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Referral Services Nurse I (Denial Letters)
Works with providers and health plan representatives and UM coordinators to clarify benefit eligibility and authorization for members....
System Functional Lead - MMIS - Santa Ana, CA
Eligibility, Claims, Clinical, CRM, Financial and related Enabling Services. Business Systems Analyst, IT, SDLC, MMIS, Medicaid, Santa Ana, CA, California,...
Reimbursement Specialist
GenomeDx Biosciences - San Diego, CA
Verifying insurance/recipient eligibility, billing and follow-up on claims to Medicare, Medicaid and Private Insurer Payers....
Sponsored by Jazz

Eligibility Specialist -West Region

Watsonville Hospital - Watsonville, CA
Eligibility Screening Services. Eligibility Screening Services, LLC (a wholly owned subsidiary of CHS) is seeking a Travel Eligibility Specialist in the West...

Bilingual Medicaid Eligibility Advisor Good Sam

The Outsource Group-Good Samaritan Hospital - San Jose, CA
Obtain legally relevant medical evidence, physician statements and all other documentation required for eligibility determination....

Unemployment Insurance Fraud, Waste and Abuse Consultant - W...

First Data - 1,309 reviews - California
That includes Health Benefit Exchange, MMIS, Medicaid, Medicare, Health Information Exchange and other IT Systems that support human services programs as well...

Medicaid Eligibility Advisor (Bilingual) Los Robles, Thousan...

Los Robles Hospital and Medical Center - 34 reviews - Thousand Oaks, CA
Obtain legally relevant medical evidence, physician statements and all other documentation required for eligibility determination....

Business Office Specialist

AseraCare - 109 reviews - Fresno, CA
May assist families with Medicaid eligibility process, including documenting in appropriate systems all follow-up and monitoring until process complete....

TeleSales Representative - TEMP

SCAN Health Plan - 40 reviews - Long Beach, CA 90806
Assess health plan needs of prospective members, verify Medicare / Medi-Cal/AZ eligibility, and facilitate telephonic enrollment....

OneCare Partner- Service

CalOptima - 14 reviews - Orange, CA
Medicare and Medi-Cal eligibility and benefits preferred. Principles and practices of health care service delivery and managed care, Medi-Cal/ CalOptima...

Customer Service Representative

HealthCare Talent - 2 reviews - Orange, CA
This position will provide information regarding eligibility, enrollment, and benefits to members and member eligibility information to providers.Position...
Easily apply

Grievance Resolution Specialist

CalOptima - 14 reviews - Orange, CA
Coordinate the overall process of complaint resolution, responding to all verbal and written complaints from members and/or providers relating to member...

Intake Coordinator

Mobility Professionals, Inc - Lake Forest, CA 92630
$13 - $15 an hour
Data entry and Insurance eligibility. \*Familiar with Medicare, Medicaid and Commercial payors a plus. Request medical documentation from physicians in order to...
Easily apply
IT Implementation & Integration Architect - Santa Ana, CA
5+ years of experience managing and leading Medicaid Eligibility or MMIS systems. Experience integrating healthcare eligibility, provider, member, claims and...
Medical Mgmt Specialist II, Telecommute Northern CA, 119389
Anthem, Inc. - 1,585 reviews - San Francisco, CA
Tracks referral according to specified timelines and notifies providers and families of CCS eligibility determinations and referrals, BCC authorizations and/or...

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