- 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
- Molina Healthcare (Riverside, CA)
- …contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie physician, group and hospital contracting, ... etc. * Working experience with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business,… more
- CVS Health (Sacramento, CA)
- …contracting, provider issues/resolutions, related systems and information contained + Provide guidance and share expertise to others on the team + Understanding ... Health Systems/Hospitals, large PCP groups, pediatricians, advanced specialist groups, hospital based providers, ancillary providers, ambulatory surgical centers, behavioral… more
- Scripps Health (San Diego, CA)
- …billing and reimbursement procedures and practices. * Working knowledge of hospital UB04, CPT-4, HCPCS, ICD-10 and Revenue codes. * Proficient in institutional ... the Scripps Health team and work alongside passionate caregivers and provide patient-centered healthcare. Receive endless appreciation while you build a rewarding… more
- Guidehouse (El Segundo, 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
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Assistant General Counsel - Hospital Operations must be a transactional/regulatory attorney ... both the corporate and local levels across the health system. This attorney will provide daily counsel on a range of operational issues. This attorney will prepare a… more
- Prime Healthcare (Ontario, CA)
- …preparing and completing entire Medicare and Medicaid cost reports for a multi-state hospital system and provide the support at audit + Knowledge of Medicare ... government reports and support their audits. The Corporate Senior Government Reimbursement Specialist is responsible for preparing and understanding the complexity… more
- TEKsystems (Covina, CA)
- …We are seeking a detail-oriented and experienced Medical Collector to join our hospital 's revenue cycle team. The ideal candidate will have a strong background in ... Medi-Cal and managed care collections, with a deep understanding of hospital billing practices and payer requirements. This role is critical in ensuring timely and… more
- LA Care Health Plan (Los Angeles, CA)
- …Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's ... the right place at the right time. Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income… more
- Sharp HealthCare (San Diego, CA)
- …Association (AHIMA); HS Diploma or Equivalent; Certified Procedural Coder - Hospital (CPC-H) - American Academy of Professional Coders (AAPC); Registered Health ... and APC's) as mandated. Uses the most accurate codes for reimbursement purposes, research, epidemiology, statistical analysis outcomes, HCAL data financial and… more
- Stanford Health Care (Palo Alto, CA)
- …planning, leadership, and operations support for Health Information Management, Hospital and Professional Coding Services, Charge Capture procedures, Revenue ... revenue capture and clinical documentation is effective in optimizing all Technical ( hospital ) and Professional revenue and quality measures outcomes. Acts a liaison… more
- Abbott (Pleasanton, CA)
- …high employer contribution + Tuition reimbursement , the Freedom 2 Save ... types: Health Plans, Managed Care Organizations, Employer Groups, managed Medicaid , FFS Medicaid and Medicare plans within...+ Demand driving and pull through with HCP sales, Hospital sales, Gov't sales as well as at the… more
- Sutter Health (San Francisco, CA)
- …of care, and observation status. + Some awareness of healthcare reimbursement systems: Health Maintenance Organization (HMO), Preferred Provider Organization ... **Position Overview:** The Physician Advisor (PA) is a key member of the hospital 's leadership team charged with meeting the organization's goals and objectives for… more
- Cardinal Health (Sacramento, CA)
- …understands the trends that affect current and future healthcare business models and reimbursement to make short and long term strategies. Will serve as an executive ... implements managed care contracting strategy including implementation of value-based reimbursement initiatives. Responsible for maintaining reimbursement strategy… more
- LA Care Health Plan (Los Angeles, CA)
- …Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's ... the right time. Mission: LA Care's mission is to provide access to quality health care for Los Angeles...Review, approve and suggest revisions on policies and procedures, member/ provider materials, compliance work plans, etc., as well as… more
- Humana (Sacramento, CA)
- …to quality review the inpatient hospital claims for proper reimbursement , handle provider disputes in a result-oriented and metrics-driven environment. ... Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development & continued education. **Use your skills to… more
- Dignity Health (Bakersfield, CA)
- …health; and ensuring efficient resource utilization, quality outcomes, and optimized reimbursement . The position requires the ability to understand and develop ... management, and/or social services. Must have a working knowledge of hospital and/or post-acute care operations, medical/nursing staff procedures, hospital … more
- Abbott (Alameda, CA)
- …high employer contribution + Tuition reimbursement , the Freedom 2 Save ... all ADC brands and customer channels, including Managed Care, Medicaid , Medicare, Retail, and Point of Care (POC). The...Develop list and net pricing recommendations in Pharmacy, DME, Hospital , POC and other channels + Prepare and present… more
- Sanofi Group (San Jose, CA)
- …+ Maintain extensive knowledge of the Managed Care, GPOs, Specialty Pharmacy, State Medicaid and Veterans Affairs selling and reimbursement environment for their ... the promotion of Belumosudil in their assigned geography. The IHM will provide on-label product information to designated key opinion leaders, health care… more