Medi-Cal Claims Quality Auditor - Associate
Blue Shield of CA
Blue Shield of CA in Long Beach seeks an Operational Quality Services Specialist, Associate to ensure claims are processed accurately and timely. This role includes performing routine audits for the Medi-Cal line of business and requires experience in claims processing. The ideal candidate will have a college degree or equivalent experience, and prior auditing experience is preferred. Employees can work virtually full-time with occasional office visits based on business needs. #J-18808-Ljbffr
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Medi-Cal Claims Quality Auditor - Associate in Long Beach, CA vacancy
- ...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...Claims
Blue Shield
Long Beach, CA5 days ago $25.38 - $36.76 per hour
...Scan-Health-Plan in California is seeking a Quality Auditor to perform operational audits across various health plan operations including Claims and Enrollment. Responsibilities include ensuring compliance with regulatory requirements and maintaining quality standards...ClaimsHourly payWork at officeRemote workSCAN Health Plan
Lakewood, CA1 day ago- ...strong leadership, deep knowledge of dental billing (including Medi-Cal & HMO plans), and the ability to collaborate across teams while... ...Hands‑on experience with Medi-Cal Dental billing, PEDO & ORTHO claims (mandatory) Strong knowledge of dental insurance billing, coding...ClaimsFull timeWork at office
Children's Happy Teeth & Happy Braces
Torrance, CA1 day ago - ...Billing Specialist, you will play a key role in managing insurance claims, patient accounts, and billing processes across PEDO & ORTHO... ...of dental billing experience Strong knowledge of HMO & Medi-Cal Dental billing, pre-authorizations, NOAs, CIFs. Experience working...ClaimsFull timeWork at officeMonday to Friday
Children's Happy Teeth & Happy Braces
Torrance, CA5 days ago - ...with the BOM in ensuring all billing and claims are submitted on time and are compliant with... ...reviews of problem areas, QA concerns, Quality Indicators and survey issues. Maintain... ...completion of applications, e.g. Medi-Cal redetermination papers and other needed documents...ClaimsWork at office
Meadow Creek Post-Acute
Paramount, CA4 days ago - ...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 office
Blue Shield of CA
Long Beach, CA2 days ago - ..., referrals, and care management for all Medi-Cal members under 21 years old and collaborates... ...working daily inventory, providing high-quality clinical reviews, performing efficient... ...guidelines. Conduct clinical review of claims for medical necessity, coding accuracy, medical...ClaimsFull timeContract workPart timeWork at officeLocal areaWork from homeHome office2 days per week
Blue Shield Of California
Long Beach, CA3 days ago - ...SSA's Claims Technical Expert (CTE) SSA's Claims Technical Expert (CTE) is responsible for developing and adjudicating the most complex, non-routine Title II and/or Title XVI cases and on public fraud issues in specific claims and post-entitlement cases. The incumbent...ClaimsTemporary work
Social Security Administration
Long Beach, CA5 days ago - A leading claims adjusting firm is seeking Independent Insurance Claims Adjusters in California. This opportunity involves assisting clients through the claims process after disasters. Ideal candidates will be licensed adjusters with experience handling multiple claims...Claims
$22 - $30 per hour
...programmed accurately for Authorizations and Claims. RESPONSIBILITIES-DUTIES Configure rates... ...with all lines of business, Medicare, Medi-Cal, and Commercial claims and know industry... ...multiple projects. Produce accurate and high-quality work on time and consistently. Individual...ClaimsHourly payFull timeContract workWork at officeFlexible hoursAdvanced Medical Management, Inc.
Long Beach, CA2 days ago- A leading insurance claims company in California seeks Licensed Claims Adjusters to join their team. This role enables you to provide crucial assistance to clients recovering from disasters. Candidates with 100 claims or more experience are preferred, but training is available...ClaimsFlexible hours
- ...investigative services. We investigate all types of insurance claims including workers' compensation, suspected fraud, liability and... ...aimed at mitigating expenses for our clients and delivering high-quality results. We are seeking a detail-oriented and proactive...ClaimsFlexible hours
J T Becker & Co Inc
Long Beach, CA11 days ago $111.54k - $167.42k
...performance, provider data management and data quality. The Data Analyst, Consultant will report... ...will work closely with Operations teams (Claims and Provider), Network Management,... ...Prior experience in government programs Medi‑Cal and Medicare is a plus. Hybrid This role...ClaimsFull timePart timeWork experience placementLocal areaWork from homeHome office2 days per weekBlue Shield
Long Beach, CA4 days ago$22 - $24.84 per hour
...Quality Assurance Specialist Join a team where your work truly matters. We're proud to have been certified as a Great Place to Work... ...oversees documentation of services by staff to assure conformity with Medi-Cal, Los Angeles County, other outside agencies, and internal...Hourly payShift work- ...Paid time off Training & development Role Description As Account Associate - State Farm Agent Team Member for Erica Ruiz - State Farm... ...customers with policy changes and inquiries. Process insurance claims and follow up with customers on claim status. Coordinate with underwriters...Claims
Erica Ruiz - State Farm Agent
Long Beach, CA4 days ago $152.4k - $178.96k
