Medi-Cal Claims Quality Auditor - Associate
Blue Shield of CA
Blue Shield of CA in Rancho Cordova is seeking an Operational Quality Services Specialist, Associate who will be responsible for performing audits for the Medi-Cal line of business. This position requires a college degree or equivalent experience and relevant experience, ideally with prior auditing experience. This role allows virtual work but may require occasional office presence based on business need. Join our leadership-driven culture aimed at personal, professional, and financial growth. #J-18808-Ljbffr Blue Shield of CA
$165k - $189k
Executive Consultant/Medicaid, Medi-Cal Systems Integrator KAI... ...leading organizational change associated with large-scale technology implementations... ...benefit coordination, claims routing, payer responsibility... ...to support delivery of quality and accountability. Apply knowledge...ClaimsContract workWork at office- Your Role The Medi-Cal Operations team is responsible for ensuring claims are processed accurately and in a timely manner. The Operational Quality Services Specialist, Associate will report to the Medi-Cal Operations Senior Manager of direct manager. In this role you will...ClaimsFull timeWork at office
- ....) - Intake, Case Management, Insurance claims, Property Damage, Medical Requests, Demand... ...a plus - Experience with Medicare and Medi-Cal - Multitasking and detail-oriented -... ...preparing Demand packages. Must maintain quality customer service to clients, doctors and...Claims
- A leading claims adjusting firm in Rancho Cordova is seeking Licensed Insurance Claims Adjusters to join their team. This role offers comprehensive training programs and a chance to thrive in a rewarding career that makes a difference in people's lives after unforeseen...ClaimsFlexible hours
- ...team works collaboratively to improve the quality of patient care and ensure all... ...utilization review, and retrospective provider claims dispute reviews. The Medical Director also... ...staff and is a knowledgeable resource in Medi-Cal regulatory requirements, measurement of health...ClaimsWork at officeAfternoon shift2 days per week
$24.14 per hour
...individuals to join our team! Title: Quality Assurance Specialist Program(s) and Location... ..., and efficiency across the organization’s Medi-Cal billing programs. This role supports the revenue cycle by reviewing claims, identifying errors, monitoring billing...ClaimsFull timeWork experience placementWork at officeLocal areaMonday to FridayFlexible hours- ...Sacramento, CA. This role involves assisting various facilities with billing Medicare, Medi-Cal, and other payer types. Candidates must be results-focused, capable of managing claims, and possess strong communication skills. The position requires a high school diploma and...ClaimsFull timeWork at office
- ...achieving optimum health, and enjoying the best quality of life possible. We bring together a... ...geographic location in billing Medicare, Medi-Cal, Managed Care insurance, hospice, private... ..., follow up, and appealing various claims to ensure payment is received. The candidate...ClaimsFull timeWork at office
- ...achieving optimum health, and enjoying the best quality of life possible. We bring together a... ...geographic location in billing Medicare, Medi-Cal, Managed Care insurance, private, and... ...billing, follow up, and appealing various claims to ensure payment is received. The candidate...ClaimsWork at office
- ...Project Manager to oversee the management and coordination of a $0 claims program as part of a critical project with one of the largest... ...‑functional initiatives. Hands‑on experience with Medicaid/Medi‑Cal/claims, along with up to date knowledge on policy, regulatory changes...Claims
- Gainwell Technologies is seeking a Dental QA Associate to support quality assurance activities related to dental claims review. This role offers the opportunity to work remotely with minimal supervision while ensuring compliance with standards. The ideal candidate will...ClaimsRemote jobFlexible hours
$21 - $25 per hour
...Two years of insurance verification experience. Experience with Medi-Cal/Healthcare insurance verification and billing preferred.... ...deductible and an out-of-pocket maximum are. Knows how these affect claim adjudication and patient responsibility. Knows how to calculate...ClaimsWork at officeMonday to FridayWeekend work- ...A leading insurance adjusting firm in California is looking for Independent Insurance Claims Adjusters to join their team. This role offers the opportunity to help individuals and businesses recover from disasters while providing flexible work options and competitive...ClaimsFlexible hours
$15k
