Claims processor • downey ca
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...Show more
Location: Whittier, CA 90601 Duration: 13 weeks / 3+ Months Shift: Day Shift | MondayFriday | 07:00 AM - 03:30 PM.Show more
As an Order Fulfillment Processor, you will play an important part of the team by assisting in picking, packing, auditing, ticketing, and tagging.You'll be working with products from some awesome c...Show more
Job Category: Administrative Requisition Number: WORKE001039.The Gardens Casino Hawaiian Gardens, CA 90716, USA.Under the direction of the Human Resources Director and in collaboration with Finance...Show more
Review, adjudicate, and process medical claims for HMO patients.Work closely with affiliated medical groups and hospitals.Evaluate provider reimbursement terms and flag non-contracted providers.Ens...Show more
The Claims Coordinator is responsible for administering workers’ compensation claims to ensure timely reporting, proper documentation, and compliance with applicable regulations.This role supports ...Show more
General Liability Claims Adjuster.Seeking a highly skilled and experienced.General Liability Claims Adjuster.This role involves managing a diverse portfolio of claims, including litigated cases, fo...Show more
We’re looking for a Claims Operations leader who enjoys balancing people leadership with operational execution.In this role, you’ll oversee daily claims processing, drive quality and turnaround tim...Show more
Shift: Day 5x8-Hour (07:00 - 15:30).Description: Must have listed claims reimbursement experience Must have DOFR Must have processed lab claims Will Need 3 Supervisor References to Submit.Location:...Show more
As a Remote Records Processor, you will be responsible for inputting and maintaining data accurately from home, including: input data accurately into company systems from home.Duties and responsibi...Show more
Under general supervision, examines and adjusts claims for Workers' Compensation benefits; monitors claim expenditures; communicates with physicians, supervisors, employees and attorneys regarding ...Show more
Shift: Day 5x8-Hour (07:00 - 15:30) Description: Claims Auditor Onsite or Remote: onsite Start/end time: 7:00 am to 3:30 pm Shift: Day Next Start date: Immediately Contract length: 3 months # of tr...Show more
Profession: Non-Clinical - Finance/Accounting Pay: $960.Assignment Length: 13 Weeks Schedule: 5x8-Hour 07:00 - 15:30 Openings: 1 Start Date: 04-20-2026 Experience: 1 year Facility Info: Log in to v...Show more
Subrogation SpecialistTransportation and Logistics IndustryCerritos, CAFull-Time Compensation: $22 to $28 per hour + full benefits OverviewA growing organization in the transportation and logistics...Show more
Contract to hire potential for the right candidate! The claims examiner reports directly to the claims manager.They are primarily responsible for the processing functions (operation, adjudication, ...Show more
Careers Advancement Opportunities .In this role, you will evaluate and process loan applications.Your responsibilities will include interviewing applicants to gather financial information, evaluati...Show more
Subrogation Specialist to join our Claims Department.Reporting directly to the Claims Manager, the Subrogation Specialist will be responsible for investigating and pursuing subrogation opportunitie...Show more
Claims Compliance Analyst Onsite Or Remote.Start/end time: 7:00 am to 3:30 pm.Show more
The average salary range is between $ 30,047 and $ 46,801 year , with the average salary hovering around $ 35,100 year .
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
The Claims Operations Supervisor is responsible for the oversight of external as well as internal processes as it relates to Claims Adjudication. This includes the compilation and scrubbing of claims data in order to analyze, track, and trend various aspects of the adjudicated claims. This includes but is not limited to, TAT compliance, Production, Error Rate, mid-month reports for forecasting, Health Plan monthly reporting including ODAG and Part C, Health Plan Universes for Audits, reports to identify potential recovery, as well as reports requested by various personnel at AltaMed. The Claims Operations Supervisor will identify root causes of claims payment errors and reports to management as well as collaborates with other departments and/or providers in successful resolution of claims related issues.
Minimum Requirements
1. HS Diploma required.
2. AA/AS or Bachelor’s degree is highly recommended.
3. Minimum of 5 years of experience in a managed care environment, claims knowledge preferred.
4. Minimum of 1 year of SQL coding and programming experience.
5. Must be knowledgeable of Medi-Cal regulations, Commercial, and Medicare rules and regulations and medical terminology.
6. Must have an understanding to read CMS-1500 and UB-04 forms and be able to read and interpret DOFRs and Contracts.
7. Must have strong organizational and mathematical skills.
Benefits & Career Development
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