California Workers Compensation Claims Specialist Opportunities! Requisition ID 2023 23742 Job Locations US CA Brea Position Type Permanent Full Time Category Claims Business Unit BUS_TPA US Excellence In Everything We Touch We are always searching for Workers Compensation Claim Examiners in the California region to join our awesome team! The purpose of this posting is to

Responsible for providing customer service and supporting Producers by servicing existing accounts and soliciting new business. Independent responsibility for managing medium and complex claims of assigned clients. ESSENTIAL DUTIES AND RESPONSIBILITIES Acts as an advocate and claims specialist to provide support to clients, claimants, Producers, and carriers; Provides ini

Who We Are Join a team that puts its People First! Since 1889, First American (NYSE FAF) has held an unwavering belief in its people. They are passionate about what they do, and we are equally passionate about fostering an environment where all feel welcome, supported, and empowered to be innovative and reach their full potential. Our inclusive, people first culture has e

Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting . The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures including coordination

Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members' care including clinical nurses and treating physicians . The Registered Nurse Case Manager will report to the FEP Department M

Expedite and oversee administrative process of clients' insured claims as assigned within region, including but not limited to general liability, builders' risk, professional liability, pollution, and auto liability claims. Essential Duties & Key Responsibilities As directed by Claims Manager, report claims in timely manner to applicable insurance carriers, and gather per

REQUIRED EXPERIENCE Take on a significant role within a world class health organization. Elevate the operational and financial effectiveness of a complex health system. Take your professional expertise to the next level. You will leverage your extensive theoretical revenue cycle knowledge as you take on a vast range of critical revenue issues. This will involve applying d

Your Role The Children's Health Program (CHP) team provides identification, referrals, and care management for all Medi Cal members under 21 years old and collaborates within Promise Clinical Team. The Case Management, Senior will report to the CHP Manager. In this role you will be Perform clinical review, assessment, evaluation of medical services for the organization us

Responsible for auditing and training claims staff on all Managed Care claims received from outside providers to ensure the Claims Examiners processed and adjudicated them accurately and consistently in accordance with outside Provider Contracts, State, Federal, CMS, DMHC and Health Plan contracts, internal departmental policies and procedures. Must maintain a productivit

Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members' care including clinical nurses and treating physicians . The Registered Nurse Case Manager will report to the FEP Department M

Your Role The Federal Employee Program (FEP) Care Management team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with their care including a multidisciplinary team and the member's treating physicians . The Registered Nurse Case Manageme

Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members' care including clinical nurses and treating physicians . The Behavioral Health Registered Nurse Case Manager will report to th

Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures including coordination o

Your Role The Case Management team performs and case management (CM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members care including clinical nurses and treating MDs.. The Case Management Nurse, Senior will report to the Manager, Care Management. In this role you will determine, develop and imp

Serves as administrative support for the Provider Relations team Resolves provider issues by interfacing with cross functional Optum teams Processes electronic communications via email, fax and text Coordinates mass mailing and outreach projects to providers and patients Helps the Operations team plan, prepare, and execute provider events and meetings Coordinates with int