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11 results for Claims Processor Administrative And Customer Support in Costa Mesa, CA

Claims Professional

Los Angeles, CA
onsite
Temporary to Hire
25.65 - 29.70 USD / Hourly
We are looking for a Claims Specialist to support workplace injury case coordination for a service organization in Los Angeles, California. This contract-to-permanent opportunity is ideal for someone with experience handling workers’ compensation documentation, medical status tracking, and communication with supervisors and adjusters. The person in this role will help maintain accurate claim records, promote timely follow-up, and assist with return-to-work efforts for employees recovering from job-related injuries. Responsibilities: • Manage an assigned group of modified duty and lost time workers’ compensation claims from intake through closure support. • Review work-related medical documentation, record key details in the system, and route records to the appropriate insurance adjuster. • Notify supervisors of initial medical findings, work status updates, and any changes that affect employee availability. • Coordinate follow-up activity by scheduling reminders for medical appointments and obtaining documented status updates within 24 hours of each visit. • Share appointment outcomes promptly with both the insurance adjuster and internal leadership to keep claim activity current. • Support early return-to-work efforts by working with management and affected employees to align contract work options with medical restrictions. • Track lost work time and modified duty assignments to ensure claim records remain complete and accurate. • Maintain ongoing communication with insurance adjusters at regular intervals until each claim is resolved, and perform routine audits of claim data for accuracy and completeness.
2026-08-27T22:24:09Z

Medical Billing Specialist (Behavioral Health)

Culver City, CA
onsite
Temporary to Hire
23.75 - 27.50 USD / Hourly
A Healthcare Company is seeking a Behavioral Health Medical Biller to support revenue cycle operations and ensure accurate, timely billing for behavioral health services. The Behavioral Health Medical Biller candidate will need to have experience with medical billing, claims processing, payment posting, and insurance follow-up. Experience working with DMH billing is a strong plus. Key Responsibilities: • Process and submit behavioral health medical claims accurately and on time • Review billing documentation for completeness and compliance • Follow up on unpaid, denied, or rejected claims with insurance carriers • Post payments, adjustments, and reconcile accounts • Verify patient insurance coverage and benefits• Examine billing documentation to confirm all required information is complete, properly supported, and aligned with payer guidelines.• Investigate outstanding accounts and communicate with insurance carriers to resolve denied, rejected, or unpaid claims.• Work closely with internal teams to resolve billing discrepancies • Maintain accurate billing records and ensure confidentiality of patient information • Support month-end reporting and accounts receivable follow-up
2026-09-18T23:48:45Z

Medical Biller/Collections Specialist

Los Angeles, CA
onsite
Temporary to Hire
26.60 - 30.80 USD / Hourly
An Ambulatory Surgery Center in Los Angeles is in the need of a Medical Biller/Collections Specialist. This Medical Biller/Collections Specialist is ideal for someone who understands the full revenue cycle and can confidently manage claims, denials, and payer follow-up for surgical services. The right candidate for the Medical Biller/Collections Specialist role will bring healthcare billing experience, strong insurance knowledge, and the ability to keep accounts moving toward timely reimbursement. Responsibilities:• Manage end-to-end billing and collections activities for surgical services, from charge review through payment follow-up.• Confirm patient coverage, authorization details, and payer information using available electronic records and insurance carrier resources before claims are submitted.• Enter billing data and post charges accurately for surgical cases while maintaining complete and organized account documentation.• Pursue outstanding third-party balances by conducting regular follow-up with commercial and government payers across multiple plan types.• Investigate explanation of benefits, identify denial causes, correct claim issues, and resubmit claims to support reimbursement.• Monitor assigned claim queues and worklists each day to address unresolved accounts, aging items, and billing exceptions in a timely manner.• Review provider documentation, including urgent care and surgical records, to ensure charges are supported and billing can proceed accurately.• Apply appropriate diagnosis, procedure, medication, and supply codes based on clinical documentation and operative reports completed by providers.• Examine aged accounts and unresolved payer responses to resolve denials, appeals, and collection issues efficiently.
2026-09-16T17:18:47Z

