Remote Claims Suspense Lead - Medi-Cal
Gainwell Technologies LLC
- Remote job
Gainwell Technologies is seeking an experienced Claims Suspense Team Lead to support California's Medi-Cal program. This remote role leads a team of Claims Examiners, prioritizes suspended claims, and ensures timely review, pricing, and resolution in accordance with Medi-Cal guidelines. The successful candidate will mentor staff, monitor productivity and quality metrics, and collaborate with the supervisor to optimize workflows in a fast-paced, compliance-driven environment. #J-18808-Ljbffr Gainwell Technologies LLC
$35.9k - $51.3k
...Technologies is seeking an experienced Medi-Cal Conlan Team Lead to support California’s Medi-Cal... ...processing Conlan member reimbursement claims. You will serve as a subject matter expert... ...is a hybrid position that is primarily remote with occasional in-office requirements...Remote workClaimsFull timeWork at officeFlexible hours- Gainwell Technologies is seeking an experienced Medi-Cal Conlan Team Lead to support California’s Medi-Cal program and Conlan operations. In this... ...to team members processing Conlan member reimbursement claims, serve as SME, help guide workflows, manage escalations and...Claims
- ...experienced Financial Cash Control Supervisor to support California's Medi-Cal program. You will oversee the Financial Cash Control team... ...transactions, ensuring accuracy and timely processing. You will lead and develop staff, manage performance against SLAs, and collaborate...Remote job
- ...hiring an experienced Financial Cash Control Supervisor to lead the California Medi-Cal financial operations. The role oversees AR, EFT enrollment... ...optimize workflows and systems such as CRM and MMIS. This remote position supports California’s Medi-Cal program. #J-18808...Remote job
- ...seeks an experienced Financial Cash Control Supervisor to lead the California Medi-Cal financial operations. You will supervise AR, EFT enrollment... ...accuracy and compliance in a high-volume environment. Remote work supported with competitive benefits. #J-18808-Ljbffr...Remote job
$9,423 per month
...Agents, and professional staff engaged in Medi-Cal provider fraud, patient abuse, and drug... ...Agents to be high producers; effectively lead a team where there are several chains of... ...and utilizing complex automated Medi-Cal claims data systems; and establishing close working...Remote workClaimsPermanent employmentFull timeWork at officeLocal area$70k - $80k
...career development. Summary The Medical Claims Research Analyst Lead serves as a functional lead for the... ..., research, or a related field; Medi‑Cal or Medicaid experience preferred. Demonstrated... ...What you should expect in this role Remote position; must reside in California....Remote jobClaimsFull timeFlexible hours- A healthcare staffing agency is seeking a Medi-Cal billing representative in Boise, ID. The candidate will handle billing and follow-up duties, including claims processing, information review, and coding. Ideally, the applicant has at least 2 years of medical billing experience...Claims
$30.38 - $36.46 per hour
Partnership HealthPlan of California is seeking a Claims Examiner II to review and resolve Medi-Cal claims while adhering to established standards. This role handles various claim types and requires strong communication and organizational skills. The ideal candidate will...ClaimsHourly pay- UCLA Health in Los Angeles is seeking a Medi-Cal Fee For Service Collections Representative to manage a portfolio of inpatient and outpatient claims. You will drive timely collections, communicate with payers, patients and internal teams to resolve issues, and ensure accurate...Claims
- ...eligibility in the PACE program. You will coordinate Medicare/Medi-Cal eligibility, annual redeterminations, COB, and retroactive enrollments... ...regulations. You will collaborate with Intake, Social Work, Claims, Pharmacy, and IDT to enable timely enrollment and seamless...Claims
- ...Blue Shield of California is seeking a Program Manager, Senior, Quality Improvement to design and manage Medi-Cal quality initiatives, driving improvements across HEDIS, MCAS, CAHPS, NCQA health plan ratings, DMHC metrics, and Medicaid QRS by collaborating with internal...Work at office
- ...California - Los Angeles Health's Patient Business Services division seeks a Medi-Cal Fee For Service Collections Representative to manage a designated portfolio of inpatient and outpatient claims, ensuring effective collection efforts and timely reimbursements. You will...Claims
$29.03 - $41.23 per hour
...enter keys to toggle section visibility Patient Business Services As a Medi-Cal Fee For Service Collections Representative, you will manage a designated portfolio of inpatient and outpatient claims, ensuring effective and efficient collection efforts. Your primary responsibilities...ClaimsHourly payContract workWork at officeMonday to Friday- ...Role: Guidewire PC Lead Location: San Antion, TX/ open for remote Certification: ACE is a must and should be validate through Guidewire Education portal... ...Specialist for guidewire policy center and guidewire claim center is responsible for managing and optimizing the...Remote workClaims
