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 Description Job Description Rooterman Hartford Company has an opening for a CDL Truck Driver. We are a Plumbing, HVAC and Drain cleaning company. The hour are Part Time and Flexible. May call for more details to (***) ***-**** or to apply. Company Description...
...partners. Today, in just the span of four years, we are servicing3500+and growing, delighted and satisfied clients. **Executive Virtual Assistant** Full Time - Work From Home Remote Job - No Experience Required Timezone: Mountain Standard Time **...
...for compassionate caregivers , STNAs , CNAs , and Home Health Aides to join our team in Omaha Nebraska and Council Bluffs 15 Hours per week Why Village Caregiving? We understand the importance of supporting our caregivers with more than just a paycheck....
...business. Key elements of the role will include achieving sales target, creating a culture of Clienteling and elevating the retail... ...Continuously train, coach, develop and provide qualitative feedback, to store directors and functional team, utilizing reward and recognition...
...Bachelor's degree or equivalent experience in Computer Science or related field Our client is... ...your skills and interests. Seniority level Seniority level Mid-Senior level... ...days ago Software Engineer - Fullstack (Entry-Level) California, United States $100,000...