HR Generalist

City of Industry, CA
remote
Temporary / Contract
27.00 - 34.00 USD / Hourly
• Serve as the primary HR contact for employees and managers • Support non-exempt, direct labor recruiting, onboarding/offboarding, performance management.• Guide managers on policy interpretation, corrective action, and documentation; escalate complex employee relations matters to HR Director.• Facilitate employee engagement, recognition, and culture building initiatives; support diversity, equity, and inclusion.• Serve as a primary resource for employee benefit questions, ensuring employees are directed to appropriate resources as needed. Ensure employees are supported with benefit questions.• Assist with safety initiatives and Workers’ Compensation claims and return-to-work coordination.• Maintain accurate, compliant employee files aligned with federal, state, and local laws.• Administer and track mandatory training; ensure certifications are completed on time.Payroll Operations• Validate time and attendance, resolve discrepancies, and ensure accurate application of wage & hour rules (FLSA; state/local).• Work with the finance team to reconcile payroll registers and GL.Compliance, Risk & Operations Projects• CA Site level - Keep policies and postings compliant with federal, state, and local requirements (e.g., EEO, FLSA, FMLA, ADA, OSHA, pay transparency).• Support audits (internal/external), EEO1/ACA reporting, I9/E-Verify, and records retention.• Administer California leave programs and related notices, including CFRA, Pregnancy Disability Leave (PDL), and coordination with EDD Paid Family Leave; manage ADA/FEHA accommodations and return to work all through Symetra.• Maintain California specific policies, postings, and practicesQualificationsRequired:• 5+ years progressive HR experience, including site level HR generalist support and end-to-end payroll processing in the state of California.• HRIS proficiency –• Solid knowledge of employment and wage & hour laws (FLSA, FMLA, ADA, EEO, state/local leaves and pay rules). Must have knowledge and experience within the state of California.• Exceptional discretion, documentation rigor, and customer service mindset.• Bachelor’s degree in HR, Business, or related field (or equivalent experience).• Certifications: PHR/SPHR or SHRM CP/SHRM SCP; FPC/CPP (American Payroll Association).• Experience with payroll, and time and attendance systems a must.• Exposure to benefits administration, open enrollment, and ACA compliance.• Spanish speaking highly desired.
2026-09-18T16:58:42Z

In House Counsel

Gardena, CA
onsite
Permanent / Full Time
200000.00 - 250000.00 USD / Yearly
We are looking for an experienced In House Counsel to join a growing food and food processing company in Gardena, California. This role will serve as a key legal advisor to business leaders and provide practical guidance across employment matters, contracts, claims, and regulatory risk. The ideal candidate brings strong judgment, a collaborative approach, and the ability to support multiple departments in a fast-paced, on-site environment. Responsibilities:• Provide day-to-day legal guidance to leadership and HR on workplace matters, employee relations issues, and policy interpretation.• Oversee employment-related disputes by coordinating strategy, managing outside counsel, and monitoring case progress through resolution.• Review, draft, and negotiate a range of commercial agreements, including vendor contracts, service arrangements, and lease documents.• Identify legal and operational risks across the business and recommend practical compliance measures to support sound decision-making.• Handle workers’ compensation, general liability, and property-related claims while partnering with internal stakeholders and external advisors as needed.• Build strong cross-functional relationships and act as a trusted legal partner to teams throughout the organization.• Support legal needs arising from business growth and evolving operational priorities in a retail-focused environment. Please send your resume to Quidana.Dove< at >RobertHalf.< com > for a confidential discussion.
2026-09-11T20:58:39Z