...compensation program, including supervision of claims administration, payment of temporary or... ...and employee safety programs related to CAL/OSHA requirements. E • Draft and... ...Insurance Administrator is highly desirable. Associate in Risk Management or Chartered Property...ClaimsPermanent employmentFull timeContract workTemporary workWork experience placementWork at officeLocal areaLong Beach Unified School District
Lakewood, CA1 day ago- ...other mitigation services. Handle communication with clients, vendors, and insurance companies regarding billing inquiries, unpaid claims, and disputes. Resolve discrepancies in invoicing, working with the operations team to address any issues or adjustments. Process insurance...ClaimsFull timeWork at office
Servpro Industries Inc
Carson, CA1 day ago - ...Reporting Support Pharmacy Medicare and Medi-Cal Analytics and Reporting Support... ...mailings, Prior Authorization, Benefits & Claims Support Pharmacy Infomart implementation... ...nonprofit mission by lowering costs, improving quality, and enhancing the member and physician...ClaimsFull timeContract workPart timeWork at officeLocal areaWork from homeHome office2 days per week
Blue Shield Of California
Long Beach, CA1 day ago $50k - $75k
...Account Associate - State Farm Agent Team Member Full Time in Tucson – AZ Hiring bonus 401(k) Bonus based on performance Health insurance... ...customers with policy changes and inquiries. Process insurance claims and follow up with customers on claim status. Coordinate with...ClaimsFull timeWork at officeTom DeBerry
Long Beach, CA5 days ago- ...retrospective utilization review, and provider claims dispute reviews. In addition, the Medical... ...clinical staff in maintaining high quality clinical reviews and work products and process... ...STARS, Dual Special Needs Plan (D-SNP), Medi-Cal, NCQA/URAC/Quality Programs, Policies/...ClaimsFull timePart timeWork at officeLocal areaWork from homeHome office2 days per week
Blue Shield Of California
Long Beach, CA2 days ago $71.7k - $103.73k
...the people and communities we serve. The Job The Senior Quality Analyst is a key contributor to the Medicare Advantage STAR... ...working within a health plan STAR team. Familiarity with claims, encounter, and EMR data. Experience supporting provider engagement...ClaimsFor contractorsRemote workScangroup
Long Beach, CA1 day ago$21.85 - $27.28 per hour
...Center in Lynwood, California. The role involves managing billing claims, coordinating EHR application activities, and liaising with... ...Degree in Computer Science and experience with EHR systems and Medi-Cal billing. The position is Per Diem with shifts during the day, offering...ClaimsHourly payShift work$64k - $92.6k
...Senior Claims Resolution Analyst Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that... ...Other duties as assigned Your Qualifications ~ Associate's degree or equivalent experience ~5+ years of related experience...ClaimsRemote workSCAN
Long Beach, CA16 days ago- ...exciting opening for a Workers Compensation Claims Specialist within the West Region. As a... ...of the claim. Assesses actual damages associated with claims and conducts negotiations,... ...trains new team members. Participates in Quality Review process. Participates in conducting...ClaimsWork experience placementLocal areaRemote work
Liberty Mutual Insurance
Long Beach, CA3 days ago $24 - $32.95 per hour
...data accurately, timely, and efficiently in order to create a claim to bill for medical services provided. Core Competencies... ...working knowledge of all sponsored programs such as Medicare, Medi-Cal, Tricare and all other payers; as well as contracted insurance...ClaimsNight shiftAfternoon shift$21.82 - $42.55 per hour
...records following review of post-payment claims. Essential Job Duties Independently re-evaluates medical claims and associated records by applying knowledge of advanced... ...Specialist (CCS), Certified Professional Medical Auditor (CPMA), or American Academy of...ClaimsHourly payFull timeContract workWork experience placementWork at officeLocal area- ...raising the standard of behavioral health. Our commitment to quality means providers follow consistent standards of care that ensure... ...Admin Done for You ~ We handle credentialing, billing, claims, EHR, and tech support—so you can focus your time and energy on...ClaimsLive inWork at officeRemote work
- ...dealership guidelines and within each manufacturer's format and time frame. Ensures that all manufacturer accounts, including warranty claims, rebates, interest protection and co-op advertising are current and accurate. Interprets the financial statement and the daily...ClaimsTemporary workWork at office
Element Partners
Long Beach, CA1 day ago - ...Award 19 times for providing the highest-quality medical care in Los Angeles. We also were... ...reviewing and submitting multi-specialty claims to third party payors, performing account... ...interpret regulations for Commercial Ins, CMS or Medi-Cal Professional and courteous demeanor. Why...ClaimsRemote work
Cedars-Sinai Medical Center
Torrance, CA4 days ago - ...Able to handle more complex claims. Good understanding of the application... .... Must meet production and quality standards. Claims processing... ...Medicaid, Medicare and/or Medi‑Cal claims highly preferred.... ...relationships with co‑workers and other associates. Additional Information All...Claims
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Medi-Cal Claims Quality Auditor - Associate. Be the first to apply!
Related searches
- quality assurance auditor Long Beach, CA
- quality control associate Long Beach, CA
- quality specialist Long Beach, CA
- quality associate Long Beach, CA
- warehouse quality control associate Long Beach, CA
- quality auditor Long Beach, CA
- quality management specialist Long Beach, CA
- claims attorney Long Beach, CA
- medical claims auditor Long Beach, CA
- quality intern Long Beach, CA