- Robert Half Office Team (Fallbrook, CA)
- …and dental industry regulations + Coordinate with insurance providers and handle claims processing + Monitor office inventory, vendor relationships, and supply ... ordering + Support financial reporting and collaborate with ownership on budgeting Requirements + 3+ years of office management experience, preferably in a dental or medical setting + Strong leadership and interpersonal skills + Familiarity with dental… more
- Guidehouse (Ventura, CA)
- …organization or other health care financial service setting, performing medical claims processing , financial counseling, financial clearance, accounting, or ... customer service.** **Knowledge of insurance and governmental programs, regulations, and billing processes eg, Medicare, Medicaid/Medi-Cal, Social Security Disability, Champ VA, Supplemental Security Income Disability, etc., managed care contracts and… more
- UCLA Health (Los Angeles, CA)
- …this role, you will: * Oversee delegated entities and ensure compliance * Manage claims processing and formulary utilization * Analyze drug utilization trends to ... identify cost-saving opportunities * Coordinate member communications * Collaborate closely with delegated medical groups * Lead initiatives to improve medication adherence and STAR ratings * Ensure timely and accurate Medicare reporting * Support the… more
- ManpowerGroup (Cypress, CA)
- …pm** **What's the Job?** + Accurately input and maintain payer data to support claims processing and billing accuracy. + Review and validate payer contracts, ... rate tables, and related documentation for completeness. + Maintain contract records in internal systems including Salesforce + Support EHR and provider onboarding by ensuring payer configurations are correctly mapped. + Collaborate cross-functionally with… more
- CenterWell (Sacramento, CA)
- …+ Support new business implementations with a goal of ensuring all pharmacy claims are processing appropriately + Drive project development and support project ... management for all product improvement initiatives + Create monthly business reviews and present to client + Escalate issues for immediate review and action whenever necessary + Request, review and approve data used for prioritization purposes + Analyze data… more
- Highmark Health (Sacramento, CA)
- …analytical and communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong ... education/training background in coding and reimbursement **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain… more
- Grant Thornton (San Jose, CA)
- …related to revenue cycle optimization, including patient access, revenue integrity, coding, claims processing , billing, and reimbursement, with a focus on ... enhancing financial performance and operational efficiency. + Strong understanding of key healthcare regulations and initiatives, and the ability to evaluate organizational compliance with regulatory bodies such as the Office of Inspector General (OIG) and the… more
- Public Consulting Group (Sacramento, CA)
- …+ Third Party Administrator Services + Enhance Health and Public Safety Services + Claims Processing Services and Solutions + Consulting and Advisory Services + ... Cost Allocation Plans and Time Studies + Cost Settlement and Supplemental Payment Strategies + Healthcare Access and Markets **Duties and Responsibilities** + Responsible for helping program recipients, family members, and caretakers navigate healthcare… more
- Dignity Health (Rancho Cordova, CA)
- …codes to individual patient health information records for data retrieval analysis and claims processing . This position is expected to perform duties in ... alignment with the mission and policies within the Dignity Health organization TJC CMS and other regulatory agencies. **Principle Duties and Accountabilities:** + Assign codes for diagnoses treatments and procedures according to the appropriate classification… more
- Sunnyside Nursing and Post-Acute Care (Torrance, CA)
- …procedural codes to individual patient information for data retrieval analysis and claims processing . Queries physicians and/or oversees the query process when ... code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. Abides by the standards of ethical coding as set forth by the American Health Information Management Association and adheres to… more