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HMO JOBS - Page 1


1 HMO Claims Examiner Redlands, CA, USA The HMO Claims Examiner administers HMO contracts by processing medical claims in an efficient, cost-effective, and timely manner. Responsible for determining financial responsibility between group ...... Apply Now>>

2 Senior Underwriter - Health Insurance Excess - HMO Reinsurance Dayton, NJ, USA Senior Underwriter - Health Insurance Excess - HMO Reinsurance - Dayton, NJ Underwrite Provider Excess and Health Maintenance Organization Reinsurance accounts including financially distressed ...... Apply Now>>

3 HMO Coordinator Buffalo, NY, USA HMO Coordinator Buffalo Center is actively seeking a motivated and experienced HMO Coordinator for our skilled nursing facility in Buffalo, NY. Competitive Rates and Excellent Benefits Packages ...... Apply Now>>

4 HMO/Occupancy Specialist Trenton, NJ, USA HMO/Occupancy Specialist Hours: 8:30 AM to 4:30 PM Duties and Responsibilities: Under supervision of an Asset Manager, conduct financial reviews of operating budgets, financial statements and monthly ...... Apply Now>>

5 Patient Account Representative, Medi-Cal HMO Torrance, CA, USA Providence is calling a Patient Account Representative, Medi-Cal HMO to Providence Regional Business Office in Torrance, CA. We are seeking a Patient Account Representative, Medi-Cal HMO to be ...... Apply Now>>

6 Claims Examiner I - HMO Claims Processing Mission Hills, CA, USA Two or more years HMO claims processing experience required in a managed care environment, preferably PMG/IPA setting within the last three years or any combination of education and/or experience ...... Apply Now>>

7 HMO Clerk III (Medical Biller/Collections) San Jose, CA, USA MAJOR JOB OBJECTIVES AND RESPONSIBILITIES: ยท Match authorization with billing and send to HMO or Hospital Risk Fund department. Strict attention must be paid to matching the bill with the authorized ...... Apply Now>>

8 HMO Biller Lakewood, NJ, USA GroFlex - Lakewood, NJ Healthcare company in Lakewood, NJ, seeking a full-time HMO biller who will be responsible to follow up on unpaid claims to ensure proper financial reimbursement from insurance ...... Apply Now>>

9 Assistant Manager of Children's Residential Home sunderland, UK ForeverCare Due to our accelerated growth, ForeverCare requires an Assistant Manager to assist in the management of the children's home. Since 2014, we have grown from one children's home to one ...... Apply Now>>

10 Senior. Underwriter, HMO Reinsurance and Provider Excess Plymouth, MN, USA We currently have an opportunity for a Senior level Underwriter to join our HMO Reinsurance and Provider Excess of Loss team. This position reports to our VP of Managed Care Excess Underwriting and ...... Apply Now>>

11 HMO Biller West Covina, CA, USA Qualifications - Strong preference for applicants familiar with HMO, private insurance and/or Medi-Cal billing practices - Excellent phone etiquette/customer service skills - Exceptional ability to ...... Apply Now>>

12 Patient Financial Representative (WMG Billing) - York - FT (HMO Insurance Billing) (46450) York, PA, USA Required Skills Minimum Experience 3 - 6 months HMO Billing experience 3 - 6 Months Medical Assistance Experience Interpersonal/communications skills ICD9 and CPT coding Insurance knowledge Computer ...... Apply Now>>

13 Customer Service Specialist I - HMO Spokane, WA, USA Customer Service Specialist I - HMO LOCATION: Spokane, Washington REQNUMBER: 173356 External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records ...... Apply Now>>

14 Sr Internal Auditor / WI MercyCare HMO Janesville, WI, USA # JOB SUMMARY ##### Design and manage the annual audit plan.# Responsible for designing and conducting financial and risk-based audits to assure MercyCare#s adherence with industry standards, federal ...... Apply Now>>

15 Sr Specialist, Member Engagement (Field) Milwaukee, WI, USA Investigates and resolves access and cultural sensitivity issues identified by HMO staff, State staff, providers, advocate organizations, subcontractors and enrollees. * Monitors all formal and ...... Apply Now>>

16 Family Medicine Holly Hil, FL, USA Large Florida HMO looking for Family Medicine provider * Located in Daytona Beach, FL * Need is 90% outpatient but does require rounding at a nursing home * This is rotated 1 week every 4 * Call is ...... Apply Now>>

17 Skilled Nursing Medical Biller San Diego, CA, USA All Health Center billing, including HMO and Medicare. * Enter claims directly into Medicare system. * Meet daily with Nursing Department Heads and Admissions to review treatment plans and changes in ...... Apply Now>>

18 PT New Grads WELCOME...Travel options with $2200 weekly Chico, CA, USA DENTAL Intergro offers both an HMO & POS Dental plan -- Dental is through Principal (POS) and Cal-Dental (HMO) Intergro pays 100% HMO dental coverage for employee if you elect POS coverage, youre ...... Apply Now>>

