- Elevance Health (Los Angeles, CA)
- …and adjustment experience strongly preferred. + Previous experience in high-volume operations ( claims , customer service, enrollment and billing) strongly ... **Financial Operations Recovery Process Specialist** **Hybrid 1** : This...working post-pay reviews, validation, and recovery processes in the healthcare industry strong preferred. + Experience managing multiple projects… more
- The County of Los Angeles (Los Angeles, CA)
- MANAGER, AREA CUSTODIAL OPERATIONS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/5003829) Apply MANAGER, AREA CUSTODIAL OPERATIONS ... providing outstanding care. WHAT DOES A MANAGER, AREA CUSTODIAL OPERATIONS DO: Plans and directs the work of a...Supervisor** *Institutions are defined as but not limited to healthcare facilities, schools, or gyms. **Experience at the level… more
- Genesis Healthcare (Elk Grove, CA)
- …growth in collaboration with Director of Rehab, Regional Clinical Director and Clinical Operations Area Director. 12. Assists in preparation of facility reports on a ... weekly and monthly basis. 13. Assists Clinical Operations Area Director and Director of Rehab in annual...within the Compliance Process, Standard/Code of Conduct, Federal False Claims Act and HIPAA. 21. Provides leadership and support… more
- CVS Health (Sacramento, CA)
- …sponsors' benefit requirements and facilitate the design and implementation of customized healthcare benefit plans. + Provide expert advice and guidance on benefit ... compliance impacting plan sponsors. + Collaborate with internal departments-including claims , customer service, and client management-to ensure effective issue… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …written and oral communication skills * Ideally experience in healthcare operations **QUALIFICATIONS** **Minimum Qualifications/Work Experience:** _Required:_ ... based on compliance-related issues and trends * Senior leadership experience in healthcare , risk management, claims management, insurance and/or other relevant… more
- Evolent (Sacramento, CA)
- …analyses into succinct presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based ... RVUs, bundled payments, etc. is preferred + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing… more
- Cedars-Sinai (Los Angeles, CA)
- …and payments for partners. + Address inquiries and provide support regarding claims processing and clearinghouse operations . + Implement corrective actions for ... Los Angeles. We off an outstanding benefit package that includes paid time off, great healthcare , and a 403(b). Join us! Discover why US News & World Report has… more
- LA Care Health Plan (Los Angeles, CA)
- …or claims review. Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business ... Payment Integrity Nurse Coder RN III Job Category: Clinical Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition… more
- Providence (Irvine, CA)
- …(law firm experience is a plus), including experience with general liability, healthcare -related claims , or commercial litigation. + Ability to manage multiple ... + Experience working collaboratively with cross-functional teams including risk, compliance, claims , and operations . + Superior communication skills in both… more
- Dignity Health (Bakersfield, CA)
- …and deep familiarity with the complexities of delegated services, including claims , utilization management, provider data, and network operations . Essential ... management, with 5+ years leading automation efforts in healthcare or delegated managed care settings. - Bachelors degree...or low-code tools. - Deep understanding of managed care operations and delegated functions ( claims adjudication, UM,… more