Claims Specialist Jobs in Pasadena, CA

Join a team that's transforming healthcare mandates into impactful projects. You will lead complex initiatives, manage diverse stakeholders, and drive compliance through strategic project management f...

Advance critical projects by leading complex, multi-stakeholder initiatives. Utilize your expertise in project management to define scope, manage resources, and ensure compliance with healthcare manda...

Transform patient access and reimbursement initiatives nationally by leading a dynamic team of Patient Access Liaisons. Drive collaboration across stakeholders to ensure timely therapy access and opti...

Champion financial reporting solutions while driving customer engagement and growth. Collaborate with sales teams to deliver value and support migration strategies, ensuring seamless integration and e...

Accelerate progress at coding for surgical and interventional radiology services. Utilize your expertise in ICD and CPT coding to optimize revenue cycle efficiency, ensuring compliance with establishe...

Take ownership of training initiatives that enhance the technical skills of audit teams. Collaborate with experts to develop impactful training programs, mentor new members, and improve audit processe...

Elevate business efficiency by analyzing and designing robust application systems. As a key player in a major IT transformation, collaborate across teams to implement Oracle’s OIPA policy administrati...

Drive impactful Community Health projects, enhancing care for vulnerable populations through data analysis, strategic planning, and stakeholder engagement, ensuring effective project execution and col...

Empower our legal strategy by owning the litigation portfolio, managing disputes and regulatory inquiries. Collaborate cross-functionally to translate legal risks into actionable guidance while buildi...

Join a strategic team to lead the third-party risk management program across a national bank. You will oversee vendor assessments and compliance, enhance frameworks, and ensure regulatory readiness wh...

Unlock your potential by optimizing clinical review processes to ensure quality medical care. Collaborate with teams to support effective member services and compliance while enhancing outcomes throug...

Tackle clinical member services reviews, ensuring medical necessity aligns with guidelines and regulations. Collaborate with teams to promote effective care delivery while maintaining compliance and c...

Engineer robust data loss prevention strategies to safeguard sensitive information across cloud, endpoints, and networks. Collaborate with teams to enhance cybersecurity defenses while ensuring compli...

Contribute to enhancing member care by assessing services for medical necessity, compliance, and cost-effectiveness. Collaborate with multidisciplinary teams to optimize outcomes and adhere to clinica...

Reimagine healthcare solutions by leveraging your analytical skills and regulatory insights to optimize claims editing and payment integrity processes while collaborating with cross-functional teams...

Transform the future of healthcare accounting as you lead a dynamic team in processing 12,000 invoices monthly and managing month-end closings, audits, and vendor engagements while ensuring compliance...

Grow your career with a pivotal role overseeing remote clinical operations, coaching your team to excellence while collaborating with care providers. Manage performance and ensure quality client care...

Unlock potential by overseeing quality assurance in construction projects through expert inspections and adherence to standards, ensuring compliance and safety in materials and methods across various...

Join a dynamic team focused on compliance and client satisfaction. Drive operational excellence and build robust audit processes by leveraging your experience in finance, accounting, and data analysis...

Drive impactful decision-making by developing robust analytical tools and frameworks. Collaborate with senior leaders to address business needs through innovative solutions, while enhancing your exper...

Lead and manage complex commercial insurance programs, ensuring profitability and strategic alignment. Oversee underwriting, client relationships, and operational performance while driving growth and...

Lead and develop Actuarial Analysts to deliver high-quality pricing analyses. Collaborate with clients and stakeholders to enhance decision-making through insights while managing project timelines eff...

Tackle Medicare/Medicaid Program Integrity challenges by developing educational materials, ensuring compliance, and guiding stakeholders on fraud, waste, and abuse strategies to enhance the integrity...

Unlock potential by optimizing scheduling workflows and enhancing patient access, collaborating with teams to analyze data and implement improvements, ensuring service excellence in healthcare operati...

Champion innovation and strategy in utilization management, leading product vision and development. Drive transformative solutions to enhance healthcare efficiency while collaborating with cross-funct...