Hybrid Contact Center Manager, Pharmacy Alignment HealthcareHybrid Contact Center Manager, PharmacyOrange, CaliforniaThis role ensures operational efficiency, supports the MAPD Pharmacy department’s goals related to medication adherence and pharmacy quality, and collaborates cross-functionally to enhance member experience and outcomes. Responsibilities include recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and performance management.
Manager, Pharmacy Technicians - Hybrid - You must live in Orange, CA Alignment Healthcare IncManager, Pharmacy Technicians - Hybrid - You must live in Orange, CAOrange, CA$58,531–$87,797 / yearThis role ensures operational efficiency, supports the MAPD Pharmacy department's goals related to medication adherence and pharmacy quality, and collaborates cross-functionally to enhance member experience and outcomes. Job Responsibilities: Supervise Pharmacy Technician Leads and pharmacy technicians to ensure timely and accurate completion of work supporting pharmacy operations in a call center environment.
NewMgr, Plan Partnerships Pacific Dental Services IncMgr, Plan PartnershipsIrvine, CA$103,000–$133,000 / yearThe Mgr, Plan Partnership manages strategic relationships with dental and medical insurance payors to support reimbursement performance, operational efficiency, provider experience, and patient access. This role partners closely with internal teams and health plan contacts to resolve issues, support contract initiatives, and advance overall payer strategy.
NewHealthcare Revenue Cycle Billing Specialist II (SNF) Wipfli Advisory LLCHealthcare Revenue Cycle Billing Specialist II (SNF)Irvine, CaliforniaRemote$23–$30 / hourFull timeAs a Specialist II in Wipfli’s Healthcare Consulting Practice, you’ll work independently with a variety of healthcare clients, skilled nursing facilities, independent living, and assited living, delivering services such as financial and operational analysis, regulatory readiness, and strategic support. Under the direction of a Senior Consultant, the Specialist II provides business services independently for the firm's more complex clients, ensuring delivery is timely, accurate and serves the client's needs in accordance with company policies and procedures.
Medical Biller Family Health MattersMedical BillerAnaheim, CA$22–$25 / hourExperience with: o Medi -Cal PPS billing o T1015 encounter billing o Managed care wrap payments o Medicare FQHC billing o Safety -net population billing (preferred) Knowledge & Skills • Strong understanding of: o HRSA FQHC billing guidelines o PPS methodology o CPT, ICD -10, HCPCS coding o Revenue cycle management • Experience with EHR and practice management systems. • Ensure correct use of FQHC billing codes, including: o Revenue code 0521 o T1015 (FQHC encounter code) o Appropriate CPT/HCPCS codes • Verify encounters meet billable visit criteria under HRSA and Medi -Cal guidelines.
Collector, Management Services Organization/Centralized Billing Office - CBO - Full Time 8 Hour Days (Non-Exempt) (Non-Union) University of Southern CaliforniaCollector, Management Services Organization/Centralized Billing Office - CBO - Full Time 8 Hour Days (Non-Exempt) (Non-Union)Pasadena, CaliforniaResponsible for ensuring timely filing and guidelines are met; provided quality control checks on paper and electronic claims; process tracers, denial and related correspondence; initiate appeals; compose and submit appeal letters specific challengeable denial issues consistent with the most update American Medical Association Current Procedural Terminology. System Folder Notes / Account Documentation Documents claim bill date, billed amounts, billing address, billing attachments, invoice number, expected payment, contractual amount, received payments, actual transplant date(s), type of transplant, pre and post periods for transplant days, and all pertinent billing data relevant to billing the claim.
SAP Vistex Functional Akkodis Group AG.SAP Vistex FunctionalCulver City, CA$60–$68 / hourProven experience supporting SAP S/4HANA transformation programs, collaborating with cross-functional teams, driving issue resolution, conducting UAT and cutover activities, and leading enterprise rights and royalties initiatives. Deep expertise in SAP Vistex Rights & Royalties Management, including solution design, configuration, licensing, royalty settlements, claims processing, testing, deployment, and post-go-live support.
Managed Care Compliance Specialist - Managed Care Cedars-Sinai Medical CenterManaged Care Compliance Specialist - Managed CareCalifornia, CAThe Managed Care Compliance Specialist is responsible for assisting with the implementation of the internal auditing and monitoring program within the Managed Care department by ensuring compliance with applicable rules and regulations, including but not limited to AB1455 and Medicare Claims Processing Guidelines. • Provides mentorship to various departments regarding compliance issues and implementation of new compliance requirements with respect to regulatory and contract language for Commercial, Medicare, and Medi-cal managed care.
Clinical Authorization Specialist (Hospital) - Prearrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union) University of Southern CaliforniaClinical Authorization Specialist (Hospital) - Prearrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)Los Angeles, CA$25–$39.69 / hourWhen extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations. The Clinical Authorization Specialist will take the lead in securing medical authorizations from third party payers (commercial and government) for outpatient clinic, inpatient admission, ancillary services and/or chemotherapy and other infused treatments as needed in assigned service line.
Clinical Authorization Specialist (Hospital) - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union) University of Southern CaliforniaClinical Authorization Specialist (Hospital) - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)Los Angeles, CA$25–$39.69 / hourWhen extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations. The Clinical Authorization Specialist will take the lead in securing medical authorizations from third party payers (commercial and government) for outpatient clinic, inpatient admission, ancillary services and/or chemotherapy and other infused treatments as needed in assigned service line.
