UM Review Nurse – LVN

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APPLY NOW Job Number 19-00248 Job Type Direct Placement Category Case Management Location Alhambra, CA Job Description Position UM Review Nurse – LVN Description To implement the effectiveness and best practices of Utilization Review, the nurse will provide high quality medical care review by appropriately applying the State, Federal, health plan and or clinical guidelines […]

Sr. Financial Reporting Analyst

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APPLY NOW Job Number 19-00253 Job Type Direct Placement Category Finance Location Alhambra, CA Job Description Position Senior Financial Reporting Analyst   Description The senior financial reporting analyst is responsible for applying generally accepted accounting principles in accordance with U.S. GAAP, perform procedures to analyze financial information, prepare accurate and timely financial statements, and ensure […]

HEDIS Nurse (LVN)

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APPLY NOW Job Number 19-00214 Job Type Direct Placement Category Nursing Location El Monte, CA Job Description Position QCI HEDIS Nurse (LVN) Description: The QCI HEDIS Nurse is responsible for performing medical record review and audit, data extraction and maintaining the HEDIS data and computer systems. This position will provide clinical support, training, development and […]

(PL) Receptionist

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APPLY NOW Job Number 19-00224 Job Type Full Time/Contract Category Administration Location Irvine, CA Job Description JOB TITLE Receptionist LOCATION Tustin, CA  DESCRIPTION Answering high-volume incoming calls Provides excellent customer service Ordering and restocking supplies Provides backup administrative support JOB REQUIREMENTS Minimum two-years office administration experience Excellent telephonic and customer service skills Proficient in MS […]

Claims Examiner lll

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APPLY NOW Job Number 19-00254 Job Type Full Time/Contract Category Recruiting Location Pasadena, CA Job Description Position Medical Claims Examiner, Managed Care Description The Medical Claims Examiner/processor is responsible for adjudicating medical claims from providers billing Medicare and Medicaid. Duties & responsibilities include but not limited to; the accurate and timely adjudication of paper and/or […]

Medical Collector; Lead – Authorizations

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APPLY NOW Job Number 19-00206 Job Type Direct Placement Category Revenue Cycle Location Los Angeles, CA Job Description Position Lead Collector; Authorizations The Lead Collector is responsible for providing direction and mentoring to all Collectors I and II on the authorization team and serves as a liaison between staff, supervisors and Management. The Lead Collector understands detailed, […]

UM Coordinator

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APPLY NOW Job Number 19-00236 Job Type Direct Placement Category Utilization Management Location Monterey Park, CA Job Description Position UM Coordinator (IPA/Medical Group)   Description Provides access to appropriate services within the time frame specified by NCQA and NIPAC standards.  Guidelines used to determine medical necessity for all authorizations are based on established community standards […]

Senior Accountant – Healthcare

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APPLY NOW Job Number 19-00252 Job Type Direct Placement Category Accounting Location Alhambra, CA Job Description Position Senior Accountant (Healthcare; IPA)   Description The IPA senior accountant is responsible for applying generally accepted accounting principles in accordance with U.S. GAAP, perform procedures to analyze financial information, prepare accurate and timely financial statements for clients, and […]

Claims Examiner; IPA Medical Group

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APPLY NOW Job Number 19-00190 Job Type Direct Placement Category Claims Location Alhambra, CA Job Description Position Claims Examiner I   Description Process and adjudicates Professional CMS-1500 of encounter claims include pre-logged PCP and/or Pediatric claims. Adjudication of encounter, PCP and Pediatric claim from beginning to end. Knowledge of some ICD-9, CPT, and HCPC codes […]

Discharge Planner – LVN

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APPLY NOW Job Number 19-00245 Job Type Full Time/Contract Category Managed Care Nursing Location Rancho Cucamonga, CA Job Description Job Title Discharge Planner, LVN Position Summary Under the direction of the Inpatient Review Nurse Manager and Supervisor, the incumbent will work with their respective Team Centers, that may include an Concurrent Review Nurse and Inpatient […]