- TTS Technologies (Anaheim, CA)
- …set by the Centers for Medicare & Medicaid (CMS), commercial insurance plans, medi - cal and managed care plans. Develop regular reports and participate in ... regular meetings on the status of claims more
- Careers Integrated Resources Inc (Costa Mesa, CA)
- …Covered California (Exchange), capitation, commercial and government payors (ie Medicare, Medi - Cal , Tricare, etc.) and how these payors process claims. ... . Demonstrates knowledge of and effectively uses patient accounting systems. . Documents all calls and actions taken in the appropriate systems. . Accurately codes insurance plan codes. . Establishes a payment arrangement when patients are unable to pay in… more
- LA Care Health Plan (Los Angeles, CA)
- Medi - Cal Product Solutions Manager II Job Category: Sales & Marketing Department: Medi - Cal Product Management Location: Los Angeles, CA, US, 90017 ... (claims, enrollment, readiness). Preferred: Direct experience with duals population and requirement. Medi - Cal : Required: Experience serving Medi - Cal … more
- WelbeHealth (North Hollywood, CA)
- …High School Diploma or Equivalency * Minimum three years of relevant Medi - Cal /Medicaid enrollment experience, including share of cost, spousal impoverishment ... Experience working directly with the county DPSS submitting, managing, and appealing Medi - Cal enrollments. * Demonstrate in-depth experience with complex Medi… more
- Centene Corporation (Sacramento, CA)
- …Position Location: Remote - Los Angeles CA **Position Purpose:** The Vice President, Medi - Cal Regional Lead will be responsible for leading a geographic region ... or territory and integrating strategic planning and tactical execution across the Medi - Cal line of business in that region. This role will ensure the plan has an… more
- UCLA Health (Los Angeles, CA)
- Description The Hospital Senior Collections Representative - Medi - Cal HMO manages a specific portfolio of inpatient and outpatient claims to maximize collection ... extensive expertise in complex collections investigations and resolution. + Experience in Medi - Cal HMO Collections, highly desired + Thorough understanding of… more
- Sutherland Global Services (Torrance, CA)
- …have: + Minimum 3 - 5 years strong experience with California Medicaid ( Medi - Cal ) In-patient billing and collection guidelines + Experience in supporting Self ... Pay - Collections + Inbound and Outbound Services: Minimum of 1-2 years + Be attentive to details + Be able to work in a fast-paced environment + Have good working knowledge in MS Office applications: Access, Word, Excel, & PPT + Be able to adjust quickly and… more
- Ventura County (Ventura, CA)
- …claims appropriately for timeliness in reimbursement and billing compliance with Medi - Cal , Medicare, and general insurance reimbursement requirements. IDEAL ... complexities of payment systems, including CPT, ICD-10, and HCPCS codes for Medicare and Medi - Cal payment processing. They are adept with the Medi - Cal … more
- LA Care Health Plan (Los Angeles, CA)
- …stars, quality, financial performance review, operational functions (claims, enrollment, readiness). Medi - Cal : Required: Experience serving Medi - Cal ... model, eligibility requirements, benefits, enrollment processes, and regulatory requirements governing Medi - Cal managed care plans. Understanding of managed care… more
- Ventura County (Ventura, CA)
- …Revenue Accounting + Acts as the main contact at the agency for Medi - Cal contract providers for budgeting, rate development and financial reporting. Oversees ... and may prepare the fiscal portion of contracts for Medi - Cal providers; + Prepares state, county, department cost, revenue and other financial reports as… more
- Aston Carter (Stockton, CA)
- …patients to include charges, payments, adjustments, and any follow-up necessary for Self-Pay, Medi Cal , Medicare, and third-party payers. . Reviews patient chart ... records to determine billable services based on payer. guidelines that include Medi - Cal , Medicare, Commercial, and State Specialty Programs. . Evaluate the… more
- System One (Los Angeles, CA)
- …Program Manager Summary Under the direction of the Senior SUD Manager, the Drug Medi - Cal Program Manager is responsible for the programmatic and contract tasks ... staff to the delivery of SUD and collateral services as needed. The Drug Medi - Cal Manager will also plan, track, measure, and report on the status of SUD… more
- City and County of San Francisco (San Francisco, CA)
- …of the A&G Program Training Analyst, the program specialist will develop and conduct Medi - Cal and CalFresh training modules that will teach Federal and State ... problem. + Participates in a variety of meetings related to CalFresh and Medi - Cal eligibility determination. Act as a program liaison as needed. + Supports… more
- Sharp HealthCare (San Diego, CA)
- …notification - documentedDissemination of admission forms - CMRI letter, ADHC, Medi - Cal questionnaireSignatures: COA, CMRI letter, financial waiver, denial ... lettersMedical record numbers are not duplicatedScreen accounts and make appropriate Medi - Cal and CMS referrals to HOS workers.Screens all Medicare inpatient… more
- Ventura County (Ventura, CA)
- …+ Previous experience working with Federal (ie, Social Security) and/or State (ie, Medi - Cal ) programs or private and public health insurances; + Previous ... providing customer service in a case management setting; + Knowledge of Medi - Cal claims; + Experience conducting investigative interviews on patients and/or… more
- LA Care Health Plan (Los Angeles, CA)
- …delivering training programs and making presentations. Preferred: 2 years of Medi - Cal , Medicare or commercial product compliance. Regulatory change management ... to manage multiple priorities and projects and meet deadlines. Knowledge of Medi - Cal Managed Care principles and/or government programs. Persuasion Skills: 1.… more
- City and County of San Francisco (San Francisco, CA)
- …requirements and contractual requirements under the Mental Health Plan and the Drug Medi - Cal Organized Delivery System contracts with the Department of Health ... and Local regulations and initiatives including Mental Health Services Act (MHSA), Medi - Cal , Drug Medi - Cal Organized Delivery System (DMC-ODS), Mental… more
- County of El Dorado (Placerville, CA)
- …alternative schedule and telecommuting. The ideal candidate will have knowledge of Medi - Cal Specialty Mental Health guidelines as well as experience conducting ... Program. Experience using the ASAM Criteria and documenting in accordance with Drug Medi - Cal standards is highly desirable. The County of El Dorado is supportive… more
- Volunteers of America Southwest (San Diego, CA)
- …Care Management (ECM) program provides a whole person approach to care for Medi - Cal beneficiaries. VOASW believes in individualizing services based on need and ... choices. The Care Manager is the primary point of contact for Medi - Cal beneficiaries and directly provides care management and care coordination services. Care… more
- UCLA Health (Los Angeles, CA)
- …accurately, and in compliance with Centers of Medicare & Medicaid Services (CMS), Medi - Cal , and other policies. You'll apply your extensive knowledge of hospital ... and conducts special project reviews. + Maintain compliance with CMS, Medi - Cal , and health plan billing regulations. + Analyze complex billing/financial data.… more