A leading insurance provider is seeking an Experienced Desk Adjuster, responsible for handling losses and claims up to $15,000. This remote position requires strong analytical, communication, and negotiating skills. Candidates are expected to have a Bachelor's degree and...ClaimsRemote job- Old Republic National Title Insurance is looking for an Associate Claims Counsel to manage and resolve title insurance claims across the United States. This position suits entry-level attorneys eager to gain practical experience in a collaborative environment. Located...ClaimsWork at office2 days per week
- University of the Pacific in Sacramento is seeking a qualified candidate to process insurance claims and handle patient records auditing. The ideal candidate has a high school diploma and three years of relevant experience in insurance billing and customer service in a...Claims
- A leading insurance adjustment company in California is seeking Independent Insurance Claims Adjusters. This role offers dynamic opportunities for personal and professional growth while helping clients recover from disasters. As a Licensed Claims Adjuster, you'll provide...ClaimsFlexible hours
- A leading insurance adjusting firm in California is looking for Independent Insurance Claims Adjusters to join their team. This role offers the opportunity to help individuals and businesses recover from disasters while providing flexible work options and competitive pay...ClaimsFlexible hours
- Philadelphia Insurance Companies is seeking a Claims Specialist - Auto to join our team in Roseville, California. This role focuses on investigating and settling complex first and third party commercial auto insurance claims. Ideal candidates will have over 10 years of...Claims
- A claims adjustment firm in California is seeking Independent Insurance Claims Adjusters to join their thriving team. This role offers flexibility and competitive compensation while supporting individuals and businesses in their recovery from disasters. Candidates must...ClaimsFlexible hours
- ...IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth...Claims
- A leading insurance adjusting firm is looking for Independent Insurance Claims Adjusters in California. Join a in-demand field with opportunities for growth and flexibility. We provide comprehensive training with industry experts to help you excel in your career. If you...ClaimsFlexible hours
- A leading claims adjusting firm is seeking Independent Insurance Claims Adjusters in Sacramento, California. This exciting opportunity allows you to help others while enjoying flexibility and competitive compensation. Ideal candidates are licensed adjusters looking to...ClaimsFlexible hours
- ...grants, federal, state, and county programs including Medicare, Medi-Cal, managed care and private insurances. Starting Bonus: $5,000... ...compliance initiatives, and continuing education. Assist with claims submission and respond to coding-related denials and audits....Claims2 days per week1 day per week
$95k - $120k
...follow-up, and collections for Medicare, Medi-Cal, Kaiser, and other managed care and commercial... ...payers. Ensures accurate and timely claim submission through Point Click Care (PCC)... ...ACC’s service lines; provides training, quality review, and performance feedback. Partners...ClaimsContract workWork at office$31.2k - $44.5k
...participate in the Small Provider Billing and Training program. Instruct providers on how to successfully bill the Medi-Cal program. Review and correct provider’s claim before adjudication. Provide telephone support to enrolled providers. One year minimum experience. What we’...ClaimsFull timeWork at officeFlexible hours$27.69 per hour
The Hispanic Alliance for Career Enhancement is seeking a Claims Representative for the Workers Compensation Training Program based in Rancho Cordova, CA. This position includes a comprehensive 4-week training program designed to equip new professionals with foundational...Claims- ...fast paced Agile environment. Understanding of SQL queries for validation and analysis. Strong documentation skills and attention to detail. Medicare/Medicaid/Medi-Cal healthcare data experience or related Healthcare industry experience. #J-18808-Ljbffr Insight Global
- A leading insurance brokerage firm is seeking a Claims Examiner based in California to take ownership of indemnity claims. You will interact with clients, handle settlements, and ensure timely resolutions while maintaining high service standards. Candidates should have...ClaimsRemote job
- Hire Up Staffing Services is looking for a Patient Account Associate to work remotely during PST or MT hours. The role involves reviewing insurance claims and verifying patient information, while resolving billing discrepancies and ensuring accurate revenue cycle operations...ClaimsRemote job
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