layiq
worthy; deserving; fitting; suitable.
A role, opportunity, or path that merits attention, time, and pursuit.
Loading LAYIQ…Job opportunity
Montebello, CA 90640; Montebello - (1401 N Montebello Blvd)
Source: AltaMed careers · View original posting
From AltaMed's posting. “We” and “our” refer to the employer.
Grow Healthy
If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone.
Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day.
Job Overview
The Claims Operations Supervisor is responsible for the oversight of external as well as internal processes as it relates to Claims Adjudication. This includes the compilation and scrubbing of claims data to analyze, track, and trend various aspects of the adjudicated claims.
This includes but is not limited to, TAT compliance, Production, Error Rate, mid-month reports for forecasting, Health Plan monthly reporting including ODAG and Part C, Health Plan Universes for Audits, reports to identify potential recovery, as well as reports requested by various personnel at AltaMed. The Claims Operations Supervisor will identify root causes of claims payment errors and reports to management as well as collaborates with other departments and/or providers in successful resolution of claims related issues.
Minimum Requirements
Associates degree (AA/AS) or Bachelor’s degree is highly recommended.
Must be knowledgeable of Medi-Cal regulations, Commercial, and Medicare rules and regulations and medical terminology.
HS Diploma required.
Minimum of 5 years of experience in a managed care environment, claims knowledge preferred.
Must have an understanding to read CMS-1500 and UB-04 forms and be able to read and interpret DOFRs and Contracts.
Must have strong organizational and mathematical skills.
Compensation
$74,144.18 - $92,680.22 annually
Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.
LAYIQ is an independent job-discovery service. This listing does not imply a partnership with or endorsement by the employer. Review the original posting for current details and availability.
Employer posted:
1 Resource Group · Houston, TX, US
Teneo external feed for LinkedIn · New York, United States
Teneo · New York, United States
VitalCaring · Madisonville,Texas, United States
VitalCaring · Madisonville,Texas, United States
City Wide Facility Solutions · US