Regal Medical Group Jobs in Glendale
9 Regal Medical Group jobs in Glendale, California found on Monster.Jobs 1 to 9 of 9
The Medical Claims Examiner III is responsible for the processing and releasing of hospital or medical claims according to established policies and procedures. Must identify procedural and system inefficiencies and work with the appropriate entities to resolve issues. Examiners also perform research, analyses, reporting and special projects as assigned. Examiners must be able to meet production re...
Present learning material in an organized and logical manner to department personnel on claims processing, including use of the EZCAP system, provider contract interpretation, DOFR, and claim handling procedures. Adjusts instruction process and pace to meet the unique needs of the staff. Serves as key point of contact between claims and Data Management and Contracting. Essential Duties and Respons...
The Hospital Compliance Auditor is responsible for performing activities related to benefit analysis and system design, and auto-adjudication applications as it applies to auditing co-pay/co-insurance benefits and claims compliance. This includes oversight of all workflow, research and documentation under limited supervision by the Claims management. Identifies potential company risks and implemen...
1. Medical Credential all new providers, Re-credential existing Providers. 2. Submit credentialing information as requested by contracted HMOs. 3. Maintain and update files on all credentialed Providers. 4. Provide credentialing information on a Provider when requested by other RMG or Lakeside departments. 5. Maintain and update Provider files in credentialing database. Qualifications: 1. Minimum...
The Master Social Workeror License Social Worker will provide assistance to members and their families in the form of counseling and resource referral. The Social Worker is responsible, along with other members of the Clinical, quality, financial and patient satisfaction outcomes of Regal Medical Group. Position Overview: 1. Develops individual treatment plans and makes recommendation for members....
The Vital Care Case Manager is responsible for the assessment, treatment planning, intervention, monitoring, evaluation and documentation on identified Vital Care patients. This Case Manager will assess and develop care plans in collaboration with the admitting, attending and consultant physicians as well as other healthcare practitioners. The goal of this position is to effectively manage the pat...
The Manager of Inpatient Case Management, is responsible for management and oversight of inpatient concurrent review, including related case management and discharge planning. The position is directly responsible for managing the daily operations of the Concurrent Review Department. Responsibilities include development and implementation of procedures, training, and processes to assure compliance...
1. Assist Medical Director of HCC/STAR and Lead Nurse of STAR/P4P/ACO with coordinating projects within the team and ensuring tasks are completed by their respective deadlines. 2. Collect data for P4P/STAR/ACO quality measures as outlined by HEDIS Technical Specifications and ACO specifications. 3. Resource for team members for clarification of measures, directions on how to complete projects and...
TheNurse Manager of ACO Case Management is responsible for the direct oversight of the ACO case management staff. The manager will oversee the daily case management activities such as the scheduling and training of staff, auditing of assessments, treatment planning, intervention and all documentation on identified ACO Beneficiaries. The ACO Manager of Case Management will be able to assess and dev...
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