We are looking for an experienced Workers’ Compensation Senior Claim Representative to join our team in Los Angeles, California. In this role, you will oversee the management of workers’ compensation lost time claims, ensuring compliance with statutory regulations and delivering exceptional customer service throughout the claims process. This is a Long-term Contract position requiring strong analytical, communication, and organizational skills.<br><br>Responsibilities:<br>• Manage all aspects of workers’ compensation lost time claims from initial setup to resolution, maintaining high standards of customer service.<br>• Conduct thorough investigations to gather facts, obtain statements, and assess compensability of claims.<br>• Administer statutory medical and indemnity benefits promptly and accurately throughout the duration of each claim.<br>• Collaborate with attorneys to oversee hearings and manage litigation processes effectively.<br>• Establish and adjust reserve amounts for medical, indemnity, and related expenses within authority limits.<br>• Coordinate with vendors, nurse case managers, and rehabilitation managers to ensure optimal medical management and return-to-work initiatives.<br>• Prepare detailed reports documenting investigation outcomes, claim settlements, denials, and evaluations.<br>• Ensure compliance with state regulations by accurately filing workers’ compensation forms and electronic data.<br>• Refer claims for subrogation and facilitate recovery opportunities by securing necessary documentation.<br>• Work closely with internal teams, including Technical Assistants and Special Investigators, to exceed customer expectations and deliver superior claims handling.
<p>We are looking for an experienced Workers’ Compensation Senior Claim Representative to join our team in Los Angeles, California. In this role, you will oversee the management of workers’ compensation lost time claims, ensuring compliance with statutory regulations and delivering exceptional customer service throughout the claims process. This is a Long-term Contract position requiring strong analytical, communication, and organizational skills.</p><p><br></p><p>Responsibilities:</p><p>• Manage all aspects of workers’ compensation lost time claims from initial setup to resolution, maintaining high standards of customer service.</p><p>• Conduct thorough investigations to gather facts, obtain statements, and assess compensability of claims.</p><p>• Administer statutory medical and indemnity benefits promptly and accurately throughout the duration of each claim.</p><p>• Collaborate with attorneys to oversee hearings and manage litigation processes effectively.</p><p>• Establish and adjust reserve amounts for medical, indemnity, and related expenses within authority limits.</p><p>• Coordinate with vendors, nurse case managers, and rehabilitation managers to ensure optimal medical management and return-to-work initiatives.</p><p>• Prepare detailed reports documenting investigation outcomes, claim settlements, denials, and evaluations.</p><p>• Ensure compliance with state regulations by accurately filing workers’ compensation forms and electronic data.</p><p>• Refer claims for subrogation and facilitate recovery opportunities by securing necessary documentation.</p><p>• Work closely with internal teams, including Technical Assistants and Special Investigators, to exceed customer expectations and deliver superior claims handling.</p>
<ul><li>Process attendance records and provider payment requests in accordance with department quality standards based upon the funder's payment rules and regulations in addition to the agency's policies.</li><li>Assist parents, providers, and staff in completing attendance records and/ or provider payment requests by responding to incoming inquiries regarding payment or claims submission.</li><li>Communicate with case managers to resolve payment authorization issues on pending claims.</li><li>Contribute to a team atmosphere by participating in monthly staff meetings, training, and assisting department co-workers as needed.</li><li>Other duties as assigned.</li></ul><p><b> </b></p>
<p>A Healthcare Company in Pasadena is in the need of a Medical Biller with at least 1 year of medical billing experience. In this role, the Medical Biller will be responsible for accurately processing insurance claims for services rendered, conducting insurance verifications, and reviewing Explanation of Benefits (EOBs) to ensure proper reimbursement.</p><p><strong>Job Responsibilities:</strong></p><ul><li>Process and submit medical claims to insurance companies and third-party payers.</li><li>Follow up on unpaid claims and resolve billing issues.</li><li>Verify insurance eligibility and calculate patient payment responsibilities.</li><li>Ensure the accuracy of patient and insurance information in billing systems.</li><li>Comply with HIPAA regulations and maintain confidentiality.</li><li>Communicate with patients, healthcare providers, and insurance representatives to resolve discrepancies.</li></ul><p><br></p>
