- Stanford Health Care (Palo Alto, CA)
- …and state regulations and guidelines, CMS (Centers for Medicare and Medicaid Services) and OIG (Office of Inspector General) compliance standards. **Locations** ... need to need to be removed from an account + Conducts audits for Medicare/ Medicaid Cost Outlier accounts prior to billing, ensuring itemized bill is accurate. +… more
- 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
- J&J Family of Companies (Santa Ana, CA)
- …. Account Management and/or Reimbursement experience working in the hospital and/or provider office setting, building strong customer relationship. . ... to payer approval processes and business acumen. . Understanding of Medicare, Medicaid , and private payer initiatives affecting reimbursement of pharmaceutical… more
- J&J Family of Companies (San Bernardino, CA)
- …+ Account Management and/or Reimbursement experience working in the hospital and/or provider office setting, building strong customer relationship. + ... to payer approval processes and business acumen. + Understanding of Medicare, Medicaid , and private payer initiatives affecting reimbursement of pharmaceutical… more
- Guidehouse (San Marcos, 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
- Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
- …Demonstrate a working knowledge of Medical Necessity and regulatory standards (Medicare, Medicaid and Manage Care) + Training: Provide staff in-service training ... ABOUT US: Formerly Aurora Santa Rosa Hospital , SRBHH was opened in 2016 and is...both inpatient and outpatient services. Proactively monitor and optimize reimbursement for external reviewers/third party payers. The Utilization Review… more
- UCLA Health (Los Angeles, CA)
- …thorough and strategic account reviews, lead efforts to resolve reimbursement discrepancies with third-party payers, and implement proactive follow-up strategies ... knowledge of medical billing processes, including familiarity with Medicare and Medicaid regulations + Advanced proficiency in analytical tools and software, with… more
- Sharp HealthCare (San Diego, CA)
- …follow-up. + Working knowledge of State and Federal programs to ensure reimbursement from Medicare, Medi-Cal, CCS programs, out-of-state Medicaid , or other ... a key member of the transplant program and must provide up to date and accurate input on patient...or Equivalent + 5 Years Experience in medical billing ( hospital and/or professional), processing financial transactions and/or finance related… more
- CommonSpirit Health (Rancho Cordova, CA)
- …including an understanding of national standards for fee-for-service and value-based provider reimbursement methodologies. + Experience in contributing to ... between CommonSpirit Health providers and payers. Recommends strategies for maximizing reimbursement and market share. Develops new managed care products with… more
- Humana (Sacramento, CA)
- …- 5 years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts. + Proficiency in analyzing, understanding ... part of our caring community and help us put health first** The Provider Contracting Professional 2 initiates, negotiates, and executes dental provider contracts… more
- Abbott (Livermore, CA)
- …management in one (or multiple) of the following fields: DME, IDTF, hospital administration, Medicare, Medicaid , commercial payors + Experience leading ... savings plan with high employer contribution . + Tuition reimbursement , the Freedom 2 Save (https://www.abbott.com/corpnewsroom/strategy-and-strength/tackling-student-debt-for-our-employees.html) student debt program… more
- University of Southern California (Alhambra, CA)
- … billing, medical records, charge audit environment, CDM maintenance, Medicare/ Medicaid reimbursement , managed care contractual arrangements, and patient ... with inpatient and outpatient billing requirements (UB-04) and CMS Medicare reimbursement methodology. + Req Knowledge of other government and third-party payer… more
- LA Care Health Plan (Los Angeles, CA)
- …agreements, applicable laws & regulations, policies, and industry standards which provide medical, hospital , vision, dental, behavioral health, transportation ... 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… more
- University of Southern California (Los Angeles, CA)
- …(ie heart, lung, liver, kidney, pancreas, etc.) for commercial, Medicare, hospital -based, provider -based inpatient and outpatient transplant accounts to support ... reports, presentations, summaries and being able to articulate and provide expert synthesis of findings. + 6. Responsible for...(eg kidney-paired donation) and be the intermediary for Keck hospital and USC care with outside recipient and donor… 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
- Sutter Health (Oakland, 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
- Sutter Health (Oakland, 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
- Sutter Health (San Francisco, CA)
- …+ Identify areas of improvement and communicate improvement strategies to hospital leadership. + Ability to provide leadership including innovation, ... potential impact on data quality for prospective payments, utilization, and reimbursement . Knowledge of ICD-10 desirable. + Strong Organization and Quantitative… more
- UCLA Health (Los Angeles, CA)
- …follow-up + Working knowledge of State and Federal programs to ensure reimbursement from Medicare, Medi-Cal, CCS programs, out-of-state Medicaid , or other ... will: + Perform all admission functions including in-house financial management + Provide leadership within his/her functional area + Verify accurate demographic 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
