- CareFirst (Fairfax, VA)
- …leadership. **Knowledge, Skills and Abilities (KSAs)** + Knowledge of call center operations claims and/or enrollment and billing and workflows. + Strong ... support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations . Investigates and… more
- UCLA Health (Los Angeles, CA)
- Description As a key leader within Medicare Advantage Operations , the Senior Manager will be responsible for overseeing the strategic management and ... or Managed Care environment with responsibility for overseeing operations in appeals & grievances, claims processing,...more years of management or progressive leadership experience in Medicare or Managed Care Operations , required *… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …(Palmetto GBA) and CMS websites + Understanding of the CMS Publication: 100-4 ( Medicare Claims Processing Manual) + Ensures claim information is complete and ... limited as other tasks may be assigned. + Submit Medicare / Medicare Advantage plan claims both...deemed necessary by management , to ensure efficient department operations + Report potential or identified problems with systems… more
- LA Care Health Plan (Los Angeles, CA)
- Medicare Advantage Product Solutions Manager II Job Category: Sales & Marketing Department: Medicare Product Location: Los Angeles, CA, US, 90017 Position ... to achieve that purpose. Job Summary The Product Solutions Manager II is responsible for working within the Product...partnerships inclusive of entry onto the Covered CA market. Medicare : Required Medicare Advantage, with experience serving… more
- UCLA Health (Los Angeles, CA)
- …preferred or equivalent work experience, preferred + 5 years previous experience in claims operations specifically related to Medicare Advantage or managed ... Description We are seeking a detailed-oriented and experienced Claims Manager to join our ...familiarity with American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS) coding guidelines such as… more
- LA Care Health Plan (Los Angeles, CA)
- …Preferred Provider Groups (PPG), Specialty Health Plans (SHP) and Pharmacy Benefit Manager (PBM) including LA Care's Claims Department. This requires interaction ... Specialty Health Plans Claims Auditor III Job Category: Accounting/Finance Department: Financial...of LA Care deficient delegates. Participates in Centers for Medicare and Medicaid Services (CMS) claim audit section of… more
- Kelly Services (Columbia, SC)
- …reimbursement + Monitoring assigned Rev Cycle claim queues and utilizing Revenue Manager for claim submission, reviewing claims for corrections/denials/errors to ... **Medical Claims Processor** Kelly(R) is looking for a Medical...+ Providing assigned Medical Claim functions in Finance and Operations **This job might be an outstanding fit if… more
- The County of Los Angeles (Los Angeles, CA)
- MANAGER III, FACILITIES OPERATIONS AND CRAFTS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4855820) Apply MANAGER III, FACILITIES ... programs. Essential Job Functions Plans, assigns, coordinates, and manages, through subordinate Manager , Facilities Operations and Crafts staff, a variety of… more
- The County of Los Angeles (Los Angeles, CA)
- MANAGER II, FACILITIES OPERATIONS AND CRAFTS, ENVIRONMENTAL SERVICES Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4762503) Apply ... MANAGER II, FACILITIES OPERATIONS AND CRAFTS, ENVIRONMENTAL...quality and safety standards consistent with the Centers for Medicare and Medicaid Services requirements. Assisting in the management… more
- Hunterdon Health Care System (Flemington, NJ)
- …for supervising, planning, organizing and coordinating the daily activities of the claims processing and accounts receivables for the ambulatory claims under ... Works with Office Coordinators, Practice Managers, Regional Managers and Operations Specialist to ensure that all front desk personnel...missing information in a timely manner to the Practice Manager ; c) Trains Account Reps to assist with Patient… more
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