- TruBridge is seeking an Institutional & ProFee Claim Biller for Commercial and Medicaid to manage day-to-day billing operations for hospital and clinic claims. This remote role supports Critical Access Hospital and Rural Health Clinic environments in the United States....Remote jobClaims
- ...Skill Requirements 1. Strong expertise in guidewire policy center and guidewire claim center configuration and customization. 2. Proficiency in guidewire data model, rules, and integration technologies. 3. Ability to translate business requirements into technical...Remote workClaims
$78k - $82k
Job Snapshot Location: Remote - California (San Diego or Southern California... ...and cultural sensitivity. Lead with trust by being consistent... ...-person care to vulnerable Medi-Cal members across San Diego... ...Important Notice: Any communication claiming to represent Pacific Health...Remote workClaimsFull timeLocal area- Crawford & Company in the United States is seeking a Team Manager - Liability to lead our claims team and drive results in a dynamic environment. You will supervise investigations, mentor staff, and ensure timely disposition of liability claims while upholding service standards...Remote jobClaimsWork from home
- Secure IQ Services is seeking a Call Centre Manager to lead customer care operations and oversee end-to-end insurance claims handling in a vehicle-focused environment. The role is fully remote with Central Standard Time hours (9 AM-5 PM) and involves coordinating teams...Remote jobClaims
- Crawford & Company is seeking a Claims Supervisor in Las Vegas to oversee workers' compensation investigations, management and timely dispositions... ...line with guidelines. You will support the VP/AVP of Claims and lead a team within the service center. The role requires strong...Remote jobClaims
$100k - $125k
...Specialist to own end-to-end sourcing and vendor performance for our claims function. In this senior individual contributor role, you will... ...selections while coordinating stewardship meetings. This remote role in the United States (excluding territories) offers base compensation...Remote workClaims- ...Consultant specializing in Revenue Cycle Management. This fully remote role supports clients across designated US states, guiding setup... ...end-to-end implementation, configure modules for optimal clean claim rates, and train client billing teams while coordinating with payers...Remote jobClaims
- Health Admins is seeking a Claims Team Lead to guide a team of 4-7 Claims Processors and Senior Processors, driving timely, accurate claims... ...coordinate with management, and ensure compliance while supporting a remote work environment and strong customer service focus. #J-18808...Remote jobClaims
$23.13 - $27.98 per hour
...the accurate and timely billing, follow up and collections of claims to government intermediaries and/or secondary payors. The position... ...computer applications High school diploma. 2 years of recent Medi-Cal and Medi-Care Billing experience - Acute Care Hospital JOB...ClaimsHourly payFull timeWork at officeLocal areaShift work$75k - $90k
A leading insurance provider in Wisconsin is seeking an Auto Claims Supervisor to lead a team of adjusters. This remote role requires residing in Wisconsin and offers a competitive salary of $75,000 - $90,000 per year. The ideal candidate will provide leadership, coaching...Remote workClaims$77.5k - $87k
A leading insurance company is searching for a Lead Claims Examiner to manage the investigation and settlement of insurance claims. This role begins remotely with a transition to a hybrid schedule in Overland Park, Kansas. Responsibilities include investigating claims,...Remote jobClaims- ...healthcare innovation company seeks a Supplemental Products Team Lead to manage and optimize claims processing for supplemental health products.... ...overseeing claims analysis, ensuring compliance, and supporting a remote team. Candidates should have a High School diploma and...Remote jobClaimsFull time
- ...rejection count, with weekly CEO reporting. Role requires 5+ years in DME billing/AR and direct Medicare DMEPOS claims experience. You will lead a small remote team and optimize payer setup and cleanup across NikoHealth and Change Healthcare. #J-18808-Ljbffr Med Supply...Remote workClaims
- Geisinger is seeking a seasoned coder to join our claims and payment integrity team. You will collaborate with external vendors, support... ...managed care. Certifications CPC and AHIMA are required. This is a remote position with a 40-hour work week. #J-18808-Ljbffr GeisingerRemote jobClaims
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