- Prime Healthcare (Ontario, CA)
- …tracking government review audits (RAC, MAC, CERT, ADR, Pre/Post Probes, QIO/Medicaid) and other payer audits as assigned. UR tech III will also function as an SME ... to support the UR tech team and remote counter parts with the specific processes as applicable. The Utilization review tech will further support the department needs for Release of Information through faxing and mailing, discharge coordination or other duties… more
- Caris Life Sciences (Sacramento, CA)
- …+ Utilize market oncology understanding and experience while discussing the healthcare payer environment and its impact on physicians and ancillary providers. + ... Billing/Reimbursement support as it relates to patients, practices and hospital customers. + Understand information technology and how it interfaces with physician office systems. Able to demo different technology solutions, ie Portal, EMR connectivity and… more
- Pfizer (Sacramento, CA)
- …* Provide key HQ colleagues, including Brand Marketing, Planning & Innovation, and Payer and Channel Access (PCA) teams, with key local and customer specific ... insights that they can then utilize in crafting new market specific materials. Professional Development * Pursue individual learning opportunities and look for ways to build, challenge, and add value in current assignments * Understand and manage own… more
- Sutter Health (Novato, CA)
- …systems, telephone consoles, document imaging, scanning, payment posting, proprietary payer websites and data quality monitoring, both accurately and efficiently. ... Possess verbal and written communication and active listening skills. Accuracy and attentiveness to detail. Decision making and problem-solving skills. Must be able to work concurrently on a variety of tasks/projects in diverse environment. Ability to meet or… more
- Dignity Health (Merced, CA)
- …guidelines to ensure progression of care. + Knowledge of managed care and payer environment preferred. + Must have critical thinking and problem-solving skills + ... Collaborate effectively with multiple stakeholders + Professional communication skills + Understand how utilization management and case management programs integrate. + Ability to work as a team player and assist other members of the team where needed. +… more
- UCLA Health (Los Angeles, CA)
- …commercial and managed care collections, highly desired + Ability to interpret payer contracts and process contractual adjustments + In-depth knowledge of UB04 ... requirements and medical billing processes + Strong analytical skills and proven proficiency in Excel and spreadsheets + Understanding of collection techniques and laws, including AB1455, the Knox-Keene Act, Health & Safety Codes, etc., Familiarity with… more
- Alameda Health System (San Leandro, CA)
- …to ensure all automation solutions adhere to healthcare regulations (HIPAA, CMS, payer guidelines). + Act as a liaison between departments, clients, IT teams, ... automation vendors, and revenue cycle leadership to facilitate smooth implementation and ongoing support. + Other duties as assigned. + Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well… more
- UCLA Health (Los Angeles, CA)
- …responsible for implementing, maintaining and developing an effective filing system for payer correspondence, as well as general errands and administrative support + ... Provide a general knowledge of overall Business Office functions Salary Range: $21.92 - $27.87/Hourly Qualifications We're seeking an exceptional, self-directed, customer-focused professional with: + Ability to push, pull, lift and carry loads up to 35 lbs +… more
- Robert Half Accountemps (Encino, CA)
- …Surgical detail-oriented fees. -Verify patient eligibility, authorization status and primary payer information via CareConnect and Insurance portals prior to claim ... submission. -Performs all data entry and charge posting functions for services as needed -Performs all third-party follow-up functions for all products and procedures. -Reviews EOBS . Make corrections as required and resubmit the claim for payments. -Performs… more
- Elevance Health (Los Angeles, CA)
- …design and execution of Value Based Payment Models strongly preferred + Prior Payer experience. For candidates working in person or virtually in the below ... location(s), the salary* range for this specific position is $116,256 to $199,296. Locations: Woodland Hills, CA; Denver, CO; District of Columbia (Washington, DC); Chicago, Il; Iselin, NJ; Hanover, MD; Mendota Heights, MN; Las Vegas, NV; New York City, NY;… more