<p>We are looking for a detail-oriented Personal Injury Plaintiff Case Manager to join our team in Los Angeles, California. In this role, you will oversee personal injury cases, ensuring efficient claim processing, effective communication, and timely management of client needs. The ideal candidate will have a strong background in case management and a commitment to delivering exceptional client service.</p><p><br></p><p>Responsibilities:</p><p>• Process and open health insurance claims with accuracy and attention to detail.</p><p>• Upload and organize critical documents into the company’s case management software.</p><p>• Schedule and coordinate medical appointments while maintaining an up-to-date calendar.</p><p>• Serve as the primary point of contact for clients, addressing their concerns promptly and professionally.</p><p>• Ensure proper documentation and tracking of case details to support smooth claim administration.</p><p>• Collaborate with internal teams to streamline workflows and maintain case progress.</p><p>• Utilize CRM tools to manage client interactions and maintain detailed records.</p><p>• Monitor case timelines and ensure all deadlines are met.</p><p>• Stay informed about personal injury law and regulations to provide informed support.</p><p>• Maintain confidentiality and adhere to legal compliance standards.</p>
<p><b>One of the NICEST law firms seeks Bilingual Spanish Case Manager!</b></p><p><br></p><p>Law firm with multiple offices seeks Law Firm Case Manager to handle intake, case management, scheduling, etc. 40 hours per week and onsite in Downtown LA.</p><p><br></p><p>Salary up to $37/hour + STRONG benefits' package!</p><p><br></p><p><strong>Placed a candidate 6 years ago that is still there and been promoted!</strong></p><p><br></p><p>TO APPLY, ONLY send resume directly to Vice President of Direct Hire, Samantha Graham at Samantha [dot] Graham [at] RobertHalf [dot] [com]</p>
We are looking for a skilled Case Manager to join our team in Encino, California. In this role, you will oversee multiple pre-litigation cases, ensuring prompt and effective resolution while providing exceptional support to clients. This is an onsite position that offers a dynamic work environment and opportunities for growth.<br><br>Responsibilities:<br>• Manage multiple pre-litigation cases, ensuring timely and effective resolution.<br>• Supervise and guide entry-level case managers in their daily tasks and responsibilities.<br>• Facilitate claims processing with insurance carriers, including health insurance, Medicare, and Medi-Cal.<br>• Coordinate property damage and loss of use claims, ensuring proper resolution.<br>• Identify healthcare providers and schedule medical appointments for injury treatment.<br>• Advocate for clients by monitoring their medical treatment and arranging necessary care based on provider recommendations.<br>• Review, analyze, and interpret medical records, surgical reports, and medical bills.<br>• Prepare case files and documentation for submission to the demands department.<br>• Communicate effectively with clients, healthcare providers, and internal staff to maintain a high level of service.
<p>A Surgery Center in Los Angeles is in the need of a Surgery Medical Billing Collections Specialist. The Surgery Medical Billing Collections Specialist must have at least 2 years of experience in the healthcare industry. The Surgery Medical Billing Collections Specialist must be able to work review aged EOBs and resolve denials.</p><p>DUTIES AND RESPONSIBILITIES</p><p>-Performs full cycle billing and collection functions for OHMG Surgical detail-oriented fees.</p><p> -Verify patient eligibility, authorization status and primary payer information via CareConnect and Insurance portals prior to claim submission.</p><p> -Performs all data entry and charge posting functions for OHMG services as needed -Performs all third-party follow-up functions for all products and OHMG surgical procedures.</p><p> -Reviews EOBS and Denials. Make corrections as required and resubmit the claim for payments.</p><p> -Work on the Athena Work Dashboard / Claim list on a daily basis for all services assigned.</p><p> -Performs daily review of Urgent Care provider chart notes to assure that documentation is complete and supportive of submitted charges prior to billing.</p><p>-Provides the correct ICD-10M code to identify the provider's narrative diagnosis -Provides the correct HCPCS code to identify medications and supplies.</p><p> -Provides the correct CPT code to accurately identify the services performed based on the provider's documentation.</p><p>- Reviews all surgical operative reports and assigns appropriate CPT codes and ICD-10-CM codes for services performed by staff surgeons.</p>
We are looking for a detail-oriented Billing Clerk to join our team in Lynwood, California. In this contract position, you will play a crucial role in managing billing operations, ensuring accuracy in claims processing, and maintaining compliance with organizational standards. This is a fully onsite role, providing an excellent opportunity to contribute directly to the success of a non-profit organization.<br><br>Responsibilities:<br>• Process billing claims accurately and efficiently, adhering to organizational policies and procedures.<br>• Utilize CareLogic software to manage billing operations and ensure data integrity.<br>• Handle accounts payable and accounts receivable tasks, verifying and reconciling transactions.<br>• Maintain electronic health records (EHR) systems to support medical billing processes.<br>• Respond to inbound calls professionally to address billing inquiries and resolve issues.<br>• Collaborate with the financial team to ensure timely and accurate submission of claims.<br>• Troubleshoot discrepancies in billing and resolve them promptly.<br>• Assist with computerized billing tasks using various accounting software systems.<br>• Ensure compliance with relevant regulations and standards in all billing activities.<br>• Provide support in the use of Epic and other medical billing software tools.