Human Resources (HR) Manager

Long Beach, CA
onsite
Temporary / Contract
40.38 - 46.75 USD / Hourly
We are looking for an experienced Workers Compensation Manager to support a dynamic operation in Long Beach, California. This Long-term Contract opportunity is ideal for someone who is detail oriented and can lead employee relations matters, oversee core HR administration, and manage benefits and workers’ compensation processes with strong attention to compliance. The role requires a hands-on partner who can balance day-to-day HR support with risk awareness and accurate documentation across sensitive employee matters. Responsibilities:• Guide managers and employees through workplace concerns, helping resolve issues fairly and in alignment with company policy and employment standards.• Oversee daily HR administrative activities, including maintaining personnel records, supporting documentation workflows, and ensuring data accuracy within HR systems.• Administer employee benefit programs by addressing inquiries, coordinating updates, and helping ensure timely and accurate processing.• Manage workers’ compensation activities from initial incident reporting through claim follow-up, maintaining complete records and supporting proper case handling.• Partner with internal stakeholders to assist injured employees, monitor claim status, and promote compliant return-to-work coordination when applicable. • Contribute to risk management efforts by identifying HR-related compliance concerns and helping implement practical corrective actions.• Prepare and maintain claim documentation, employee files, and other sensitive records with a high degree of confidentiality and accuracy.Review and coordinate newly reported injury claims, ensuring proper documentation, timely reporting, and adherence to state workers' compensation requirements.Oversee California claims activity, including compliance with applicable workers' compensation regulations, benefit administration guidelines, and medical treatment processes.Act as the primary liaison between employees, management, claims administrators, medical providers, nurse case managers, and other claim-related partners.Monitor claim investigations, medical treatment plans, disability benefits, and claim resolution strategies to ensure appropriate handling and outcomes.Coordinate return-to-work and modified duty programs by working with operational leadership and employees to accommodate work restrictions whenever possible.Maintain detailed and confidential claim records while ensuring all required documentation is accurate, complete, and properly tracked.Review incident reports, witness statements, medical records, surveillance footage, and other supporting materials to assist with claim investigations.Monitor claim activity and vendor performance, identifying service issues, trends, and opportunities for improvement.Provide guidance to managers and supervisors regarding injury reporting procedures, documentation requirements, workplace accommodations, and return-to-work practices.Partner with Human Resources, Risk Management, Safety, Legal, Payroll, and Operations teams on complex, litigated, catastrophic, or high-exposure claims.Analyze workers' compensation metrics and prepare reports highlighting claim trends, costs, compliance concerns, and program performance.Recommend process improvements that help reduce claim severity, improve employee outcomes, and control workers' compensation expenses.
2026-09-10T21:18:41Z

Medical Claims Examiner

San Bernadino, CA
onsite
Temporary to Hire
26.00 - 33.00 USD / Hourly
We are seeking a detail-oriented Medical Claims Examiner to join our team. In this role, you will review, analyze, and process medical claims accurately and efficiently while ensuring compliance with company policies, client requirements, and regulatory guidelines. The ideal candidate will have strong knowledge of claims adjudication, medical terminology, and healthcare insurance processes. Experience with EZ-CAP is a plus, and grievances experience is highly preferred.Key Responsibilities:<ul><li>Review and process medical claims for accuracy, completeness, and eligibility</li><li>Analyze claims to determine coverage, payment, and denial outcomes</li><li>Research and resolve claim discrepancies, adjustments, and pended claims</li><li>Interpret provider contracts, benefit plans, and reimbursement guidelines</li><li>Ensure timely adjudication of claims in accordance with turnaround standards</li><li>Investigate and respond to inquiries related to claims status, denials, and escalations</li><li>Maintain accurate documentation of claim actions and decisions</li><li>Collaborate with internal departments, providers, and health plan representatives to resolve complex claims issues</li><li>Assist with appeals and grievance-related cases as needed</li><li>Stay current on policies, procedures, and regulatory requirements affecting claims processing</li></ul>
2026-09-15T02:24:07Z

Assistant Controller

Temecula, CA
onsite
Permanent / Full Time
110000.00 - 150000.00 USD / Yearly
We are looking for an Assistant Controller to support a broad range of accounting and financial activities for our organization in Temecula, California. This position plays a key role in maintaining accurate records, producing timely financial information, and supporting compliance across payroll, tax, reporting, and operational finance functions. The role is designed for a detail-oriented individual who can build deep knowledge across the accounting department and grow into increased leadership responsibility over time. Responsibilities: • Oversee general ledger activity and help produce complete monthly financial statements with accuracy and timeliness. • Coordinate year-end schedules, supporting documentation, and audit materials for external tax preparation and financial statement review. • Monitor estimated tax obligations, submit required payments, and maintain supporting records for corporate tax compliance. • Administer fixed asset and depreciation records, including preparation of required property tax filings. • Record daily cash activity and perform reconciliations for bank and investment accounts to ensure balances are accurate. • Provide backup support for payroll and related HR administration, including payroll processing, leave tracking, benefit premium payments, and response to employment-related notices or claims. • Develop working oversight of accounts receivable and accounts payable processes, with the expectation of guiding these functions as needed. • Prepare recurring sales tax, regulatory, census, and business registration filings while supporting insurance or government audits and annual information reporting such as W-9 and 1099 administration.
2026-08-25T18:38:40Z

