Remote Claims Suspense Lead - Medi-Cal
Gainwell Technologies
- 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
$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- ...seeking a Provider Field Representative Lead to provide functional leadership to provider... ...complex inquiries, billing support, and claims research. The role emphasizes guidance,... ...collaboration across internal and client teams in a remote California setting. The position requires...Remote jobClaims
- Qualfon is seeking detail-oriented Medi-Cal Claims Processing Specialists to review and resolve suspended claims accurately and efficiently in a home-based setup. Ideal candidates have knowledge of healthcare billing, strong analytical skills, and the ability to apply policies...Remote jobClaimsWork from home
- 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
- Gainwell Technologies is seeking an experienced Claims Appeals Team Lead to support California’s Medi-Cal appeals operations from our West Sacramento office. You will coordinate daily provider appeals activities, guide Appeals Examiners, and drive quality and throughput...ClaimsWork at office
- Gainwell Technologies is seeking an experienced Claims Appeals Supervisor to support California’s Medi-Cal program at our West Sacramento office. You will supervise... ...responses and compliance with requirements. You’ll lead Appeals Examiners, monitor performance, address...ClaimsWork at office
- ...Technologies in California is hiring an Out-of-State Provider Specialist to support Medi-Cal by reviewing out-of-state claims and coordinating enrollment for providers. This 100% remote, full-time role requires strong analytical skills and familiarity with Medicaid operations...Remote jobClaimsFull time
- Qualfon is seeking a detail-oriented Medi-Cal Claims Processing Specialist to review and resolve suspended claims accurately and efficiently. The ideal candidate will have knowledge of healthcare billing, strong analytical skills, and the ability to apply policies and regulations...Remote jobClaims
- ...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
- Gainwell Technologies is seeking an experienced Financial Cash Control Supervisor to lead the team supporting California's Medi-Cal program. You will oversee accounts receivable, EFT enrollment, refunds, financial correspondence, and related transactions.You will drive...Remote job
- Gainwell Technologies is seeking a Financial Cash Control Team Lead to support California's Medi-Cal program in a remote role. You will lead AR operations, research and resolve complex financial issues, and ensure accurate processing of medical-related payments. Collaboration...Remote job
$24 per hour
Medi-Cal Claims Processing Specialist Overview Qualfon is a global provider of omnichannel customer... ...solutions. From call center support to lead generation to ecommerce fulfillment, we... ...home internet service while working remotely. What We Offer We lead by example to ensure...Remote workClaimsWork at officeLocal areaWork from home$70k - $80k
...Provider Field Representative Lead Provides functional leadership... ...Representatives serving California’s Medi‑Cal provider community. This role... ...inquiries, billing support, claims research, provider education,... ...should expect in this role Remote position; candidate must...Remote jobClaimsFlexible hoursNight shift$70k - $80k
...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 .... ...What you should expect in this role Remote position; must reside in California....Remote workClaimsFull timeFlexible hours$9,423 per month
...Fraud Control Unit (MFCU), the Division of Medi-Cal Fraud and Elder Abuse (DMFEA) works... ...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- Qualfon is seeking a Medi-Cal Claims Examiner to review, process, and adjudicate suspended healthcare claims to ensure accurate and timely payment. You’ll apply Medi-Cal policies, verify member eligibility and provider information, and document outcomes in the claims system...Claims
- 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
- ...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
- Qualfon is a global provider of omnichannel customer experience and business support solutions. As a Medi-Cal Claims Examiner, you will review, process and adjudicate suspended healthcare claims to ensure accurate and timely payment in line with Medi-Cal policies and reimbursement...Claims
- ...Medi-Cal Member Appeals And Grievances Rn Senior The Medi-Cal Member Appeals and Grievances team is responsible for clinically reviewing... ...that are the result of either a preservice, post-service or claim denial. The Medi-Cal Appeals and Grievances RN Senior will...ClaimsFull timePart timeWork at officeLocal areaWork from homeHome office2 days per week
$54.2k - $77.4k
...Claims Suspense Supervisor - Hybrid - West Sacramento, CA Great companies need... ...claims operations for California's Medi-Cal program. In this role, you will lead a team responsible for... ...position that will primarily work remotely, with occasional in-office requirements...Remote workClaimsFull timeWork at officeMonday to FridayFlexible hours$29.03 - $41.23 per hour
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 include: Conducting regular...ClaimsHourly payContract workWork at office$21 per hour
...? We’re looking for an enthusiastic Remote Insurance Follow-Up Team Lead to join our growing team! In this role... .... Analyze and resolve unpaid claims. Contact insurance carriers for claim... ...a Business professional environment Medi-Cal knowledge a major benefit High school...Remote jobClaimsFull timeTemporary workWork at office$37.5k - $53.5k
...Claims Data Entry Team Lead - Onsite - West Sacramento, CA Join the group that solves business challenges... ...claims operations for California's Medi-Cal program at our West Sacramento office... ...at our West Sacramento, CA office. Remote or hybrid work is not available for...Remote workClaimsFull timeWork at officeFlexible hours$112.6k - $239.8k
...9-15 We are seeking a talented individual to join our Forensic Accounting & Claims Services team at Marsh . The role can be based in any of our US offices or Remote. As an Engagement Lead – Forensic Accounting & Claims Services Consultant, you will act as a recognized...Remote workClaimsMinimum wageFlexible hours$40 - $55 per hour
...required equipment inspections under MSHA and Cal/OSHA standards Work alongside the... ...diesel engines Prior work at a small, remote, or older underground mine Your own mechanic... ...covers roughly 1,735 acres of mining claims in the heart of the northern Sierra gold country...Remote workClaimsHourly payFull timeShift work- The California Department of Justice, Division of Medi-Cal Fraud and Elder Abuse in Sacramento, seeks a Criminal Prosecutions Supervisor (Deputy Attorney General Supervisor) to oversee DAGs and support staff in complex state and federal courts. This permanent, full-time...Remote workPermanent employmentFull time
$110k - $120k
...Multiple remote perm, full-time Epic Certified Lead Analyst, Resolute PB positions. Location: CST Time Zone. Salary: $110-120K + Full Benefits. ***... ...Must hold Epic Certification in Resolute PB Admin or PB Claims. Hands-on experience with application configuration...Remote workClaimsPermanent employmentFull timeVisa sponsorshipWork visa$190k - $230k
...You Can Count On.Hybrid schedule: 2 days remote / 3 in‑officeCompetitive pay + generous PTOMedical... ...seeking an Actuarial Pricing Leaderto lead the actuarial pricing function for a... ...closely with underwriting, product, and claims teams to drive profitable growth.**Please...Remote workClaimsTemporary workWork at office3 days per week- WCF Insurance is seeking a Claims Compliance Strategy Specialist to ensure regulatory adherence across the claims organization. This exempt... ...analyze laws, and manage risk in a dynamic environment. Open to remote candidates within the US, with occasional travel to Sandy, UT HQ...Remote jobClaims
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