- Cedars-Sinai (CA)
- **Job Description** The Managed Care Compliance Specialist is responsible for assisting with the implementation of the internal auditing and monitoring ... healthcare people throughout Los Angeles and beyond. **Req ID** : 11981 **Working Title** : Managed Care Compliance Specialist - Managed Care … more
- MSC Industrial Supply Co. (Vallejo, CA)
- …: Vallejo, CA - Napa, CA- **BRIEF POSITION SUMMARY:** The- _Vendor Managed Inventory (VMI) Specialist -_ ensures customer satisfaction through solutions by ... MSC customer solutions and sales associates through execution of CARE program. + CARE is defined as...incremental solution growth. + Lead focus of 100% safety compliance for VMIS team + Repair and maintain vending… more
- LA Care Health Plan (Los Angeles, CA)
- Care Management Specialist II, D-SNP Team (12...care professionals in a hospital, medical group or managed care setting, such as a health insurance ... net required to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills...systems. Knowledge of and ability to comply with HIPAA compliance . Ability to interview, assess and coordinate care… more
- Ventura County (Ventura, CA)
- …the compliance office. Experienced in leading and training staff on Managed Care , Medicaid, Medi-Cal, Medicare, and Commercial Insurance, they ensure ... billing and supervises or conducts training on the specific areas of Managed Care /Medicaid/Medi-Cal/Medicare and/or Commercial Insurance; + Works with the… more
- LA Care Health Plan (Los Angeles, CA)
- …Preferred Bachelor's Degree Experience Required: At least 2 years of experience in Managed Care with specific experience in resolving member and provider ... Customer Solution Center Appeals and Grievances Specialist II (Temporary) Job Category: Customer Service Department:...apply regulations. At least 5 years of experience in Managed Care working with Medicare, Medi-Cal and… more
- University of Southern California (Alhambra, CA)
- …medical records, charge audit environment, CDM maintenance, Medicare/Medicaid reimbursement, managed care contractual arrangements, and patient accounting. + ... department charge processes to improve charge capture and coding compliance . The Senior RI Specialist also coordinates...+ Pref Healthcare operations experience, particularly in an acute care hospital setting. + Pref Current knowledge of the… more
- Dignity Health (Bakersfield, CA)
- …for ensuring the accuracy and quality of claims processing within a managed care service organization. This role involves auditing claims, identifying ... improve overall claims accuracy and efficiency. The Claims Quality Specialist will work closely with the Claims Research colleague...processing, quality assurance, or a related role within a managed care or healthcare environment. + Strong… more
- Dignity Health (Bakersfield, CA)
- …efforts related to claims overpayments, underpayments, and billing issues within a managed care service organization. This role involves review/ensuring accurate ... of 5 years of experience in claims research, analysis, or a related role within a managed care or healthcare environment - Proven experience in a lead role, with… more
- WestCare Foundation (Fresno, CA)
- …ensures claims are submitted accurately and timely directly to insurance carriers and Medi-Cal Managed Care Plans (MCPs) in accordance with all DHCS, payer, and ... organizational guidelines. The specialist works closely with fiscal, clinical, and data teams...Prepare, submit and track CalAIM claims directly to Medi-Cal Managed Care Plans and insurance carriers. +… more
- Teva Pharmaceuticals (Sacramento, CA)
- …and virtual environments, and be proficient with technology + Knowledge of reimbursement, managed care , or marketing preferred + New product launch experience ... NeuroPsych Sales Specialist - Sacramento W, CA Date: Nov 7,...access and outcomes for patients across all points of care , we're thoughtfully expanding our US sales teams. Sales… more