- Careers Integrated Resources Inc (Costa Mesa, CA)
- …within assigned work queues. . Obtains the maximum amount of reimbursement by evaluating claims at the contract rate with the use of the contract management tool for ... . Reports new/unknown billing edits to direct supervisor for review and resolution. . Has a strong understanding of...Medicare, Medi-Cal, Tricare, etc.) and how these payors process claims . . Demonstrates knowledge of and effectively uses patient… more
- LA Care Health Plan (Los Angeles, CA)
- Claims Quality Auditor II Job... regulations and company policies. Responsible for High Dollar Claim review of 125K, current knowledge of First ... net required to achieve that purpose. Job Summary The Claims Quality Auditor II works...on complex claims problems. Duties Performs high quality review of payable and post payment… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the largest… more
- SCI Shared Resources, LLC (Whittier, CA)
- …explore alternatives, and troubleshoot situations. Elevates problems up to the Account Claims Specialist II when unable to resolve. Process funeral insurance ... Works under the close direction of the Senior Specialist II . **Essential Job Functions:** Must be able to perform... claims and assist with third party insurance claims timely. + Submit total casket protection claim… more
- LA Care Health Plan (Los Angeles, CA)
- …Physician Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims medical review . Monitors and oversees the collection and ... productive workplace environment. Perform prospective, concurrent, post-service and retrospective claim medical review processes. Utilizing considerable clinical… more
- LA Care Health Plan (Los Angeles, CA)
- …member and provider complaint and appeals issues, including eligibility, access to care, claims , benefit, and quality of care concerns. Experience working with ... Customer Solution Center Appeals and Grievances Specialist II (ALD) Job Category: Customer Service Department: CSC...Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and… more
- LA Care Health Plan (Los Angeles, CA)
- …Manager II Job Category: Administrative, HR, Business Professionals Department: Claims Data and Support Services Location: Los Angeles, CA, US, 90017 Position ... Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and...purpose. Job Summary The Enterprise Shared Services Program Manager II is responsible for leading and managing a portfolio… more
- The County of Los Angeles (Los Angeles, CA)
- AGRICULTURAL/WEIGHTS & MEASURES INSPECTOR II (CANINE UNIT) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4373953) Apply AGRICULTURAL/WEIGHTS ... & MEASURES INSPECTOR II (CANINE UNIT) Salary $64,152.00 - $86,441.52 Annually Location Los Angeles County, CA Job Type Full time Job Number V0009F Department… more
- LA Care Health Plan (Los Angeles, CA)
- …Fair Hearing cases as assigned. Prepares resolved complaint files for CMS external review organization - Quality Improvement Organization (QIO) or Independent ... Customer Solution Center Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances...Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and… more
- The County of Los Angeles (Los Angeles, CA)
- PUBLIC HEALTH MICROBIOLOGIST II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4163716) Apply PUBLIC HEALTH MICROBIOLOGIST II Salary ... a regular station. Their particular organizational role requires Public Health Microbiologists II to assist supervision in the identification and tryout of new… more
- LA Care Health Plan (Los Angeles, CA)
- …Physician Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims medical review . Monitors and oversees the collection and ... Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location:...Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and… more
- LA Care Health Plan (Los Angeles, CA)
- …Duals program administration including stars, quality , financial performance review , operational functions ( claims , enrollment, readiness). Preferred: Direct ... Medi-Cal Product Solutions Manager II Job Category: Sales & Marketing Department: Medi-Cal...Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and… more
- Emanate Health (Covina, CA)
- … claim follow-up, accurate payment and adjustment reconciliation, correspondence review within departmental standards. Provide training support to individuals as ... keep well in body, mind and spirit by providing quality health care services in a safe, compassionate environment....to experience excellence in all we do through the quality of our services, our teamwork, and our commitment… more
- The County of Los Angeles (Los Angeles, CA)
- …Two years of full-time experience at the level of an Agricultural/Weights & Measures Inspector II in the service of the County of Los Angeles . Experience at the ... level of an Agricultural/Weights & Measures Inspector II is defined as an inspector that performs inspections and investigations to enforce Federal, State and local… more
- The County of Los Angeles (Los Angeles, CA)
- …will be accepted starting January 25, 2021 at 8:00 am (PT). The first review of applications will take place onFebruary 8, 2021. The exam will remain open ... Coping with Uncertainty + Responsibility + Working to High Quality Standards + Willingness to Learn + Maintaining Good...multiple choice test in order to proceed to Part II - writing assessment. MULTIPLE CHOICE TESTS ARE NOT… more
- The County of Los Angeles (Los Angeles, CA)
- …APPLICATIONS WILL BE ACCEPTED STARTING OCTOBER 28, 2020 AT 8:00 AM The first review of applications will take place onNovember 6, 2020. This examination will remain ... Coping with Uncertainty + Responsibility + Working to High Quality Standards + Willingness to Learn + Maintaining Good...multiple choice test in order to proceed to Part II - writing assessment. MULTIPLE CHOICE TESTS ARE NOT… more
- The County of Los Angeles (Los Angeles, CA)
- …of the Environmental Impact Reports in compliance with the California Environmental Quality Act (CEQA). Explains County and State environmental regulations to the ... Planning from an accredited four-year college or university. Option II : A bachelor's degree * from an accredited four-year...you prepare for the test, we advise you to review all related materials that you deem necessary. +… more
- The County of Los Angeles (Los Angeles, CA)
- …Federal and State Legislative Agendas by working with County departments to review existing agendas and to submit recommendations for changes to existing, new, ... Coping with Uncertainty + Responsibility + Working to High Quality Standards + Willingness to Learn + Maintaining Good...in Part I in order to proceed to Part II - writing assessment. MULTIPLE-CHOICE AND/OR SIMULATION ASSESSMENT(S) ARE… more
- Veterans Affairs, Veterans Health Administration (Long Beach, CA)
- …by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities Position duties for a body radiologist ... needed for specific clinical indications. Provides oversight of technical image quality with feedback to technologists. Provides education and supervision of… more
- Emanate Health (Covina, CA)
- … claim follow-up, accurate payment and adjustment reconciliation, correspondence review within departmental standards. Pull Productivity reporting for all Patient ... on master spreadsheet. Assist with monthly audits for Patient Account Representative II , address and resolve account escalations, provide training support to new… more
