- Sharp HealthCare (La Mesa, CA)
- …ensures that all claims submitted comply with rules and regulations governing Medicare and Medi - Cal billing . The Manager determines appropriate staffing ... account activities from admission notification through creation of final billing product. The Manager is accountable for...education regarding the rules and regulations governing Medicare and Medi - Cal patient registration and billing .… more
- Sutherland Global Services (Torrance, CA)
- …will have: + Minimum 3 - 5 years strong experience with California Medicaid ( Medi - Cal ) In-patient billing and collection guidelines + Experience in ... accountable, dynamic & people person to join us as an Associate Manager to oversee customer deliverables, process maintenance & improvement, and people management… more
- Guidehouse (Gardena, CA)
- …**:** None **What You Will Do** **:** The **Insurance Patient Account Representative - Medi - Cal / HMO Emphasis** is an extension of a client's business office ... **_Questions regarding this position, you may contact Chris Rivera ( Manager , Talent Acquisition) at ###_** **Essential Job Functions** +..., Talent Acquisition) at ###_** **Essential Job Functions** + Medi - Cal & HMO Claims + Account Review… more
- System One (Los Angeles, CA)
- …subcontracted 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 ... Health- Substance Abuse Prevention and Control (SAPC). The Drug Medi - Cal Manager will also collaborate...Management treatment. Essential Functions + Oversight of invoicing and billing for DMC, CM-RI, FDDC, and RBH + Supervise… more
- City and County of San Francisco (San Francisco, CA)
- …and implements billing regulations and provider updates related to Medicare and Medi - Cal . The 1664 Patients Accounts Manager also performs other related ... processing, and/or collecting healthcare service reimbursements or medical claims from Medi - Cal (Medicaid), Medicare, insurance, third party payors, and… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …for the collection of outstanding balances from all Commercial HMO PPO Medi - Cal & Managed Care payors professional claims. Responsible for identifying ... JOB SUMMARY: Under the direction of the Supervisor Professional Billing & Coding follows Federal State & local regulatory...remain open from the "date posted" until the hiring manager has determined there is a sufficient applicant pool… more
- Scripps Health (San Diego, CA)
- …and revenue coding with an ability to interpret and apply Medicare and Medi - Cal and other third-party payor billing regulations. Demonstrates exceptional ... and monitor CDM changes. Provides other support to the Manager Chargmaster as needed. CDM responsibilities include but are...to all applicable departments. * Reviewing all Medicare and Medi Cal newletters updates performs periodic review… more
- Nevada County (Grass Valley, CA)
- …Your experience in understanding the complicated web of Mental Health Services Act, Medicare, Medi - Cal , Drug Medi - Cal Organized Delivery Systems, and ... and certify all network and organizational providers for compliance with state/federal Medi - Cal and DMC-ODS requirements and process all required filings for… more
- Sharp HealthCare (San Diego, CA)
- …system experience. **Essential Functions** + **QUALITY** Assures compliance with all Medicare and Medi - Cal billing regulations by reviewing bulletins and ... direction of the Vice President Hospital Revenue Cycle, the ** Manager , Revenue Cycle A/R Management** is responsible for all...billings are in compliance with Payer Contract, Medicare and Medi - Cal billing regulations. No facility… more
- Stanford Health Care (Palo Alto, CA)
- …on government guidelines; updates staff and outside departments on Medi - Cal /Medicare regulations. **Education Qualifications** + Bachelor's degree from ... payors. Identifies issues, monitors performance, and assists in problem resolution. PFS Manager acts as a liaison between vendors and hospital departments. This… more
- Robert Half Office Team (Torrance, CA)
- …attendance agreements with caregivers and clients, fostering informed decision-making. + Verify Medi - Cal eligibility and assist clients in enrolling in benefits. ... Description The Bilingual Spanish Case Manager is responsible for delivering exceptional customer service...service, case management, or related field. + Knowledge of Medi - Cal and other public assistance programs. +… more
- Stanford Health Care (Palo Alto, CA)
- …knowledge of pre-authorizations and reimbursement regulations pertaining to Medicare, Medi - Cal , and children's health programs with previous experience ... Industry Knowledge: + Strong knowledge of eligibility and enrollment requirements for Medicare, Medi - Cal , Workers' Comp, Managed Care (HMO, PPO, POS, etc. ),… more
- UCLA Health (Santa Monica, CA)
- … will manage a panel of clients and report progress regularly to contracted Medi - Cal Managed Care Plans (MCPs) and complete documentation as required by the ... Description The Homeless Healthcare Collaborative Case Manager functions as a part of the street...MCPs for coordination and billing purposes. Salary Range: $60100.00 - $123900.00 Annually Qualifications… more
- LA Care Health Plan (Los Angeles, CA)
- …and Adjustments, Share of Cost, MOU; Membership - Enrollment, Medicare, Medi - Cal , Covered California, Dual eligibility, retro-active membership; Varied ... Enterprise Shared Services Program Manager II (Limited Duration- 12 months)) Job Category:...API Experience working on: Claims - Intake, adjudication, premium billing , capitation and FFS check runs, batch jobs, accumulators,… more
- Sutter Health (Sacramento, CA)
- …working knowledge of federal and state reimbursement program requirements (eg, Medicare and Medi - Cal ) and federal and state fraud and abuse, anti-kickback, and ... and quality standards. * Understanding of healthcare operations, revenue cycle, billing , coding, and healthcare it environments. * Written and verbal communication… more
- Robert Half Office Team (Emeryville, CA)
- …knowledge of Worker's Compensation appeals and collections, A+ Knowledge of Medicare and Medi - Cal HMO Regulations and Billing Guidelines High school diploma ... status aging report. If no response, present account for collections/lien to the Billing Manager for collection decision. . Work with the Billing Manager… more
- John George Psychiatric Pavilion (Oakland, CA)
- …related to annual CPT updates, quarterly HCPCS updates, payor specific updates (eg Medi - Cal , CPSP, etc.) 3. Processes CDM change requests and coordinates with ... Alameda Health System. Determines the CPT/HCPCS codes, revenue center codes and billing information to support accurate and correlated to each payer. Accountable for… more
- Dignity Health (Sacramento, CA)
- …to ensure claims are populated with correct/proper coding based on Medicare and Medi - Cal billing guidelines. Responsible for updating CDM dictionary. ... the Human Trafficking Medical Home. **Responsibilities** The incumbent is knowledgeable in billing procedures with a variety of payer sources. Has knowledge in the… more
- Sharp HealthCare (San Diego, CA)
- …coverage through MCA for SRS/SCMG and MPV (or Portal) for potential Medicare or Medi - Cal .Use Coordination of Benefits (COB) standards to prioritize billing ... registration/ billing activities including Joint Commission, Title XXII, Medicare and Medi - Cal regulations. + Knowledge of ICD-10, CPT, and/or RVS coding.… more
- Robert Half Accountemps (Long Beach, CA)
- …denials and rejections. The Medical Collections Specialist must be well versed with Medi - Cal , HMO, PPO and Government insurance. The right person for this ... to resolve outstanding claims issues. - Report any identified billing issues that result in non-collection to the ...billing issues that result in non-collection to the manager . - Identity common denial errors. - Behavioral Health… more