Medical Authorization Assistant (Behavioral Health - Utilization Management) - Covered California CalOptima... while serving as a contact between physicians, providers and CalOptima Health staff. You will also participate in telephone...
Sr Fraud, Waste and Abuse Investigator (Investigator Sr) CalOptima Join Us in this Amazing Opportunity The Team..., CalOptima Health, health networks and members from case management to resolution and identifies overpayment of funds...
Regulatory Affairs & Compliance Analyst, Policies & Procedures CalOptima Join Us in this Amazing Opportunity The..., and implementation of CalOptima Health policies and procedures. You'll aim to strengthen CalOptima Health's policy framework and ensure...
Member Liaison Specialist Sr, Behavioral Health Clinical / Care Management - Covered California CalOptima... to members, CalOptima Health BH providers, health networks and community agencies to coordinate services. You will regularly...
. Ensure timely and accurate documentation of case notes, service records, and updates in AICA, HMIS, and CalOptima Connect...
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...
, CalOPTIMA, MediCal, etc. Qualifications: Bilingual in Spanish Previous Medical Front Office experience Knowledge...
General knowledge of insurance payors: PPO, HMO, POS, EPO, Medicare, Medi-Cal, & CalOptima Bi-lingual (English/Spanish...
General knowledge of insurance payors: PPO, HMO, POS, EPO, Medicare, Medi-Cal, & CalOptima Bi-lingual (English/Spanish...