Examiner Salary at Orange Coast Title Co BETA

WHO WE ARE: AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation! Does the idea of doing something that really makes a difference in peoples lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees? If so, AIDS Healthcare Foundation is the place for you! Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them. AHFs core values are: Patient-Centered Value Employees Respect for Diversity Nimble Fight for Whats Right STILL INTERESTED? Please continue! YOUR CONTRIBUTION TO OUR SUCCESS!: The Claims Department is a dynamic department that provides

Job Title: Claims Examiner I Target Compensation Range: $25.00-$28.00/hour, depending on the level of relevant qualifications and experience. About Us: Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize accessibility, affordability, and quality in all aspects of our services. Join us in our mission to transform healthcare delivery and make a meaningful difference in the lives of our members. SUMMARY: Under the direction of the Vice President of Claims, this position is responsible for manual input and adjudication of claims submitted to the health plan. The ideal candidate will need to interpret and utilize capitation contracts, payor matrixes, subscriber benefit plan, and provider contracts; as well as resolving customer service inquiries, status calls, and claim tracers. ESSENTIAL DUTIES AND RESPONSIBILITIES in

Job Title: Claims Examiner II Target Compensation Range: $70,000 - $80,000/year, depending on the level of relevant qualifications and experience. About Us: Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize accessibility, affordability, and quality in all aspects of our services. Join us in our mission to transform healthcare delivery and make a meaningful difference in the lives of our members. SUMMARY: Under the direction of the Vice President of Claims, this position is responsible for manual input and adjudication of claims submitted to the health plan. The ideal candidate will need to interpret and utilize capitation contracts, payor matrixes, subscriber benefit plan, and provider contracts; as well as resolving customer service inquiries, status calls, and claim tracers. ESSENTIAL DUTIES AND RESPONSIBILITI

Job Description: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. Requirements: California WC claims knowledge SIP certificate Min. 3 Years of experience Remote in CA NIT001

The coordinator is a vital part of the transplant team, responsible for ensuring that patients undergoing transplant evaluations and procedures have appropriate financial coverage. This role focuses on insurance verification, securing authorizations, counseling patients on their benefits, and supporting overall financial readiness. The coordinator works closely with clinical staff and plays a key role in improving operational workflows to enhance patient care. Key Responsibilities: Verify insurance coverage and obtain authorizations for transplant-related services. Provide patients with clear guidance on insurance benefits, coverage issues, and available options. Interpret transplant-specific insurance benefits and communicate them effectively. Address real-time insurance and financial questions from patients and staff. Collaborate with care teams during case discussions and meetings. Follow standardized processes to ensure timely financial clearance. Analyze insurance data and share r

APR Consulting, Inc. has been engaged to identify a Claims Examiner Location: Whittier, CA 90601 Position: Claims Examiner Pay Rate: $29.10 to $32/hr Duration: 13 weeks Shift: Day 5x8-Hour (07:00 am - 03:30pm) Summary The claims examiner reports directly to the claims manager. They are primarily responsible for the processing functions (operation, adjudication, and payment) of UB-92 and HCFA-1500 claims that are received from PHP affiliated medical groups and hospitals for HMO patients. Education High school graduate or equivalent required. Must have physical proof on hand if background check is unable to verify your education background. QUALIFICATION Minimum of 2 years claims ADJUDICATION related experience in ambulatory, acute care hospital, HMO, or IPA environment Knowledge of payment methodologies for: Professional (MD), Hospital, Skilled Nursing Facilities, and Ancillary Services Knowledge and understanding of timeliness and payment accuracy guidelines for commercial, senior and

Job Description Job Description Education and / or Experience: High School Diploma and 3 years adjudication experience in a managed care setting. Knowledge of CPT-4, HCPCS, Hospital Revenue, and ICD-9 coding. Knowledge of HMO, DHS, DMHC, and CMS claims processing guidelines. Strong knowledge of Microsoft Windows environment such as Word and Excel. Self-starter, willing to take on multiple tasks. Must meet minimal claims adjudication production standards. Strong knowledge of Coordination of Benefits (COB) applications. Must be able to interpret health plan benefits. Must be able to review, interpret and apply contract rates. Ability to communicate effectively orally and written typing 35 words per minute. Strong organizational skills with emphasis on prioritizing and attention to details Position Summary: To evaluate and determine the appropriate path and to assist in the expedited processing of all claims, special projects and escalated reconsiderations originating from various interna

JOB TITLE: Senior Claims Examiner DEPARTMENT: Claims Services COMPANY OVERVIEW: Carl Warren & Company is a leading nationwide Third-Party Administrator (TPA) founded in 1944. Carl Warren has been a trusted partner specializing in property and casualty claims management, subrogation recovery, and litigation management for private and public sectors, insurance companies, and captives. Our clients count on us to care for their needs when the unexpected happens. Our culture is derived from the people that created it. We are not different in what we do. We are different in how we do it. Our culture helps us collaborate, unite, and create a diverse workforce. Our people are at the core of our purpose, vision, mission, and values. We offer competitive compensation and a comprehensive benefits package: 401k + employee match Medical, dental, vision, life, and disability insurance Paid Time Off (PTO) Paid Holidays Paid Sick leave Professional development programs Work-life quality and flexibilit