- Scripps Health (San Diego, CA)
- …coding * Mailroom experience. **Job:** **Finance* **Organization:** **Scripps Health Corp* **Title:** * Director , HMO Claims Services * **Location:** ... have been with Scripps Health for over 10 years. The Director of HMO Payment ( Claims ) Services for Scripps Health Plan, leads claims payment team and… more
- Sharp HealthCare (San Diego, CA)
- …or more years of clinical practice of medicine. + 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons License - ... plan functions that interface with medical management such as provider relations, member services , benefits and claims management, IT management, etc. + Plans,… more
- Sharp HealthCare (San Diego, CA)
- …the requested service . This position is responsible for conducting retrospective claims review for services to determine the medical appropriateness of the ... etc. + Retrospective Review Coordinate, review, and process retrospective claims for medical care and services including,...at the UM Care Coordinator level of review.Appropriately identify claims for review by the Medical Director … more