🚨 Now Hiring: RN Case Manager – Los Angeles, CA Region 🚨 💻 Work from home + local field travel 💰 Salary: $87,000 – $101,000 annually 🎉 Quarterly Bonus Opportunities 📚 Free CEUs for licenses & certificates 💳 License & Certification Reimbursement We’re looking for an RN with a passion for case management to join our team! ✨ RN degree required ✨ National Certification preferred (CCM, CRC, COHN, CRRN) ✨ Workers’ Comp Case Management experience a plus 📍 Location Requirement Candidates must be based in one of these California areas: San Fernando, Van Nuys, Santa Clarita, Granada Hills, Panorama, Valencia, Oxnard, Westlake Village, Palmdale, or Chatsworth. ✅ Your Impact: You’ll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You’ll support patients/employees receiving benefits under insurance lines including Workers’ Compensation, Group Health, Liability, Disability, and Care Management. This is your chance to grow your career, earn great rewards, and enjoy true work-life balance. 👉 Apply today and make an impact in the community! Why Crawford? Because a claim is more than a number — it’s a person, a child, a friend. It’s anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community – one claim at a time. At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We’re looking for the next generation of leaders to take this journey with us. We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com. When you accept a job with Crawford, you become a part of the One Crawford family. Our total compensation plans provide each of our employees with far more than just a great salary - Pay and incentive plans that recognize performance excellence - Benefit programs that empower financial, physical, and mental wellness - Training programs that promote continuous learning and career progression while enhancing job performance - Sustainability programs that give back to the communities in which we live and work - A culture of respect, collaboration, entrepreneurial spirit and inclusion Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Specialty Admission Coordinator is responsible for managing specialty medication referrals from receipt through insurance clearance to ensure timely and accurate patient access to therapy. This role serves as the key point of contact for benefit investigation, prior authorization, coordination with internal stakeholders (pharmacy and nursing staff) and financial counseling with patients. The coordinator plays a critical role in ensuring referrals meet payer requirements and in facilitating seamless communication between patients, providers, pharmacy staff and the sales team. This is a remote position. Monday-Friday 8:30am-5:30pm (MST or PST) Responsibilities - Owns and manages the specialty referral from initial intake through insurance approval - Conducts timely and accurate benefit investigation, verifying both medical and pharmacy benefits - Identifies and confirms coverage criteria, co-pays, deductibles and prior authorization requirements - Prepares and submits prior authorization requests to appropriate payers - Maintains clear, timely communication with pharmacy teams, sales representatives and prescribers regarding the status of each referral and any outstanding information - Coordinates and delivers financial counseling to patients, including explanation of out-of-pocket costs, financial assistance options and next steps - Ensures all documentation complies with payer and regulatory requirements - Updates referral records in real-time within computer system - Collaborates with patient services and RCM teams to support a smooth transition to fulfillment - Tracks and reports referral statuses, turnaround times and resolution outcomes to support process improvement Supervisory Responsibility: No Qualifications - High school diploma or GED required; Associate’s or Bachelor’s degree preferred. - Minimum of 2 years of experience in a healthcare, specialty pharmacy, or insurance verification role. - Experience working with specialty medications, including benefit verification and prior authorization processes. - Experience in patient-facing roles is a plus, especially involving financial or benefit discussion. - Familiarity with payer portals. - Strong understanding of commercial, Medicare, and Medicaid insurance plans. - Proven track record of communicating effectively with internal and external stakeholders. - Desired: Experience in Microsoft BI. Experience in Outlook, Word, and PowerPoint. Requirements - Percentage of Travel: 0-25% - To perform this role will require constant sitting and typing on a keyboard with fingers, and occasional standing, and walking. - The physical requirements will be the ability to push/pull and lift/carry 1-10 lbs. Company Description Amerita, an affiliate of BrightSpring Health Services, is a specialty infusion company focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. Committed to excellent service, our vision is to combine the administrative efficiencies of a large organization with the flexibility, responsiveness, and entrepreneurial spirit of a local provider. For more information, please visit www.ameritaiv.com . Follow us on Facebook , LinkedIn , and X . Salary Range USD $21.00 - $29.00 / Hour

• Review medical bills submitted by insurance companies related to MVA injuries sustained for NJ and or NY-covered insureds • Interpret medical documentation ensure accuracy of billed services IE: CPT, HCPCs codes • Assign proper CPT, HCPCs codes based on the review outcome • Review CPT codes for unbundled services • Review billed modifiers for accuracy of use • Crosswalk CPT codes per regulatory requirements to ensure correct reimbursement • Interpret fee schedule guidelines and apply those guidelines in daily reviews • Document review outcomes for customers in a professional easy to understand manner • Use various resources, IE: eBooks, 3M software to support reviews • Participate in conference calls as needed with customers and/or attorneys • Participate in virtual and in-person testimony or trial when needed • Assist with various special projects and other duties as assigned

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description SAIC is looking for a Full-Time Remote Medical Coder III to provide remote medical coding support to government Medical Treatment Facilities assigned under the Defense Health Agency (DHA) Medical Coding Program Branch. - Experience in multiple coding modalities/specialties, such as: - Inpatient professional - Inpatient facility - Same day surgeries - Observation - Emergency Department - Outpatient specialty/primary care encounters Qualifications - A minimum of five (5) years of medical coding and/or auditing experience in four or more medical, surgical, and ancillary specialties within the past fifteen (15) years. - A minimum of one (1) year of performance in the specialty is required to be qualifying. - Multiple specialties encompass different medical specialties (i.e., Family Practice, Pediatrics, Gastroenterology, OB/GYN, etc.) that utilize ICD, E&M, CPT, and HCPCS codes. - Ancillary specialties (PT/OT, Radiology, Lab, Nutrition, etc.) that usually do NOT use E&M codes do not count as qualifying experience. - Coding, auditing, and training exclusively for specialties such as home health, skilled nursing facilities, and rehabilitation care will not be considered as qualifying experience. - Coding experience limited to making codes conform to specific payer requirements for the business office (insurance billing, accounts receivable) is not a qualifying factor. Requirements - Applicants must have ONE of the following medical coding certifications: RHIT/RHIA/CPC/CCS-P/CEMC/CEMA/CCS/CIC. - Applicants who possess multiple certifications from the list above are preferred. - Medical coding personnel shall maintain the required continuing education hours in order to maintain current and proper national certification (requirements for this position). - Selected applicant must do the following before starting, based on government requirements: - Pass a pre-employment coding test - Provide proof of specific vaccinations - Be subject to a government security investigation and must meet eligibility requirements - Must be a US Citizen.