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Claims Resolution Specialist - Covered California 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 Specialist Sr, Community Health (Bilingual Required) in 505 City Parkway West
The Program Specialist Sr for Community Health will lead the coordination of projects, pilots and initiatives that advance organizational goals, improve member health outcomes and support compliance with regulatory requirements established by the Centers for Medicare & Medicaid Services (CMS), Department of Health Care Services (DHCS), Department of Managed Health Care Services (DMHC) and the National Committee for Quality Assurance (NCQA).
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Accounting Clerk in 505 City Parkway West
The Accounting area monitors the plan’s financial condition through external audits of financial data and ensures compliance with federal and state regulations and tax filing requirements.
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Grievance & Appeals Nurse Specialist in 505 City Parkway West
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.
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Manager Customer Service, Enrollment & Premium Billing (Covered California) in 505 City Parkway West
The Customer Service team provides information regarding eligibility, enrollment, benefits and assists members and providers with questions related to Covered California.
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