Insurance Collections Specialist Your Behavioral HealthInsurance Collections SpecialistTorrance, CA$21–$24At YBH, we pride ourselves on being a centralized hub teeming with resources designed to aid clients and their families in pinpointing the optimal support tailored to their distinct needs and aspirations for well-being. Answering questions from patients, clerical staff and insurance companies, Compiling and tracking outstanding balances owed to our providers.
Sr Fraud, Waste and Abuse Investigator (Investigator Sr) CalOptimaSr Fraud, Waste and Abuse Investigator (Investigator Sr)Orange, CA$72,096–$115,353 / yearWe are hoping you will join us as a Sr Fraud, Waste and Abuse Investigator (Investigator Sr) and help shape the future of healthcare where you'll be an integral part of our OOC - Fraud & Waste team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet.
Medical Review Nurse II - SNF/MDS Auditor MachinifyMedical Review Nurse II - SNF/MDS AuditorCA$85,000–$100,000 / yearMust be able to independently work within Microsoft Office products including Word, Excel, PPT, to Include creating/saving documents in folders, setting up and utilizing spreadsheets, copying and pasting data from one document to another. Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country.
Medical Accounts Receivable Representative (Level Two) California Medical Business ServicesMedical Accounts Receivable Representative (Level Two)Arcadia, CaliforniaPhysical: Primary functions require sufficient physical ability and mobility to work in an office setting; to stand or sit for prolonged periods of time; to occasionally stoop, bend, kneel, crouch, reach, and twist; to lift, carry, push, and/or pull light to moderate amounts of weight; to operate office equipment requiring repetitive hand movement and fine coordination including use of a computer keyboard; to travel to other locations using various modes of private and commercial transportation; and to verbally communicate to exchange information. Huntington-Hill Imaging Center (managed by California Medical Business Services, LLC) is dedicated to improving medical practices through the use of innovative technologies, strategic partnerships, and years of industry experience.
Billing & Insurance AR Specialist OneOncology IncBilling & Insurance AR SpecialistCARemoteWe are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve. OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases.
Account Representative - USC Care MSO CBO - Full Time 8 Hour Days (Non-Exempt)(Non-Union) University of Southern CaliforniaAccount Representative - USC Care MSO CBO - Full Time 8 Hour Days (Non-Exempt)(Non-Union)CA$26–$41.28 / 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 organization encompasses 17 clinical departments, with approximately 1,500 physicians and 2,000 staff delivering care across more than 80 locations from Kern County to Orange County and into Las Vegas.
Medical Billing / Frontdesk Kohan International FoundationMedical Billing / FrontdeskCULVER CITY, CAMedical Biller/Office Administrator (Full-Time, In-Person) We are a non-profit group therapy practice seeking a skilled and dedicated Medical Biller/Office Administrator to join our team immediately! Fluency in Tagalog/Filipino is A MUST to effectively serve our diverse clientele and team but not required.
Manager, RCM Client Success Modernizing Medicine IncManager, RCM Client SuccessCAGenerous Paid Time Off and Paid Parental Leave programs, Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs, Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed, Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning, Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles, Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters. Job Description Summary: ModMed is hiring a Manager, RCM Client Success to oversee team members, including Enterprise Client Advisors, Client Advisors, and Leads, who support assigned RCM Specialties and ensure that exceptional service delivery, client satisfaction, and adherence to revenue cycle management objectives are met across assigned verticals.
Claims Manager Medicare Advantage Plan Flexible-Hybrid UCLA Health SystemClaims Manager Medicare Advantage Plan Flexible-HybridLos Angeles, CA$95,400–$208,300 / yearThe Claims Manager of the Medicare Advantage Plan will: Implement and maintain efficient and streamlined claims adjudication processes that effectively utilize technology to automate business processes and maximize the accuracy of claims payments. As a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.n.
Patient Navigator HealogicsPatient NavigatorCorona, CaliforniaLearn more about this role here: Healogics is the largest provider of advanced wound care services in the United States, treating more than 300,000 chronic wound patients annually across over 600 sites. All Healogics employees must perform their job responsibilities according to all Healogics policies, Hospital policies, as well as to accrediting organizations, federal and state regulation, and to the Centers for Medicare and Medicaid Services (CMS) guidelines, as applicable.
