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IEHP
IEHP
1 001 – 5 000 Xodimlar
KonsaltingLogistikaSug‘urta
IEHP Riverside va San Bernardino okruglarida kam daromadli shaxslar hamda oilalarga xizmat ko‘rsatuvchi mintaqaviy sog‘liqni saqlash rejasidir. 1995-yilda tashkil etilgan ushbu tashkilot Medi-Cal, DualChoice va Covered California kabi dasturlar orqali tibbiy sug‘urta qamrovini taqdim etadi hamda a’zolarni tibbiy xizmatlar bilan bog‘lash uchun mahalliy shifokorlar va sog‘liqni saqlash muassasalari bilan hamkorlik qiladi. Uning jamoaga yo‘naltirilgan yondashuvi ruhiy salomatlikni qo‘llab-quvvatlash, fitnes dasturlari va sog‘lom turmush tarzi bo‘yicha ta’limni ham o‘z ichiga oladi.
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Kompaniyadagi ish o‘rinlari

Claims Specialist I, Provider Claims (California Remote)

Evaluate and resolve provider medical claims for Inland Empire Health Plan, including coverage and payment decisions, disputes, appeals, and adjustments.

USAmerika Qo‘shma ShtatlariCAKaliforniya
25 $ – 33 $ / soat
MasofaviyTo‘liq stavkaO‘rta darajaSeniorTalab Qilinadigan Til: inglizchaSug‘urta da’volari bo‘yicha mutaxassis

Tavsif

  • Review professional and institutional claims, including high-dollar and outpatient and inpatient claims
  • Determine coverage and payment levels
  • Resolve provider disputes and appeals
  • Prepare resolution letters
  • Process claim adjustment requests accurately and on time under standard procedures and regulatory guidelines
  • Contribute to payment adjustment projects
  • Manage complex claims as assigned
  • Support IEHP’s Quality Program goals, including HEDIS, CAHPS, and NCQA accreditation

Talablar

  • Bring at least four years of experience evaluating and processing institutional and professional medical claims
  • Be proficient with medical claims systems, ICD-10 and CPT coding, medical authorization review, provider contract rate interpretation, and medical benefit coverage decisions
  • Have prior experience managing provider disputes, appeals, and claim adjustments
  • Experience in an HMO or managed care setting is preferred
  • Medicare and/or Medi-Cal experience is preferred
  • Experience in a managed care or government payer environment is helpful
  • Have a high school diploma or GED
  • Understand claims operations and customer service standards
  • Know ICD-9, ICD-10, CPT, and HCPC coding and general claims processing practices
  • Demonstrate strong analytical and problem-solving skills
  • Be proficient with Microsoft Office and advanced Microsoft Excel
  • Have strong written communication skills
  • Be able to analyze data and interpret regulatory requirements
  • Have excellent communication and interpersonal skills, strong organization, and data entry skills
  • Type at least 45 words per minute
  • Have excellent oral and written communication skills
  • Build effective working relationships across the organization
  • Maintain a professional demeanor
  • Show telephone courtesy and patience.
  • State-of-the-art onsite fitness center
  • Medical, dental, and vision insurance coverage

Imtiyozlar

  • State-of-the-art onsite fitness center
  • Medical, dental, and vision insurance
  • Life insurance and short- and long-term disability options
  • Career advancement and professional development opportunities
  • Wellness programs supporting work-life balance
  • Flexible Spending Account for health care and childcare
  • CalPERS retirement plan
  • 457(b) plan with employer contribution match
  • Employer-paid life insurance
  • Pet care insurance

O‘xshash ish o‘rinlari

Johnson & Johnson

Remote Contract Director, Key Account Management

Johnson & Johnson
H1B vizasi homiysiBiotexnologiyaFarmatsevtika mahsulotlariSog‘liqni saqlash
USAmerika Qo‘shma ShtatlariCOKoloradoILIllinoysIAAyovaKSKanzasMNMinnesotaMOMissuriWIViskonsin
131 000 $ – 211 600 $ / yil
MasofaviyTo‘liq stavkaYetakchiTalab Qilinadigan Til: inglizchaDirektor

Lead pricing, negotiations, and Surgery portfolio contracts for Johnson & Johnson health systems. Shape account strategy, ensure compliance, and support profitable performance across seven U.S. states.

Ochish
Ascensus

Regional Vice President, Retirement Sales – California (Remote)

Ascensus
5 001 – 10 000 Xodimlar
H1B vizasi homiysiKonsaltingMoliyaSug‘urta
USAmerika Qo‘shma ShtatlariCAKaliforniyaMasofaviyTo‘liq stavkaYetakchiTalab Qilinadigan Til: inglizchaVitse-prezident

Lead retirement plan sales across California by building relationships with financial professionals and intermediary firms. The role covers territory development, product positioning, prospecting support, and sales coordination.

Ochish
Fetch 📦

Director of Strategic Accounts, Florida (Remote)

Fetch 📦
201 – 500 Xodimlar
KonsaltingLogistikaMehmondo‘stlik
USAmerika Qo‘shma ShtatlariFLFlorida
200 000 $ – 240 000 $ / yil
MasofaviyTo‘liq stavkaYetakchiTalab Qilinadigan Til: inglizchaDirektor

Lead enterprise and national customer relationships for Fetch’s PropTech platform, expanding strategic accounts and securing complex agreements. Grow regional adoption and revenue through cross-functional partnership and account expansion.

Ochish