8 claims examiner iii jobs found

The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer service requirement to achieve the best possible outcome in the claim, supporting the goals of claims department and of CorVel. This is a remote position. Candidates must reside in California. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce...

Position Title: Examiner II, Claims Location: Montebello, CA 90640 Post Date: Posted Yesterday Description: Work Boldly. Live Brilliantly. At AltaMed, we don’t just serve our communities, we are part of them. We have raised the expectations of what a community clinic can deliver because we think quality care is for everyone. And, we are determined to provide it no matter the challenges because this is more than a job. It’s the calling of our lives and it compels us to keep moving forward. Job Overview A Claims Examiner is responsible for analyzing and the adjudication of medical claims as it relates to managed care. Performs payment reconciliations and/or adjustments related to retroactive contract rate and fee schedule changes. Resolve claims payment issues as presented through Provider Dispute Resolution (PDR) process or from claims incident/inquiries. Identifies root causes of claims payment errors and reports to Management. Responds to provider...

Position Title: Claims Examiner II Location: Montebello, CA 90640 Post Date: Posted Yesterday Description: Work Boldly. Live Brilliantly. At AltaMed, we don’t just serve our communities, we are part of them. We have raised the expectations of what a community clinic can deliver because we think quality care is for everyone. And, we are determined to provide it no matter the challenges because this is more than a job. It’s the calling of our lives and it compels us to keep moving forward. Job Overview A Claims Examiner is responsible for analyzing and the adjudication of medical claims as it relates to managed care. Performs payment reconciliations and/or adjustments related to retroactive contract rate and fee schedule changes. Resolve claims payment issues as presented through Provider Dispute Resolution (PDR) process or from claims incident/inquiries. Identifies root causes of claims payment errors and reports to Management. Responds to provider...

ABOUT THE POSITION The Riverside County Assessor-County Clerk-Recorder's (ACR) Office seeks to fill a ACR Technician Trainee/I/II position located in Riverside. The current opening is in Public Service, but this recruitment may also be used to fill future vacancies with ACR through out Riverside County. The selected candidate will perform technical and clerical work for the ACR Public Service Team. The ACR Technician will also respond to questions and provide information to the public. Additionally, the incumbents will be performing other related duties as required. The most competitive candidates will possess experience reviewing, interpreting, and processing legal documents, strong knowledge of basic arithmetic, and ability to explain policies and procedures. Lastly, the department seeks candidates that possess excellent customer service skills, ability to multi-task, strong analytical abilities, and experience using Microsoft Office Suite. The level at which the...

ABOUT THE POSITION The County of Riverside's Human Resources Temporary Assignment Program (TAP) is seeking a Temporary Veterinary Assistant to support the Department of Animal Services. We have several vacancies for our offices in Jurupa Valley and San Jacinto. Under supervision, assists Veterinary Surgeon by performing routine and para-professional duties involved in the surgical sterilization of small animals at a County Spay and Neuter Clinic; assists in the care and treatment of animals; and performs other related duties as required. The Veterinary Assistant is an entry-level classification and reports to a Supervising Registered Veterinary Technician. The County Spay and Neuter Program and shelter functions as part of the Veterinary Services Division of the Riverside County Department of Animal Services. Sterilization surgeries are performed on small animals (e.g., dogs, cats and rabbits), and shelter animals are examined and treated for minor illnesses or injuries....

ABOUT THE POSITION Click Here to learn more about the incredible benefits of working for the County of Riverside! The County of Riverside's Purchasing and Fleet Department has an opportunity for an Accountant I position in Riverside. This position will be responsible for providing services such as accounts receivable, reconciling accounts, general accounting, and creating financial reports. The incumbent will also be responsible for monthly projections of expenses/revenues as well as act as back up for Accounts Payable and processing invoices. The department seeks candidates with prior accounts receivable billing, Internal Service Fund, and/or general fiscal experience. Those with a background utilizing Microsoft Excel and accounting software such as PeopleSoft. The Accountant I is distinguished from the Accountant II classification in that the latter is the fully qualified journey level classification in the series, having greater scope of...

ABOUT THE POSITION The County of Riverside's Human Resources Temporary Assignment Program (TAP) is seeking a Temporary Veterinary Assistant to support the Department of Animal Services in Coachella, California. Under supervision, assists Veterinary Surgeon by performing routine and para-professional duties involved in the surgical sterilization of small animals at a County Spay and Neuter Clinic; assists in the care and treatment of animals; and performs other related duties as required. The Veterinary Assistant is an entry-level classification and reports to a Supervising Registered Veterinary Technician. The County Spay and Neuter Program and shelter functions as part of the Veterinary Services Division of the Riverside County Department of Animal Services. Sterilization surgeries are performed on small animals (e.g., dogs, cats and rabbits), and shelter animals are examined and treated for minor illnesses or injuries. The Veterinary Assistant is distinguished from the...

ABOUT THE POSITION Licensed Vocational Nurse III - Correctional Facilities The Riverside University Health System - Correctional Healthcare Services Department has immediate openings for Licensed Vocational Nurses to join our team. This posting will be used to fill openings at our Adult and Juvenile Facilities located throughout Riverside County (Banning, Indio, Murrieta/Temecula and Riverside). The position requires to have one or more years of experience working as an LVN in the care of patients in acute care, clinic assignments or a correctional health facility and must be certified in blood withdrawal. Duties will include: Blood withdrawals, diabetic checks, wound care, medication administration, PPD reads, Covid testing and vaccinations and other treatments scheduled; As well as other duties assigned throughout the day. Locations available: Larry D. Smith Correctional Facility - Banning Cois M. Byrd Detention Center - Murrieta/Temecula Robert Presley...