Are you an experienced healthcare claims professional looking for a **remote position** with a company that values your skills and offers long-term growth potential? Our client, a leading healthcare organization, is seeking a **Claims Processor** with **strong experience in Medi-Cal and Medicare claims**—especially for **professional claims** submitted by specialists such as Cardiologists, Surgeons, and OB-GYNs.
🧩 What You’ll Do:
* Review and process **non-delegated provider claims** (professional and outpatient)
* Ensure claim accuracy and verify services against **Medicare/Medi-Cal fee schedules**
* Determine eligibility for payment or denial
* Handle **coordination of benefits (COB)**, denials, and service reductions
* Collaborate with internal teams to resolve claim issues and ensure timely processing
✅ What We’re Looking For:
** Must live in Southern California***
* **2+ years** of hands-on experience in **professional or institutional claims processing**
* Proven knowledge of **Medicare and Medi-Cal** guidelines, policies, and fee schedules
* Strong understanding of **CPT**, **ICD-9**, and **ICD-10** coding
* Familiarity with **capitated managed care** (a plus!)
* Proficiency in **Windows-based applications** and solid **data entry** skills
* Highly organized, detail-oriented, and able to thrive in a remote setting
💻 Why You’ll Love This Role:
* 100% **remote work** – enjoy work-life balance from anywhere in the U.S.
* Join a **mission-driven team** making a real impact in healthcare
* Competitive pay and potential for **long-term placement**
* Work independently while still being part of a **collaborative team environment**
...Job Title: Embedded Systems Software Engineer Location: Amsterdam Job Type: Full-time | Start-up Environment About them:... ...Engineer to join the dynamic team. You will be responsible for developing and integrating software for embedded devices, ensuring seamless...
...a highly organized, efficient, and trustworthy professional to assist and manage daily personal, family, and some professional tasks.... ...Manage all incoming and outgoing communications Schedule travel Planning events Qualifications Bachelor's degree or equivalent...
Position Summary: Supervise Manufacturing department group leaders, team leaders, and team members for assigned area(s)/shift (e.g., assembly, filter, injection molding, powertrain, stamping, urethane, welding, etc.) to ensure safety, quality, positive work environment...
...Emergency Medicine Physician opportunity in Stephenville, TX Excellent full-time opportunity for an emergency medicine (EM) physician to join our team in Stephenville, Texas. Join a team that promotes compassionate care and work in a supportive environment. Position...
...will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:*The California Fair Chance Act *Los Angeles City Fair Chance Ordinance*Los...