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Customer Service Representative, Sr. (OneCare) (Bilingual Required)
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505 City Parkway West
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| The Customer Service team provides information regarding eligibility, enrollment, benefits and assists members and provider with questions related to the Med-Cal programs. |
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Data Analyst, Sr. (Finance - Encounter Data)
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505 City Parkway West
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| The Finance department is responsible for procuring business insurance, reviewing the financial viability of the delegated entities, and processing delegated entities’ inbound encounter data to submit along with in-house claims data to CMS and DHCS as outbound encounter data for all lines of business. |
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Claims Examiner, Sr.
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505 City Parkway West
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| The Claims Administration Department is responsible for managing and processing of all medical claims in accordance with industry standards and regulations, ensuring accuracy and timely reimbursement to healthcare providers. |
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Manager, Communications (Digital)
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505 City Parkway West
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| The Manager, Communications (Digital) will lead the strategy, development and execution of content and messaging of CalOptima Health’s digital communications, including oversight of member-facing messaging across platforms such as texting, email, IVR and organization website. |
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Grievance & Appeals Nurse Specialist
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505 City Parkway West
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| The Grievance and Appeals Resolution Services (GARS) Department is responsible for coordinating thorough reviews to provide appropriate resolutions to verbal and written complaints, appeals and disputes for both members and providers. |