- Prime Healthcare (Ontario, CA)
- …Responsibilities This position requires relocating to Ontario, California. TheVice President of Health Plan Operations and Claims is responsible for the ... to improve the quality and minimize process cost of Claims for all Prime Healthcare's self-insured Employee Health... Claims for all Prime Healthcare's self-insured Employee Health Plans. Through in-depth audit and review of … more
- UCLA Health (Los Angeles, CA)
- …Take your career to the next level. You can do all this and more at UCLA Health . The Claims Quality Auditor will be responsible for the daily audit of all ... + Knowledge of claims adjudication systems + Flexibility and adaptability UCLA Health is a world-renowned health system with four award-winning hospitals and… more
- LA Care Health Plan (Los Angeles, CA)
- …execution, reporting and corrective action plans monitoring of financial solvency and claims processing compliance for specialty health plans and vendors. These ... of business. The position is responsible for the Department of Managed Health Care (DMHC) claims data submissions for LA Care and its Plan Partners (PPs) and… more
- Insight Global (Burbank, CA)
- …the Health Fund. The Senior Participant Service Specialist/Analyst will process health insurance claims and answers calls from the customer (participant, ... providers, physicians, hospitals etc.) Adhere to eligibility, claims and call policies and procedures while making sound claim/call decisions. Foster strong… more
- Humana (Sacramento, CA)
- …health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex ... as a focus on collaborative business relationships, value based care, population health , or disease or care management. Medical Directors support Humana values, and… more
- Humana (Sacramento, CA)
- …health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex ... management, utilization management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation. **Preferred… more
- Humana (Sacramento, CA)
- …health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex ... a focus on collaborative business relationships, value based care, population health , or disease or care management. **Responsibilities** The Medical Director… more
- The County of Los Angeles (Los Angeles, CA)
- …our patients and our communities by providing extraordinary care. DEFINITION: Prepares reimbursement claims for health and/or mental health care provided ... HEALTH CARE FINANCIAL ANALYST/COMMUNITY PROGRAMS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4827547) Apply HEALTH CARE FINANCIAL… more
- The County of Los Angeles (Los Angeles, CA)
- …successfully pass the assessment will be considered for permanent appointment to Health Care Financial Analyst. DEFINITION: Prepares reimbursement claims for ... HEALTH CARE FINANCIAL ANALYST / EMERGENCY APPOINTMENT HOMELESSNESS...for Federal, State, and/or Special Programs to determine if claims for reimbursement conform to applicable rules and regulations… more
- Humana (Sacramento, CA)
- …first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works on ... Qualifications** + Medical utilization management experience + Working with health insurance organizations, hospitals and other healthcare providers, patient… more