- Managed Care (Full-Time, Day Shift) -
Our mission is to participate in Jesus Christ’s ministry, bringing health, healing, and wholeness to humanity by: Creating a supportive faculty practice framework that allows Loma Linda University School of Medicine physicians and surgeons to educate, conduct research, and deliver quality health care with optimum efficiency, deploying a motivated and competent workforce trained in customer service and whole person care principles and providing safe, seamless and satisfying health care encounters for patients while upholding the highest standards of fiscal integrity and clinical ethics. Our core values are compassion, integrity, humility, excellence, justice, teamwork and wholeness.
This Claims Examiner 2-Mgd Care will process professional and hospital HMO Risk claims in accordance with the individual provider contracts in an accurate and timely manner, verify system assigned risk pool determination in accordance with HMO Division of Financial Responsibility matrix, initiate check run, perform standard reporting, ensure audit readiness, and process third party claims. Performs other duties as needed.
High School Diploma or GED required. Bachelor’s Degree in Computer Science, Business, or similar degree preferred. Minimum five years managed care claims processing experience with professional claims and institutional claims.
Knowledge of Microsoft Office Suite. Must be well versed in medical terminology, CPT, and ICD9/10 coding guidelines. Comprehensive understanding of institutional inpatient and outpatient hospital claims processing, DRG’s and all other institutional calculation standards. Comprehensive understanding of professional claims adjudication process. Understanding of the Managed Care health care delivery system. Able to keyboard 40 wpm. Able to use a computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint). Operate/troubleshoot basic office equipment required for the position. Able to work calmly and respond courteously when under pressure; collaborate and accept direction. Able to think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position.Certified Professional Coder preferred. Valid Driver’s License at time of hire.Claims Examiner 2-Managed Care • Loma Linda, California
Certified Registered Nurse Anesthetist | Anesthesiology - General/Other.LocumJobsOnline is working with CompHealth to find a qualified Anesthesiology CRNA in Hesperia, California, 92395!.CRNA for G... Show more
Ardor Health Solutions is looking for a Physical Therapist to join our travel team in a HOME HEALTH setting, in Hesperia, CA! This is a full time travel contract position.Requirements include, but... Show more
Interested? There is more to tell.Feel free to request information, or just pick up the phone and give Global Medical Staffing a call.Monday ‐ Friday 8 am ‐ 5 pm with guaranteed 8 hours p... Show more
OverviewWhat you can expect!Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience!... Show more
LRS Healthcare - Nursing is seeking an experienced Intensive Care Unit Registered Nurse for an exciting Travel Nursing job in Wildomar, CA.Shift: Inquire Start Date: ASAP Duration: 13 weeks Pay: $2... Show more
Registered Nurse (RN) | Emergency Room (ER) / Trauma.TravelNurseSource is working with AMN Healthcare to find a qualified ER/Trauma RN in LOMA LINDA, California, 92354!.Job Description & Requir... Show more
Surrogates Start at $75K$95K+ $1,250 Bonus + $11K Pre-Pregnancy Payout.Looking for a high-paying opportunity with real support and no upfront costs?.Become a Surrogate and earn up to.All expenses ... Show more
Some locum assignments can be as short as a day, others, years.Some are far from home, others are local.Whatever it is you're looking for, we offer true opportunities, not just postings.CompHealth ... Show more
AlliedTravelCareers is working with Prime Time Healthcare to find a qualified CT Tech in Modesto, Connecticut!.Now Hiring: Allied Healthcare CT - Modesto, CA.Contact us for Pay Information.Actual a... Show more
Tahoma, Geneva, sans-serif;"><span style="font-size:17pt;font-variant:normal;white-space:pre-wrap;"><span style="color:#000000;"><span style="font-weight:700;"><span style="... Show more
Fusion Medical Staffing is seeking an experienced Emergency Room Registered Nurse for an exciting Travel Nursing job in Wildomar, CA.Shift: Inquire Start Date: 05/18/2026 Duration: 13 weeks Pay: $2... Show more
LRS Healthcare - Nursing is seeking an experienced Emergency Room Registered Nurse for an exciting Travel Nursing job in Wildomar, CA.Shift: Inquire Start Date: 05/18/2026 Duration: 13 weeks Pay: $... Show more
Victorville, CA • Behavioral Health.Do you have a passion for ensuring the highest standards of care in the field of behavioral health? .Are you driven to improve the lives of individuals facing me... Show more
Southwest Healthcare is hiring a Staff Registered Nurse in Wildomar, California.This role involves providing excellent patient care and requires at least one year of acute care experience.You must ... Show more
Liability Claims AdjusterAt Allstate, great things happen when our people work together to protect families and their belongings from life's uncertainties.And for more than 90 years our innovative ... Show more
Global Privacy PolicySedgwick's caring counts commitment is to value the right of privacy of the companies and individuals we serve.It is Sedgwick's policy to comply with all applicable privacy and... Show more
Claims Representative (IAP) - Workers Compensation Training Program | Riverside, CA.By joining Sedgwick, you'll be part of something truly meaningful.It's what our 33,000 colleagues do every day fo... Show more
Registered Nurse (RN) | Emergency Room (ER) / Trauma.TravelNurseSource is working with AMN Healthcare to find a qualified ER/Trauma RN in LOMA LINDA, California, 92354!.Job Description & Requir... Show more
