- Sharp HealthCare (San Diego, CA)
- …To act as a liaison between PFS Business Office Staff and Regulatory Compliance department. Utilize the payer contract tool to report payer trends. **Required ... form submissions.Demonstrates effective customer relations by:Consistently communicate with Executives, Operations Senior Management, department members and other Sharp employees… more
- Newegg Inc. (Diamond Bar, CA)
- …Connect, CRM, WFM) to track key metrics such as ASA, AHT, SLA compliance , and agent utilization. + Analyze reason-for-contact trends and customer survey results ... with established KPIs, SLAs, and business goals across global contact center operations . Systems Administration & Support + Serve as the system administrator and… more
- UCLA Health (Los Angeles, CA)
- …You'll ensure that hospital charges are processed promptly, accurately, and in compliance with Centers of Medicare & Medicaid Services (CMS), Medi-Cal, and other ... capture processes. + Manages and conducts special project reviews. + Maintain compliance with CMS, Medi-Cal, and health plan billing regulations. + Analyze complex… more
- Banc of California (Santa Ana, CA)
- …Responsible for supporting the Warehouse Lending team, and ensuring the smooth operations of the Warehouse Lending Department. Performs a variety of clerical and ... memorandum and preliminary variable term letter + Track quarterly compliance documents; responsible for reviewing monthly seller certification and calculation… more
- Navy Federal Credit Union (San Diego, CA)
- …analytical expertise to ensure solutions align with strategic objectives, regulatory compliance , and superior member experience. The incumbent will manage product ... + Strong understanding of commercial lending processes (origination, servicing, compliance ). + Extensive experience with advanced knowledge of systems analysis… more
- US Tech Solutions (Sunnyvale, CA)
- …team with Responsible AI domain expertise and diverse backgrounds in operations , strategy, ethics, risk management, product management, and program management. ... to develop a set of prompts that will sufficiently test product compliance with standards. This may entail leveraging LLM-based prompt generation tools and/or… more
- Highmark Health (Sacramento, CA)
- …Translate moderate-to-complex business needs and business rules to define and execute operations activities for high quality solutions to meet customer and plan ... structures **Preferred** + 3 - 5 years of experience in health insurance operations , benefits operations , or other related field related is preferred + 3 - 5… more
- UCLA Health (Los Angeles, CA)
- …You will: + Analyze complex financial data + Identify trends in revenue cycle operations + Summarize data and present reports to leadership + Serve as liaison with ... units on revenue cycle systems, processes and procedures + Maintain compliance with government regulations, reimbursement issues, etc. + Analyze hospital billing… more
- Sutter Health (Sacramento, CA)
- …eligible members by reconciling payments to contracted rates and maintaining compliance with Health Plan (HP) agreements and regulatory requirements. Analyzes and ... financial terms in capitation contracts, ensuring accurate setup in collaboration with Operations and MCF.** + **Validate CMS Medicare Advantage and ACA risk scores,… more
- ASM Research, An Accenture Federal Services Company (Sacramento, CA)
- …Assurance Analysts provide QA support to monitor performance for all Military OneSource operations to meet minimum standards in the SLAs and Performance Metrics. In ... analysis of Duty to Warn, Adverse Incidents, and Mandated Reporting in compliance with defined processes and reporting standards + Monitors customer interactions for… more
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