Medical Claims Examiner

San Bernardino, CA
onsite
Temporary to Hire
25.01 - 33.67 USD / Hourly
A Medical Claims Organizations is in the immediate need of Medical Claims Examiner with experience in grievances and appeals to join the team. The Medical Claims Examiner is responsible for reviewing, investigating, and resolving member and provider grievances and appeals in compliance with regulatory requirements and internal policies. The Medical Claims Examine candidate will have hands-on experience working within EZ-CAP and a solid understanding of health plan operations. Key Responsibilities: <ul><li>Review, research, and process member and provider grievances and appeals accurately and within required turnaround times</li><li>Use EZ-CAP to document, track, and manage case activity</li><li>Analyze case details, benefits, claims, authorizations, and supporting documentation to determine appropriate resolutions</li><li>Ensure all grievances and appeals are handled in accordance with health plan policies, CMS, DMHC, and other applicable regulatory guidelines</li><li>Communicate with internal departments, providers, and members regarding case status and resolution</li><li>Prepare written correspondence for grievance and appeal determinations</li><li>Maintain complete, accurate, and audit-ready documentation</li><li>Identify trends or recurring issues and escalate as needed</li></ul>
2026-09-15T02:24:07Z

Grievance and Appeals Specialist

San Bernardino, CA
onsite
Temporary to Hire
27.37 - 35.91 USD / Hourly
A Healthcare Plan in San Bernardino is in need of a Grievance and Appeals Specialist with strong health plan industry experience to join their team. The Grievance and Appeals Specialist is responsible for reviewing, investigating, and resolving member and provider grievances and appeals in compliance with regulatory requirements and internal policies. The Grievance and Appeals Specialist candidate will have hands-on experience working within EZ-CAP and a solid understanding of health plan operations. Key Responsibilities:<ul><li>Review, research, and process member and provider grievances and appeals accurately and within required turnaround times</li><li>Use EZ-CAP to document, track, and manage case activity</li><li>Analyze case details, benefits, claims, authorizations, and supporting documentation to determine appropriate resolutions</li><li>Ensure all grievances and appeals are handled in accordance with health plan policies, CMS, DMHC, and other applicable regulatory guidelines</li><li>Communicate with internal departments, providers, and members regarding case status and resolution</li><li>Prepare written correspondence for grievance and appeal determinations</li><li>Maintain complete, accurate, and audit-ready documentation</li><li>Identify trends or recurring issues and escalate as needed</li></ul>
2026-09-15T02:24:07Z

Medical Insurance Collections Specialist

Los Angeles, CA
onsite
Temporary to Hire
25.01 - 31.90 USD / Hourly
A Hospital in Los Angeles is seeking an experienced Medical Insurance Collections Specialist to join its revenue cycle team. The Medical Insurance Collections Specialist role will focus on insurance follow-up and collections for HMO and PPO payers, with an emphasis on resolving outstanding balances, researching claim issues, and securing timely reimbursement. The ideal candidate for the Medical Insurance Collections Specialist role will also have experience working with UB04 claims in a hospital setting. Key Responsibilities:<ul><li>Perform insurance collections follow-up on outstanding hospital claims with a focus on HMO and PPO payers. </li><li>Contact insurance companies and payers to obtain claim status, secure payment, and resolve unpaid or underpaid accounts. </li><li>Review and work hospital UB04 claims to ensure accurate billing and proper reimbursement..</li><li>Investigate and resolve claim denials, rejections, underpayments, and payment delays. </li><li>Submit corrected claims, supporting documentation, and appeals as needed to facilitate payment resolution. </li><li>Follow up on aged accounts receivable and maintain productivity in line with departmental goals. </li><li>Document all collection activity, account updates, and payer communications in the billing system.</li><li>Collaborate with billing, coding, and patient financial services teams to resolve claim discrepancies and improve reimbursement outcomes. </li><li>Monitor payer trends and escalate recurring issues impacting collections. </li></ul> Qualifications:<ul><li>3+ years of experience in medical insurance collections, insurance follow-up, or healthcare accounts receivable..</li><li>Hospital billing or collections experience required. </li><li>Strong knowledge of HMO and PPO insurance plans, payer guidelines, and reimbursement processes. </li><li>Experience working with UB04 claims required. </li><li>Familiarity with denial management, appeals, and claim resolution processes</li><li>Strong attention to detail, organizational skills, and ability to manage a high-volume workload..</li><li>Excellent communication and problem-solving skills..</li><li>Proficiency with hospital billing systems and electronic medical records preferred.</li></ul>
2026-09-17T20:48:43Z