim section. Manages all data associated ... departmental reports. Handles regulatory reporting. + Serves as administrator for the RMIS System . Sets up new users, sets user privileges for data entry, setting… more
    First Student (12/23/25)
    - Related Jobs