Role Description MedPOINT Management in Sherman Oaks, CA is looking for a detail-oriented Hospital Claims Adjuster to join our dynamic healthcare team. In this role, you'll play a critical part in reviewing and processing hospital claims with accuracy and efficiency. If you're passionate about healthcare operations and thrive in a fast-paced environment, we want to hear from you! Responsibilities: - Review, analyze, and adjudicate inpatient and outpatient hospital claims in accordance with plan guidelines - Verify patient eligibility, benefits, and coverage prior to claims processing - Identify and resolve claim discrepancies, denials, and underpayments - Apply ICD-10, CPT, and DRG coding knowledge to ensure accurate claim adjudication - Coordinate with providers, hospitals, and internal departments to resolve claim issues - Ensure compliance with state and federal healthcare regulations, including HIPAA - Maintain accurate documentation and meet productivity and quality benchmarks Qualifications - 2+ years of experience in hospital or medical claims adjudication - Proficiency in ICD-10, CPT, HCPCS, and DRG coding - Familiarity with managed care, HMO, PPO, and IPA claims processing - Strong knowledge of EOB preparation and explanation of benefits - Experience with claims management software and healthcare information systems - Excellent analytical, problem-solving, and organizational skills - Strong attention to detail with the ability to meet deadlines in a high-volume environment Requirements - 2+ years of experience in hospital or medical claims adjudication - Proficiency in ICD-10, CPT, HCPCS, and DRG coding - Familiarity with managed care, HMO, PPO, and IPA claims processing - Strong knowledge of EOB preparation and explanation of benefits - Experience with claims management software and healthcare information systems - Excellent analytical, problem-solving, and organizational skills - Strong attention to detail with the ability to meet deadlines in a high-volume environment Benefits - 401(k) - 401(k) matching - Bonus based on performance - Dental insurance - Employee discounts - Free food & snacks - Health insurance - Opportunity for advancement - Paid time off - Parental leave - Savings bank - Training & development - Vision insurance - Wellness resources

• Point of contact for technical warranty cases – handling customer contact by phone and in writing • Evaluate the plausibility of damage reports • Processing and monitoring of automated data imports • Managing external partners • Ensuring transparent cost control • Communication and information exchange with all stakeholders

Role Description At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it’s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives. It takes empathy, precision, and a strong sense of partnership—and that’s exactly what you’ll find here. We’re a team of fast-paced fixers, empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence. Here, you’ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you’re here, you’re part of something bigger. You’re part of a team that shows up, stands together, and leads with purpose. How you'll make an impact: - Apply claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims. - Interact extensively with various parties involved in the claim process to ensure effective communication and resolution. - Provide exceptional customer service to our claimants on behalf of our clients exhibiting empathy through each step of the claims process. - Handle claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethics requirements. - Document and communicate claim activity timely and efficiently, supporting the outcome of the claim file. Qualifications - Claims Background: Commercial General Liability Bodily Injury and Litigation Management - Jurisdictional Experience: Any - Active Adjusters' licenses: TX, FL, NY preferred Requirements - High School Diploma. - Minimum of 5 years related claims experience. - Appropriately licensed and/or certified in all states in which claims are being handled. - Knowledge of accepted industry standards and practices. - Computer experience with related claims and business software. Benefits - Medical/dental/vision plans, which start from day one! - Life and accident insurance - 401(K) and Roth options - Tax-advantaged accounts (HSA, FSA) - Educational expense reimbursement - Paid parental leave - Digital mental health services (Talkspace) - Flexible work hours (availability varies by office and job function) - Training programs - Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing - Charitable matching gift program - And more...

Role Description The primary role of this position is to assist physicians and support the Credentialing team with preparing and submitting credentialing, enrollment, recredentialing applications and follow up on the status of applications for Physicians and Payers and keep a detailed log of all tasks. The Credentialing Specialist will be responsible for supporting all aspects of credentialing and recredentialing and any other administration duties assigned by management. Credentialing Specialist I: - Supports the TeleMed2U Provider Network’s credentialing process for all TeleMed2U clinical providers, in accordance with NCQA, URAC, Joint Commission and CMS accreditation standards, Federal and State laws, and TeleMed2U’s policies. - Assists with the management of TeleMed2U Provider Network’s credentialing applications, to ensure distribution, receipt, processing, and timely management through our credentialing process. - Ensures all credentialing and enrollment applications accuracy prior to submission. - Monitors provider enrollment application status, follow up with the payors. - Manage CAQH profiles for TeleMed2U’s Provider Network. - Prepare and submit rosters to health insurance plans to ensure provider participation. - Update various databases to ensure proper tracking of payor enrollments, credentialing and update requests. - Maintain necessary records of outstanding enrollment applications and requests. - Coordinate all managed care credentialing activities to ensure provider participation status. - Credentialing activities require substantial contact with outside agencies. - Maintain Credentialing database. - Follow-up with managed care companies to ensure expedient credentialing. - Remains current on policies affecting provider enrollment credentials & delegated clients/payers. Credentialing Specialist II: - All Credentialing Specialist I responsibilities. - Serve as a liaison for training new team members. - Identify conflicting or questionable information while processing applications and highlight sensitive information for committee members. Credentialing Specialist III: - All Credentialing Specialist I and II responsibilities. - Acts as a mentor to other Credentialing Specialists. - Provides support and assistance within the department. - Leads with minimal supervision. - Prepare specialized reports as requested, including analysis and presentation findings. - Other duties as assigned. Qualifications - Credentialing experience. - High School Diploma or equivalent. - 3 years of experience in credentialing (for Credentialing Specialist II). - 1 year minimum healthcare experience (for Credentialing Specialist II). - Credentialing Specialist II with TeleMed2U minimum 1 year (for Credentialing Specialist III). - 4 years experience minimum in Credentialing and/or Licensing (for Credentialing Specialist III). - Top performer at current level, who has demonstrated proficiency in all areas of Credentialing. - Excellent verbal and written communication skills. - Ability to multitask and work independently. - Excellent attention to detail. - Experience with state licensure application submission process for multiple states. - High school diploma required/GED. Preferred - Medicare and Medicaid enrollment experience preferred. - Bachelor’s degree preferred. - 1-3 years of experience in licensing, payor enrollment and credentialing preferred. Physical Requirements - Prolonged periods of desk work and computer use. - Ability to lift 15 lbs.