• Medicaid Provider Hospital

    Humana (Sacramento, CA)
    …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
    Humana (12/02/25)
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  • Provider Contracting Executive

    Humana (Sacramento, CA)
    …The Provider Contracting Executive initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements. The Provider ... diverse scope and complexity ranging from moderate to substantial. The Provider Contracting Executive communicates contract terms, payment structures, and … more
    Humana (12/02/25)
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  • Field Reimbursement Manager (Immunology…

    J&J Family of Companies (San Bernardino, CA)
    …+ Account Management and/or Reimbursement experience working in the hospital and/or provider office setting, building strong customer relationship. + ... to payer approval processes and business acumen. + Understanding of Medicare, Medicaid , and private payer initiatives affecting reimbursement of pharmaceutical… more
    J&J Family of Companies (10/21/25)
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  • Patient Account Representative - Hospital

    Guidehouse (San Marcos, CA)
    …None **What You Will Do** **:** The **Insurance Patient Account Representative - Hospital A/R Emphasis** is an extension of a client's business office staff. ... and three days from home._** **Essential Job Functions** + Hospital Claims + Account Review + Appeals & Denials...Claims + Account Review + Appeals & Denials + Medicare/ Medicaid + Insurance Follow-up + Customer Service + Billing… more
    Guidehouse (11/16/25)
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  • Utilization Review Clinician (Santa Rosa)

    Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
    …Demonstrate a working knowledge of Medical Necessity and regulatory standards (Medicare, Medicaid and Manage Care) + Training: Provide staff in-service training ... ABOUT US: Formerly Aurora Santa Rosa Hospital , SRBHH was opened in 2016 and is...both inpatient and outpatient services. Proactively monitor and optimize reimbursement for external reviewers/third party payers. The Utilization Review… more
    Sacramento Behavioral Healthcare Hospital (12/04/25)
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  • Senior Commercial Hospital Collections…

    UCLA Health (Los Angeles, CA)
    …thorough and strategic account reviews, lead efforts to resolve reimbursement discrepancies with third-party payers, and implement proactive follow-up strategies ... knowledge of medical billing processes, including familiarity with Medicare and Medicaid regulations + Advanced proficiency in analytical tools and software, with… more
    UCLA Health (11/26/25)
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  • Transplant Financial Coordinator - Transplant…

    Sharp HealthCare (San Diego, CA)
    …follow-up. + Working knowledge of State and Federal programs to ensure reimbursement from Medicare, Medi-Cal, CCS programs, out-of-state Medicaid , or other ... a key member of the transplant program and must provide up to date and accurate input on patient...or Equivalent + 5 Years Experience in medical billing ( hospital and/or professional), processing financial transactions and/or finance related… more
    Sharp HealthCare (11/05/25)
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  • Senior Analyst Payer Analytics and Economics

    CommonSpirit Health (Rancho Cordova, CA)
    …including an understanding of national standards for fee-for-service and value-based provider reimbursement methodologies. + Experience in contributing to ... between CommonSpirit Health providers and payers. Recommends strategies for maximizing reimbursement and market share. Develops new managed care products with… more
    CommonSpirit Health (12/05/25)
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  • Sr. Manager, Payor Relations & Regulatory Affairs

    Abbott (Livermore, CA)
    …management in one (or multiple) of the following fields: DME, IDTF, hospital administration, Medicare, Medicaid , commercial payors + Experience leading ... savings plan with high employer contribution . + Tuition reimbursement , the Freedom 2 Save (https://www.abbott.com/corpnewsroom/strategy-and-strength/tackling-student-debt-for-our-employees.html) student debt program… more
    Abbott (09/20/25)
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  • Senior Revenue Integrity Specialist - Clinical Rev…

    University of Southern California (Alhambra, CA)
    … billing, medical records, charge audit environment, CDM maintenance, Medicare/ Medicaid reimbursement , managed care contractual arrangements, and patient ... with inpatient and outpatient billing requirements (UB-04) and CMS Medicare reimbursement methodology. + Req Knowledge of other government and third-party payer… more
    University of Southern California (11/19/25)
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