Program Specialist, Community Relations CalOptima Join Us in this Amazing Opportunity The Team You'll.... You will work closely with the department manager to support CalOptima Health initiatives through community engagement, program...
Behavioral Health Utilization Management Medical Case Manager CalOptima Join Us in this Amazing Opportunity The.... You will be responsible for prior authorizations, concurrent review and related processes. You will utilize CalOptima Health's medical...
of insurance payors: PPO, HMO, POS, EPO, Medicare, Medi-Cal, & CalOptima preferred Bi-lingual (English/Spanish, or English...
and experienced Medical Case Manager on behalf of CalOptima Health to join the Behavioral Health Utilization Management (BHI - BH...
, service records, and updates in KIPU, HMIS, and CalOptima Connect systems. Develop and maintain a network of partnerships...
as needed. Qualifications At least two years medical back office experience. Knowledge of insurance groups e.g. Medi-Cal, CalOptima, Medicare...
experience preferred General knowledge of insurance payors: PPO, HMO, POS, EPO, Medicare, Medi-Cal, & CalOptima preferred Bi...
. Responsibilities Verify insurance (PPO & Medi-Cal: Denti-Cal, IEHP, Molina, CalOptima) Submit claims with proper documentation...
database (HMIS, CES System, WellSky, and CalOptima) in a timely manner (as each database requires). Exit guests from case load... and internal/external database, close out guests’ physical files. Accuracy of CalOptima (CalAIM) billing process submission...
of insurance payors: PPO, HMO, POS, EPO, Medicare, Medi-Cal, & CalOptima Bi-lingual (English/Spanish, or English/Vietnamese...