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Director, Information Technology (Data Analytics and Artificial Intelligence Technology) (Director IV) in 505 City Parkway West
IT provides best-in-class technology solutions that enhance the health outcomes of our members and the community we serve.
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Director, Information Technology (Claims, Membership, Benefits, Provider and Contact Center) (Director IV) in 505 City Parkway West
IT provides best-in-class technology solutions that enhance the health outcomes of our members and the community we serve.
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Claims Examiner Sr in 505 City Parkway West
The Claims Examiner Sr. analyzes and processes claims. This position is responsible for following regulatory and internal guidance in conjunction with CalOptima policies and procedures as they apply to claims adjudication. The Claims Examiner is responsible to adjudicate claims that require minimal research and problem solving. 3-4 years of health claims processing background. Knowledge of Medicare and Medi-Cal processing preferred. Examiner is expected to adjudicate tier one claim type with attention to detail in order that high quality standards are met. The challenge of consistently and accurately processing an increased volume of claims in a production environment is attainable with appropriate staffing levels. The return on the investments is that the approval of this position will allow us to continue meeting regulatory compliance and timeliness requirements.
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Claims Examiner Sr in 505 City Parkway West
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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Program Assistant (Quality Initiatives) in 505 City Parkway West
CalOptima Health is seeking a Program Assistant to provide administrative support projects and department leadership.
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