for all Partnership lines of business. Responsibilities: Perform concurrent and retro claims audits on new Claims examining staff.... Document audits and report all audit outcomes following the Partnership Claims Operating Instruction Memorandums on claims...
in Title 22, Medi-Cal Provider Manual, DMHC and/or CMS regulatory requirements and Partnership policies and procedures.... Works with other Partnership departments to resolve issues relating to authorization of medical services. Audits medical...
as assigned. Qualifications: Education and Experience Minimum three (3) years claims examining experience;or Partnership... claims examining experience and completion of Partnership claims training;or equivalent combination of education...
, Visio, and PowerPoint. Valid California driver’s license and proof of current automobile insurance compliant... with Partnership policy are required to operate a vehicle and travel for company business. . Performance Based Competencies...
Current and unrestricted California Registered Nurse License. Valid California driver’s license and proof of current... lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients;Promote...
of general business office machines operations. Valid California driver’s license and proof of current automobile insurance... to move, carry, or lift objects of varying sizes, weighing up to 25 lbs. All HealthPlan employees are expected...
. All HealthPlan employees are expected to: Provide the highest possible level of service to clients;Promote teamwork... and cooperative effort among employees;Maintain safe practices;and Abide by the HealthPlan’s policies and procedures, as they may...
. All HealthPlan employees are expected to: Provide the highest possible level of service to clients;Promote teamwork... and cooperative effort among employees;Maintain safe practices;and Abide by the HealthPlan’s policies and procedures, as they may...
to improve Consumer Assessment of Healthcare Providers and Systems (CAHPS) performance across all of Partnership’s product lines... interventions. Collaborate with Partnership’s provider network leadership team to align practice transformation and clinical...
of general business office machines operations. Valid California driver’s license and proof of current automobile insurance... required, ability to move, carry, or lift objects of varying sizes, weighing up to 25 lbs. All HealthPlan employees are expected...