Benefits Specialist | Remote Third Party CSBenefits Specialist | RemoteEastvale, CARemoteWhether you're experienced in benefits administration or looking to start a new career path, we provide the training, mentorship, and support needed to succeed. We're expanding our team and seeking motivated individuals who enjoy helping people, solving problems, and building meaningful relationships.
Lead PFS Insurance Specialist Ambry Genetics CorpLead PFS Insurance SpecialistCA$32–$33 / hourThe Lead Collector should have the ability to work any claim, regardless of aging, and must work with both commercial and government payers, review EOB's and medical policy to evaluate and submit for appeals, as well as perform in-depth research to appropriately obtain coverage for any denied claims. The Lead Collector will also develop and deliver reports to management to summarize payer and claims issues, and contribute suggestions for policy and process improvements; additionally, the Lead Collector will take point on implementing process changes within their team.
DENTAL BILLER - DENTAL Front Office - Bilingual CbDENTAL BILLER - DENTAL Front Office - BilingualRiverside, California$20–$25 / hourThey will have a proven track record of closing big treatment plans, excellent knowledge of PPO insurance, Denti-Cal billing procedures, and at least 2 years of experience in dental billing. Responsibilities: Handle all aspects of dental billing, including submitting claims, processing payments, and managing accounts receivable.
Provider Data Integrity Analyst - MSO Contracting - Full Time 8 Hour Days (Exempt) (Non-Union) University of Southern CaliforniaProvider Data Integrity Analyst - MSO Contracting - Full Time 8 Hour Days (Exempt) (Non-Union)CA$71,386–$116,865 / yearReporting to the Manager of Payor Relations and Reimbursement, the Provider Data Integrity Analyst plays a critical role in maintaining the accuracy and integrity of provider data across Keck Medicine of USC's faculty practice plans, hospitals, and affiliated clinical enterprises as it pertains to payer enrollment. The Provider Data Integrity Analyst serves as a key steward of provider data, supporting accurate claims processing, regulatory compliance, directory accuracy, and network integrity for faculty physicians, advanced practice providers, residents, fellows, and allied health professionals.
Mgr, Plan Partnerships PDS HealthMgr, Plan PartnershipsIrvine, California$103,000–$133,000 / yearFull timeOverview: The Mgr, Plan Partnership manages strategic relationships with dental and medical insurance payors to support reimbursement performance, operational efficiency, provider experience, and patient access. This role partners closely with internal teams and health plan contacts to resolve issues, support contract initiatives, and advance overall payer strategy.
Vendor and Supplier Manager IV Kaiser PermanenteVendor and Supplier Manager IVPasadena, CAServes as a consultant to stakeholders and process owners by providing consultation and trusted partnership to stakeholders and teams to drive process improvements; developing management systems to sustain process changes; developing stakeholder process improvement leadership competencies; providing training and guidance to stakeholders; and providing ongoing coaching to build a continuous improvement mindset, and build capabilities that drive results. Performs data analyses to support process improvement initiatives by identifying appropriate data analysis tools and approach to assess system or process performance; determining suitable data gathering and analysis methods (e.g., process observation, hard data, etc.); defining data requirements and obtaining customer agreements, including customer requirements as appropriate; conducting analyses and performing experimental tests; and identifying and alleviating risks through data-driven analysis.
Risk Manager MV Transportation IncRisk ManagerEl Monte, CA$97,000–$114,000 / yearThis role is exclusively assigned to the potential contract and plays a crucial role in mitigating risk exposure, supporting safe operations, and driving continuous improvement in loss prevention efforts. The Risk Manager will serve as the primary point of contact for all Agency-related risk management matters and must be available and responsive at all times via mobile phone, email, or text message.
PI Case Manager- Bilingual CASEPEER Experience Preferred Trauma Law PCPI Case Manager- Bilingual CASEPEER Experience PreferredTorrance, CAFull timeDay to day tasks include frequent client contact, medical records collection, review, and analysis, assisting clients with medical providers, appointments, liability investigations, insurance claims processing, resolving property damage and loss of use, preparing files to submit to our demand department, and providing superior client service. A fantastic and rare opportunity to be an integral part of a reputable, and rapidly growing law firm that handles significant TBI and catastrophic cases in a positive team focused environment while working along side two "superstars" in the personal injury field.
HR - HR Business Partner II CR England, Inc.HR - HR Business Partner IIRiverside, CAStrong knowledge of employment law and regulatory complianceProven ability to conduct complex investigations and document findings clearlyExcellent communication and influencing skills across all organizational levelsStrong judgment, critical thinking, and problem-solving abilityAbility to manage competing priorities in a fast-paced environmentHigh level of professionalism, confidentiality, and integrityBilingual (English/Spanish) preferred. Bachelor's degree in Human Resources, Business, or related field7+ years of progressive HR experience, including HRBP or employee relations rolesExperience in transportation, logistics, or regulated industries strongly preferred.
Technical Service Metallurgist Nucor CorporationTechnical Service MetallurgistFontana, California$89,107.20–$152,401.60Collaborate with the sales team, mill metallurgists, to develop new grades/products or processes to support customers' business and market needs. Work with technical and commercial teammates from other Nucor divisions to support customers near NCSI or in target markets.