Familiarity with DHCS, DMHC, CMS dispute handling regulations. What We Offer * Remote work offered * Equipment provided * Paid training to set you up for success * Comprehensive benefits: Medical ...
Quick apply
Familiarity with DHCS, DMHC, CMS dispute handling regulations. What We Offer * Remote work offered * Equipment provided * Paid training to set you up for success * Comprehensive benefits: Medical ...
Quick apply
Familiarity with DHCS, DMHC, CMS dispute handling regulations. What We Offer * Remote work offered * Equipment provided * Paid training to set you up for success * Comprehensive benefits: Medical ...
Familiarity with DHCS, DMHC, CMS dispute handling regulations. What We Offer * Remote work offered * Equipment provided * Paid training to set you up for success * Comprehensive benefits: Medical ...
Familiarity with DHCS, DMHC, CMS dispute handling regulations. What We Offer * Remote work offered * Equipment provided * Paid training to set you up for success * Comprehensive benefits: Medical ...
Tampa, FL · On-site +1
Familiarity with DHCS, DMHC, CMS dispute handling regulations. What We Offer * Remote work offered * Equipment provided * Paid training to set you up for success * Comprehensive benefits: Medical ...
Tampa, FL · On-site +1
Familiarity with DHCS, DMHC, CMS dispute handling regulations. What We Offer * Remote work offered * Equipment provided * Paid training to set you up for success * Comprehensive benefits: Medical ...
Sherman Oaks, CA · On-site +1
$24 - $27/hr
Remote POSITION SUMMARY: The Assisted Living Waiver Program Care Coordination Agency (ALWP CCA ... DHCS ALWP Policy * Participates in appropriate continuing education as may be required and/or ...
Sherman Oaks, CA · On-site +1
$24 - $27/hr
Remote POSITION SUMMARY: The Assisted Living Waiver Program Care Coordination Agency (ALWP CCA ... DHCS ALWP Policy * Participates in appropriate continuing education as may be required and/or ...
Los Angeles, CA · Remote
$65K - $80K/yr
Ensure compliance with state and federal regulatory requirements, including CMS, DHCS, DMHC, and ... Remote or hybrid work flexibility. * Opportunity to play a key leadership role within a growing ...
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Los Angeles, CA · Remote
$65K - $80K/yr
Ensure compliance with state and federal regulatory requirements, including CMS, DHCS, DMHC, and ... Remote or hybrid work flexibility. * Opportunity to play a key leadership role within a growing ...
$24 - $27/hr
Remote POSITION SUMMARY: The Assisted Living Waiver Program Care Coordination Agency (ALWP CCA ... DHCS ALWP Policy * Participates in appropriate continuing education as may be required and/or ...
$24 - $27/hr
Remote POSITION SUMMARY: The Assisted Living Waiver Program Care Coordination Agency (ALWP CCA ... DHCS ALWP Policy * Participates in appropriate continuing education as may be required and/or ...
Torrance, CA · On-site +1
$120K - $130K/yr
... remote programming environments. The Director brings strong clinical insight, operational ... Ensure full compliance with DHCS, Joint Commission, and telehealth regulations, maintaining audit ...
Torrance, CA · On-site +1
$120K - $130K/yr
... remote programming environments. The Director brings strong clinical insight, operational ... Ensure full compliance with DHCS, Joint Commission, and telehealth regulations, maintaining audit ...
Fountain Valley, CA · Remote
$24.01/hr
Fountain Valley, CA / Predominantly Remote Department: IPA - Provider Network Status: Full-Time ... NCQA, ICE, DMHC, DHCS, CMS, and contracted health plans. * Use pertinent data and facts to identify ...
Fountain Valley, CA · Remote
$24.01/hr
Fountain Valley, CA / Predominantly Remote Department: IPA - Provider Network Status: Full-Time ... NCQA, ICE, DMHC, DHCS, CMS, and contracted health plans. * Use pertinent data and facts to identify ...
Torrance, CA · Remote
$120K - $130K/yr
... remote programming environments. The Director brings strong clinical insight, operational ... Ensure full compliance with DHCS, Joint Commission, and telehealth regulations, maintaining audit ...
Torrance, CA · Remote
$120K - $130K/yr
... remote programming environments. The Director brings strong clinical insight, operational ... Ensure full compliance with DHCS, Joint Commission, and telehealth regulations, maintaining audit ...
Be Seen First
Los Angeles, CA · Remote
$65K - $80K/yr
Ensure compliance with state and federal regulatory requirements, including CMS, DHCS, DMHC, and ... Remote or hybrid work flexibility. * Opportunity to play a key leadership role within a growing ...
Quick apply
Urgent
Be Seen First
Los Angeles, CA · Remote
$65K - $80K/yr
Ensure compliance with state and federal regulatory requirements, including CMS, DHCS, DMHC, and ... Remote or hybrid work flexibility. * Opportunity to play a key leadership role within a growing ...
Urgent
Fountain Valley, CA · Remote
$24.01/hr
Fountain Valley, CA / Predominantly Remote Department: IPA - Provider Network Status: Full-Time ... NCQA, ICE, DMHC, DHCS, CMS, and contracted health plans. * Use pertinent data and facts to identify ...
Fountain Valley, CA · Remote
$24.01/hr
Fountain Valley, CA / Predominantly Remote Department: IPA - Provider Network Status: Full-Time ... NCQA, ICE, DMHC, DHCS, CMS, and contracted health plans. * Use pertinent data and facts to identify ...
Fountain Valley, CA · Remote
$24.01/hr
Fountain Valley, CA / Predominantly Remote Department: IPA - Provider Network Status: Full-Time ... NCQA, ICE, DMHC, DHCS, CMS, and contracted health plans. * Use pertinent data and facts to identify ...