Patient Navigator PRN Healogics IncPatient Navigator PRNCorona, CARequired Education, Experience and Credentials: High School Diploma or General Education Development (GED); Associate's degree preferred Minimum of Two (2) or more years office administration experience, preferably in a medical setting; Prior medical coding experience preferred Preferred Knowledge, Skills and Abilities: Proficient in Microsoft Office (Word, Excel, Outlook) Good customer, interpersonal and communication skills, both orally and in writing Organization and time-management skills Ability to type 60 words per minute (wpm) Basic math skills Attention to details Ability to maintain confidentiality Ability to work in fast paced environment and to work on multiple projects at the same time Ability to work with others and in a team environment Physical Demands: Being in a stationary position for extended periods of time (4 hours or more) Viewing computer screen for extended periods of time (4 hours or more) Keying frequently on a computer for 4 hours or more Reading Communicating Detecting sounds by ear Close, distance and peripheral vision Lifting/moving items up to 75 pounds with equipment assistance Repetitive motions Bending/stooping Writing Work Environment: * Patient care environment The hourly rate for this position generally ranges between $19.69-$24.20 Learn more about this role here: Healogics is the largest provider of advanced wound care services in the United States, treating more than 300,000 chronic wound patients annually across over 600 sites.
Jr. Quality Improvement Coder Astiva HealthJr. Quality Improvement CoderOrange, CA$27–$30 / hourIn this role, the Junior QI Coder will partner with the Director to collaborate with network providers and IPA's to improve the quality of care through quality improvement activities that will include RAF, HEDIS, CMS Star Ratings and other health plan reporting. Apply official CPT/HCPCS and ICD10 coding guidelines, internal guidelines, and state specific Medicare/Medicaid coding instructions to review and analyze professionally coded services and coding queries.
SVP AI & Data ReveleerSVP AI & DataCARemote$305,000–$355,000 / yearDirect the engineering teams that extract medical codes and quality data from charts: retrospective risk extraction built on Textract OCR, Comprehend Medical, and Gemini; prospective risk extraction that runs PDF and CCDA charts through Gemini and a custom rules engine to surface candidate ICD codes; and quality and HEDIS extraction that applies large language models to chart content. The SVP, AI & Data sets technical direction and architecture, partners with engineering and product leadership on delivery, and stays close enough to the systems to make sound build decisions - while giving team leaders the autonomy to own their domains.
Medical Director - Orthopedic Surgeon - Remote from anywhere UnitedHealth Group IncMedical Director - Orthopedic Surgeon - Remote from anywhereLos Angeles, CARemote$248,500–$373,000 / yearWe are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes.
Account Follow-Up Representative I Harris Computer SystemsAccount Follow-Up Representative ILos Angeles, CARemote$18–$26 / hourTimely follow-up on hospital patient accounts that are outstanding for insurance payment, including but not limited to the following processes: verify claim payment status, rebill to patient's insurance, proration to correct financial class and notation of patient accounts with steps taken for resolution. As a wholly owned subsidiary of Constellation Software Inc. ("CSI", symbol CSU on the TSX), Harris has become the cornerstone for CSI's investment in utility, local government, school districts, public safety, and healthcare software verticals.
Patient Care Coordinator Upperline Health IncPatient Care CoordinatorCAUpperline Health providers coordinate patients' care among a team of physician specialists, nurse practitioners, care navigators, nutritionists, social workers, and pharmacists for integrated treatment that addresses patients' immediate and long-term health needs. The Patient Care Coordinator will be responsible for medical front desk receptionist duties including greeting patients in a friendly manner, and ensuring patients are accurately checked in and prepared for their appointments in a timely manner.
Claims Review Nurse NeueHealthClaims Review NurseLos Angeles, CABy uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid. Evaluate and process claims and post-service authorization requests for medical procedures, medications, and services based on clinical guidelines such as: Medicare criteria, Medicaid/Medi-Cal criteria, MCG, or Health Plan specific guidelines.
Medical Monitor, Medical Device CRO NAMSA IncMedical Monitor, Medical Device CROCAMinimum of 3 years of experience in clinical research or medical monitoring, preferably with a Contract Research Organization and multiple classes of devices across various therapeutic areas, including but not limited to cardiovascular, neurology, orthopedics, and urology. For assigned projects, maintain relationship with appropriate C-level / VP-level team member from sponsor side (this is separate from project management discussions which will be the responsibility of the NAMSA Project Manager).
Payment Specialist I El Proyecto del Barrio IncPayment Specialist ICAEmployees driving personal vehicles for El Proyecto business must provide El Proyecto proof of a valid driving license, and auto liability insurance. To receive mileage reimbursement, the employee must log their mileage and submit the mileage expense report to their Appropriate Administrator.
Payment Processing Specialist Skilled Wound CarePayment Processing SpecialistLos Angeles, CA$21–$26 / hourThe processor handles a variety of payment methods including credit cards, debit cards, checks, and electronic payments, while maintaining the highest level of patient confidentiality. The Medical Billing Payment Processor is responsible for accurately collecting, processing, and reconciling patient payments prior to and at the time of service.