<p>A Hospital in Los Angeles is seeking a Medical Biller with expertise in hospital billing and deep knowledge of Medi-Cal regulations. The Medical Biller must at least two years of experience in Medical Billing and Collections. The Medical Biller must be able excel at denials management, appeals, and insurance follow-up, </p><p><strong>Key Responsibilities:</strong></p><ul><li>Submit and track hospital claims to Medi-Cal and other insurance payers, ensuring compliance with billing regulations</li><li>Review, analyze, and resolve denied or rejected Medi-Cal claims</li><li>Prepare and submit timely appeals for denied claims, including supporting documentation</li><li>Perform follow-up with payers and patients to secure payment and resolve outstanding account balances</li><li>Accurately update patient accounts and billing records</li><li>Collaborate with clinical and administrative teams to gather documentation, clarify billing issues, and improve revenue cycle processes</li></ul><p><br></p>
We are looking for an organized and detail-oriented Billing Clerk to join our team on a contract basis in Tustin, California. In this role, you will play a crucial part in managing billing processes, ensuring accuracy in financial transactions, and maintaining efficient documentation. This position is ideal for someone with strong analytical skills and a solid understanding of billing systems.<br><br>Responsibilities:<br>• Prepare and issue accurate billing statements to clients in a timely manner.<br>• Monitor and track payment collections, ensuring adherence to due dates and resolving discrepancies.<br>• Maintain and update billing records using computerized systems to ensure accuracy and completeness.<br>• Collaborate with internal teams to verify billing information and address any inconsistencies.<br>• Generate detailed reports on billing activities for internal review and auditing purposes.<br>• Respond promptly to client inquiries regarding invoices and payments to ensure customer satisfaction.<br>• Assist in the reconciliation of accounts to ensure proper financial reporting.<br>• Follow established procedures to process billing adjustments and credits when necessary.<br>• Ensure compliance with company policies and industry regulations in all billing operations.
<p>We are looking for a compassionate and thorough Bilingual Case Manager to join our team in Los Angeles, California. In this long-term contract position, you will play a vital role in providing support to individuals by connecting them with essential resources and services. This is a great opportunity for someone with strong organizational skills and a passion for helping others thrive in challenging circumstances.</p><p><br></p><p>Responsibilities:</p><p>• Conduct comprehensive intake assessments to understand clients' needs and develop personalized service plans.</p><p>• Provide ongoing case management, including crisis intervention and support for clients.</p><p>• Facilitate access to community resources such as housing, healthcare, employment, and mental health services.</p><p>• Maintain accurate and up-to-date documentation of case notes and ensure compliance with program guidelines.</p><p>• Collaborate with internal team members and external social service providers to coordinate effective client care.</p><p>• Participate in regular team meetings, training sessions, and development opportunities.</p><p>• Monitor client progress and adjust service plans as necessary to meet evolving needs.</p><p>• Advocate for clients to ensure they receive appropriate services and support.</p><p>• Stay informed about local community programs and resources to enhance service delivery.</p>