Fountain Valley, CA · Remote
$24.01/hr
Fountain Valley, CA / Predominantly Remote Department: IPA - Provider Network Status: Full-Time ... NCQA, ICE, DMHC, DHCS, CMS, and contracted health plans. * Use pertinent data and facts to identify ...
Fresno, CA · Remote
$50K - $78K/yr
Remote Pay Range: $50,000-$78,000 PER YR Department: HCBA 700 POSITION SUMMARY: The HCBA Open Case ... The Case Manager must report all signs of abuse or neglect to DHCS and the Ombudsman (if abuse or ...
Fresno, CA · Remote
$50K - $78K/yr
Remote Pay Range: $50,000-$78,000 PER YR Department: HCBA 700 POSITION SUMMARY: The HCBA Open Case ... The Case Manager must report all signs of abuse or neglect to DHCS and the Ombudsman (if abuse or ...
Understanding of NCQA Accreditation standards, HEDIS, CAHPS and state regulatory requirements (DHCS, DMHC). * Strong project management skills, including ability to manage timelines, facilitate ...
Understanding of NCQA Accreditation standards, HEDIS, CAHPS and state regulatory requirements (DHCS, DMHC). * Strong project management skills, including ability to manage timelines, facilitate ...
Long Beach, CA · Remote
$76K - $149K/yr
Understanding of NCQA Accreditation standards, HEDIS, CAHPS and state regulatory requirements (DHCS, DMHC). * Strong project management skills, including ability to manage timelines, facilitate ...
Long Beach, CA · Remote
$76K - $149K/yr
Understanding of NCQA Accreditation standards, HEDIS, CAHPS and state regulatory requirements (DHCS, DMHC). * Strong project management skills, including ability to manage timelines, facilitate ...
Long Beach, CA · Remote
$76K - $149K/yr
Understanding of NCQA Accreditation standards, HEDIS, CAHPS and state regulatory requirements (DHCS, DMHC). * Strong project management skills, including ability to manage timelines, facilitate ...
Long Beach, CA · Remote
$76K - $149K/yr
Understanding of NCQA Accreditation standards, HEDIS, CAHPS and state regulatory requirements (DHCS, DMHC). * Strong project management skills, including ability to manage timelines, facilitate ...
San Francisco, CA · Remote
$76K - $149K/yr
Understanding of NCQA Accreditation standards, HEDIS, CAHPS and state regulatory requirements (DHCS, DMHC). * Strong project management skills, including ability to manage timelines, facilitate ...
San Francisco, CA · Remote
$76K - $149K/yr
Understanding of NCQA Accreditation standards, HEDIS, CAHPS and state regulatory requirements (DHCS, DMHC). * Strong project management skills, including ability to manage timelines, facilitate ...
Los Angeles, CA · Remote
$76K - $149K/yr
Understanding of NCQA Accreditation standards, HEDIS, CAHPS and state regulatory requirements (DHCS, DMHC). * Strong project management skills, including ability to manage timelines, facilitate ...
Los Angeles, CA · Remote
$76K - $149K/yr
Understanding of NCQA Accreditation standards, HEDIS, CAHPS and state regulatory requirements (DHCS, DMHC). * Strong project management skills, including ability to manage timelines, facilitate ...
San Jose, CA · Remote
$76K - $149K/yr
Understanding of NCQA Accreditation standards, HEDIS, CAHPS and state regulatory requirements (DHCS, DMHC). * Strong project management skills, including ability to manage timelines, facilitate ...
San Jose, CA · Remote
$76K - $149K/yr
Understanding of NCQA Accreditation standards, HEDIS, CAHPS and state regulatory requirements (DHCS, DMHC). * Strong project management skills, including ability to manage timelines, facilitate ...
Sacramento, CA · Remote
$76K - $149K/yr
Understanding of NCQA Accreditation standards, HEDIS, CAHPS and state regulatory requirements (DHCS, DMHC). * Strong project management skills, including ability to manage timelines, facilitate ...
Sacramento, CA · Remote
$76K - $149K/yr
Understanding of NCQA Accreditation standards, HEDIS, CAHPS and state regulatory requirements (DHCS, DMHC). * Strong project management skills, including ability to manage timelines, facilitate ...
$9.13 - $9.83
6% of jobs
$9.83 - $10.53
5% of jobs
$10.53 - $11.23
0% of jobs
$11.23 - $11.93
3% of jobs
$11.93 - $12.63
5% of jobs
$12.63 - $13.33
4% of jobs
$13.37 is the 25th percentile. Wages below this are outliers.
$13.33 - $14.03
15% of jobs
The median wage is $14.32 / hr.
$14.03 - $14.73
26% of jobs
$15.13 is the 75th percentile. Wages above this are outliers.
$14.73 - $15.43
17% of jobs
$15.43 - $16.13
9% of jobs
$16.13 - $16.83
8% of jobs
$9
$13
$16
Other
Medical, Dental, Vision, Life, Retirement, PTO
Posted 4 days ago
Claims Quality Auditor| Remote
Job Type: Full time
Work Setup: Remote
Reports to: Claims Supervisor
Position Summary:
TheClaims Quality Auditor plays a key role in ensuring the accuracy, compliance, and effectiveness of claims processing and provider dispute resolution. The ideal candidatehas hands on experience withEZCap,auditing claims, analyzing dispute claims and evaluating internal policies and regulatory requirements, with a particular focus on Medi-Cal and commercial health plans.This role is responsible to partners closely with cross-functional teams to drive continuous improvement and operational excellence.
Key Duties:
Qualifications:
What We Offer
COMPANY OVERVIEW:
Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans members and providers.
The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans members and providers. The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients.
Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines.