- PIH Health (Whittier, CA)
- …of appropriate contractual adjustments, write-offs, credit balances, and correspondence from various Medi -Cal and or Managed Care HMO Plans. Review of Medi -Cal ... specific Managed Care HMO Contracts and or Division of Financial Responsibility (DOFRs), Medi -Cal Managed Care HMO Contracted PPG, and PHP Matrixes to submit bill… more
- WELLSPACE HEALTH (Sacramento, CA)
- …Health Centers (FQHC), Certified Community Behavioral Health Center (CCBHC), Drug Medi -Cal and Specialty Mental Health programs, California's second largest 988 ... Suicide and Crisis Lifeline Center, an independent Risk Bearing Organization (WellSpace Nexus), and more into a seamless confluence of care. To ensure the highest quality of care, WellSpace is accredited by the Joint Commission for Ambulatory Care, Behavioral… more
- County of El Dorado, CA (Placerville, CA)
- …schedule and telecommuting. The ideal candidate will have knowledge of Medi -Cal Specialty Mental Health guidelines as well as experience conducting mental ... the ASAM Criteria and documenting in accordance with Drug Medi -Cal standards is highly desirable. The County of El...will vary. The ideal candidate will have knowledge of Medi -Cal Specialty Mental Health guidelines and experience conducting mental… more
- Kern Medical (Bakersfield, CA)
- …resources and websites to explore and assess eligibility; initiates referrals for Medi -Cal, CMS, CCS, and KMCHP; administers KMC Financial Assistance Policy and ... of: State and federal government funding programs such as Medicare, Medi -Cal, CCS, TRICARE/CHAMPUS, Workers' Compensation; and commercial insurance payers; billing… more
- SUNSHINE ENTERPRISE USA LLC (Orange, CA)
- …one year of relevant experience in dealing with grievance guidelines or Medi -Cal/Medicaid or Medicare programs Job Type: Contract Duration: 6 months Position ... required. 1 year of experience in appeal and grievance guidelines or Medi -Cal/Medicaid or Medicare programs required. An equivalent combination of education and… more
- UHS (Madera, CA)
- …experience in a hospital business office is preferred. Experience with Medicare, Medi -Cal, and all other major payors, computers, and business software programs ... and secondary payers. Prepare and submit all Treatment Authorization Request for Medi -Cal/County pay. Contact all payers at a 30-day interval after billing to… more
- GATEWAYS HOSPITAL & MENTAL HEALTH CENTER (Los Angeles, CA)
- …assist patients with applications and maintenance of public benefits (eg, Medi -Cal, Minor Consent Program, General Relief, and County-funded programs). Support ... treatment, mental health care, and social service systems. Familiarity with Medi -Cal and other public benefit programs. Experience working with vulnerable… more
- California Job Shop (Berkeley, CA)
- …assessments as well as gain hours towards licensure if needed. Assisting at-risk Medi -Cal recipients or potential eligibles to understand the need for MH services. ... Actively encouraging and engaging reluctant and difficult Medi -Cal recipients/potential eligibles to accept needed MH and healthcare services. Operate a motor… more
- Placer County California (Auburn, CA)
- …such as foster care nursing, HCPCFC, Wraparound, MHBG, Mobile Crisis, Foster Care, Medi -Caid, etc. is also required. The candidate will directly participate in the ... to or during the interview process. Applicants for positions with access to Medi -Cal billing software or who are licensed providers must clear the Federal Exclusion… more
- Mood Health (Huntington Beach, CA)
- …supportive work environment for our therapists and psychiatrists. We accept Medicaid, Medi -Cal, Medicare, and Commercial insurance, allowing us to serve a diverse ... and identities. Accessible mental health care: We provide quality services to Medi -Cal & Commercial clients without additional paperwork or administrative tasks for… more
- Commonspirit Health (Northridge, CA)
- …required. Knowledgeable in managed care group workers? compensation, Medicare Medi -Cal admission requirements. Strong ability to interpret contractual guidelines. ... Mathematical aptitude. Bilingual preferred (Spanish/English). Must maintain current Fire Safety cards. This position is represented by SEIU-UHW and is covered by the terms and conditions of the applicable collective bargaining agreement. more
- Institute on Aging (Yolo, CA)
- …and monitors appropriate community services based a good knowledge of Medicare, Medi -Cal, and other entitlement programs. Establishes and maintains a care management ... relationship with clients and their significant others as appropriate, offering respect, dignity and support. Provides crisis intervention, advocacy, problem solving and therapeutic interventions. Meets with clients at least monthly, and more often as… more
- The Oncology Institute of Hope and Innovation (Cerritos, CA)
- …CPT and ICD10 Knowledge Medical Terminology Insurance knowledge; PPO, HMO, Medi -Cal, Medicare, Workers Compensation The estimate displayed represents the typical ... wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. Pay Transparency for hourly teammates… more
- Kaiser Permanente (Panorama City, CA)
- …knowledge of regulatory requirements and accreditation standards (TJC, Medicare, Medi -Cal, etc.). Demonstrated ability to utilize written and verbal communication, ... interpersonal, critical thinking and problem-solving skills. Demonstrated ability in planning, organizing, conflict resolution and negotiating skills. Computer literacy skills required. Preferred Qualifications: Bachelors degree in nursing or healthcare… more
- UnitedHealth Group (Sacramento, CA)
- …SalesForce SmartSheet experience Capitation experience Knowledge of Medicare and Medi -Cal reimbursement methodologies Familiarity with fee for Service Model *All ... employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we… more
- Artech LLC (San Diego, CA)
- …Diego, CA (Remote) Introduction This role exists to support our client's Medi -Cal expansion by providing excellent customer service and case resolution. Required ... Skills & Qualifications Ability to work directly for the company on a W2 basis Call Center experience Customer service experience EPIC experience Experience in appeals handling High School Diploma Preferred Skills & Qualifications Experience in healthcare or… more
- SAC Health (San Bernardino, CA)
- …preferred. Working knowledge of insurance verification/eligibility insurance programs (ex: Medi -cal, MediCare and sliding fee programs) preferred. Experience with ... electronic health records, familiarity with EPIC preferred. Essential Technical/Motor Skills: Must be proficient in MS Office Suite (Word, Excel, PowerPoint, Outlook). Must be able to use widely support internet browsers. Must have the ability to use… more
- Blue Shield of California (Rancho Cordova, CA)
- …technical, cultural and process changes necessary for the Medicare, Commercial and Medi -Cal lines of businesses (LOBs). In collaboration with our medical directors, ... you will follow up / report results to the appropriate committees for further resolution. You will work with a clinical team comprised of Registered Nurses (RNs), physicians and administrative staff to ensure operational compliance with timeliness and… more
- UMass Memorial Health (Worcester, MA)
- …experience. Software used: Word processing, spreadsheet, presentation graphics, database, Medi -Tech, IDX, Lynx, etc. Unless certification, licensure or registration ... is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements. All qualified applicants will receive consideration for… more
- PACS (Florissant, MO)
- …acceptable. Two (2) year clinical nursing experience preferred. Knowledge of Medicare, Medi cal and Medicaid programs and benefits. PCC Knowledge Language Skills ... Ability to read technical procedures. Ability to read and comprehend policy and procedure manuals. Ability to effectively present information and respond to questions from managers and employees. Mathematical Skills Ability to apply concepts such as fractions,… more
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