Actuary CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community... in Orange, CA, at least two (2) days per week minimum. The Actuary will ensure the fiscal integrity of CalOptima Health...
Member Liaison Specialist (Customer Service) CalOptima Join Us in this Amazing Opportunity The Team You'll... needs within and outside the health network and CalOptima Health during the original interaction. - Addresses member...
skills General knowledge of insurance payors: PPO, HMO, POS, EPO, Medicare, Medi-Cal, & CalOptima Bi-lingual (English...
including PPO's, HMO's, Medicare, Medi-Cal, and CalOptima. Follow up unpaid claims and work toward resolution. Resolve billing...
of insurance payors: PPO, HMO, POS, EPO, Medicare, Medi-Cal, & CalOptima Bi-lingual (English/Spanish, or English/Vietnamese...
with IEHP, Molina, CalOptima, Health Net, and Anthem payer portals. Power BI experience. Experience with capitated...
current. Enter guest case notes into internal and external database (HMIS, CES System, WellSky, and CalOptima) in a timely... files. Accuracy of CalOptima (CalAIM) billing process submission in a timely manner by designated deadline. Practice...
, CalOPTIMA, MediCal, etc. Qualifications: Bilingual in Spanish Previous Medical Front Office experience Knowledge...
as needed. Qualifications At least two years medical back office experience. Knowledge of insurance groups e.g. Medi-Cal, CalOptima, Medicare...
EAP, Carelon/Anthem, IEHP, CalOptima, and any additional contracted payers. Submission must be completed before the client... EAP, Carelon/Anthem, and Medi-Cal managed care plans (including CalOptima and IEHP). Strong working knowledge of the...