Position Summary. We are looking for a Customer Service Representative to join our Member Services team in Northridge. Under general supervision, respond to telephone inquiries from members, Health Plans, providers and employer groups to provide information and clarification relating to RMG services such as claims, referrals, and eligibility in resolving inquiries and more. Essential Duties and Responsibilities include the following. Serve as the...
We are seeking a skilled HRIS Data Analyst to join our team. The ideal candidate must be located within a reasonable commuting distance to West Hills, CA. If you have strong HRIS experience and are ready to make an impact, we'd love to hear from you. Job Description. The Data Analyst will support the HR, Member Services & PALS team and report directly to the SVP of Human Resources, Member Services, and Patient Assistance Line. They will be respon...
Position Summary. This position is directly responsible for researching and maintaining coordination of benefits of all contracted and non contracted health plan entities as reported by any health plan, provider, Medicare, TPL, Workers Comp or internal departments. They are to ensure that all EZ-Cap system eligibility data is current and accurate. Researches and maintains systems and changes to existing eligibility in a timely manner. Essential D...
MUST BE ABLE TO WORK FULLY ONSITE IN NORTHRIDGE & WEST HILLS, CA. Position Summary. The Encounter Data Analyst I, interprets results using a variety of techniques, ranging from simple data aggregation via statistical analysis to complex data mining. Designs, develops, implements and maintains business solutions. Works directly with clients and project and business leaders to identify analytical requirements. This position is responsible for analy...
Position Summary. The Benefits Analyst is responsible of Providing daily leadership and coordination in the maintenance of Regal Medical Group's claims processing system. Supports accuracy of member benefit set up, assignments, claims processing, financial accuracy and data integrity. Applying analytical skills in improving system automation. Essential Duties and Responsibilities include the following. Provides daily oversight of benefits configu...
The Accountant performs professional and analytical tasks in the accounting/finance function. Tasks are sometimes repetitive in nature and follow prescribed procedures. At other times tasks are unique and require independent analysis to achieve general objectives. Work is performed independently, but is reviewed by management prior to release. As circumstance warrant, procedures are developed to provide accounting control over areas of financial ...
Position Summary. To direct, empower, and lead operational departments such as Claims, Customer Service, Human resources and Facilities/Mailroom in meeting all of the objectives and compliance goals. To maintain in strict confidence, all MRG/HPN, member, provider and Health Plan information to which Vice President of Operations has access. Essential Duties and Responsibilities include the following. Coordinate the development of, and oversee the ...
Position Summary. The Outpatient Coordinator is responsible for coordinating non-clinical tasks to support the delivery of case to members who meet case management criteria. Responsibilities include but are not limited to assisting in scheduling medical appointments, durable medical equipment, home health, eligibility/benefit verification, requesting medical records, data entry, and review of medical management reports. The Coordinator, Medical i...
The Provider Recruiter is responsible for recruiting talent for Professional Licensed level positions including Medical Directors, Physicians, Hospitalists and Advance Practitioners Clinicians (Nurse Practitioners, Physician Assistants). The position is an integral member of the recruitment team. This individual will develop candidate pools and must be capable of generating successful results in a fast paced environment. This role will be directl...
Position Summary. Under the general direction of the Senior VP of Regional Operations, the Project Manager primary responsibilities will be the oversight of all network Management. This includes oversight of all workflow, research and documentation under limited supervision by the Network management. Identifies potential company risks and implements appropriate courses of action and develop strategies to reduce adjudication errors. Analyzes all r...
The Employee Services Generalist provides day-to-day support across a broad range of HR functions, including employee relations, compliance, benefits administration, policy interpretation, and HR operations. This role partners with managers and employees to ensure fair, consistent, and compliant HR practices while promoting a positive workplace culture. The Generalist also supports recruitment and onboarding activities as needed, assists with inv...
Position Summary. The Project Specialist is responsible for taking lead on planning, developing, managing, and implementing outpatient case management program specific special projects. This includes gathering requirements for the special project through direct interface with the leadership team, other employees within the Outpatient Case Management department, other departments within the company, clients, vendors and administration, as well as ...