19 Urgent Care, Urgent Care Physician Needed in Redlands, CA Redlands, CA, USA The Health Care Insurance is an HMO plan utilizing Beaver physicians. For a modest additional cost, a non-Beaver primary care group (which accepts our HMO plan, currently with Blue Cross-Anthem) can ...... Apply Now>>

20 Claims Examiner II Riverside, CA, USA HMO Claims Responsible for preparing, researching, analyzing, pre-coding and the adjudication of all types of claims (Contracted providers, Non-contracted, 1500 or UB claims forms, Senior and ...... Apply Now>>

21 Hospitalist, Medical Director Bothell, WA, USA Knowledge of NCQA, HEDIS, Medicaid, MediCare and Pharmacy benefit management, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization ...... Apply Now>>

22 Program Manager, Clinical, Quality Improvement San Francisco, CA, USA The Clinical Program Manager, Quality Improvement HMO / ACO is responsible for the development and execution of targeted, quality improvement initiatives in support of the HMO and ACO lines of ...... Apply Now>>

23 Automotive Sales - Victory Toyota Seaside, CA, USA We offer great benefits for our employees; medical PPO & HMO, dental and vision insurance, free life insurance, 401K plans, and voluntary benefit plans such as disability, cancer and accident ...... Apply Now>>

24 Collector - Community Care (44637) Overland Park, KS, USA Audit HMO EOB's (Explanation of Benefits) for rejections and short pays on a timely basis. * Research the rejection, based on rejection code - identify the nature of the problem and implement a ...... Apply Now>>

25 Network Management - Manager Brentwood, TN, USA ... at HMO or PPO) is required * 4 years of experience in HMO provider/hospital/ancillary contracting and network development with emphasis on risk/value based contracting is required * 1 year of ...... Apply Now>>

26 Network Management - Manager Belleville, IL, USA Candidate Experience: * 5 years of relevant work experience in the healthcare sector, (preferably at HMO or PPO). * 3 years experience in HMO provider/hospital/ancillary contracting and network ...... Apply Now>>

27 CNC Turning Machinist Auburn Hills, MI, USA Total Health Care HMO free to employees! This includes medical and vision. Dental is also included with Delta Dental. Nationwide 401k available for eligible employees. Employee incentives from tool ...... Apply Now>>

28 CNC Prototype Quality Inspector Auburn Hills, MI, USA Benefits We offer free HMO health care (with an option to upgrade for an additional cost), dental, optical and life insurance. Total Health Care HMO free to employees! This includes medical and ...... Apply Now>>

29 Account Representative/Appeals/Collections Tampa, FL, USA Three (3) years of knowledge in HMO PPO/Commercial, Medicare, or Medicaid/Government payers or business office setting * Typing skills equal to 35 words per minute net * Proficiency in performance of ...... Apply Now>>

30 Internal Medicine - Physician Tampa, FL, USA They PREFER candidates with experience in HMO but open to training.Must want to be in the area. Client looking for long term physiciansPer client it\'s a \"great family town and good school district ...... Apply Now>>

31 Claims Processor San Diego, CA, USA One-year previous claims * processing experience in an HMO or indemnity insurance setting (HMO preferred). . Preferred Skills and Qualifications * High school graduate or equivalent preferred. * Some ...... Apply Now>>

32 Part Time Dentist Palmdale, CA, USA Experienced Dentist for busy, established practice,with knowledge of ppo, hmo, dentical and all aspects of general dentistry including: endo, oral surgery (3d molars and implants plus) perio ...... Apply Now>>

33 Director Of Managed Care Long Beach, CA, USA The contracts include such payer entities as HMO's, PPO's, EPO's, Workers Compensation carriers and MediCal. By securing optimal reimbursement and protecting the interests of the hospitals in ...... Apply Now>>

34 Medical Claims Audit Analyst San Diego, CA, USA Knowledge of health insurance or HMO operations with emphasis on claims processing, system set up and auditing software. * Ability to positively communicate with coworkers. * Excellent organizational ...... Apply Now>>

35 Pulmonary Critical Care Medicine, Pulmonary Critical Care Medicine (Idaho Falls, ID) Idaho Falls, ID, USA This unique opportunity offers tremendous professional advantages including the following: - Work in an area without HMO s where you can earn the income you deserve - Join an established practice ...... Apply Now>>

36 Program Assistant / Activities Assistant Evanston, IL, USA Optional dental HMO or PPO insurance * Tuition reimbursement promoting lifelong learning * Employee wellness programs, including free annual wellness screening * Learning to Age Well Program ...... Apply Now>>

37 Care Manager, Social Worker - Care Management, Full Time, Days, 8 Hours Mission Viejo, CA, USA Requires six (6) months of clinical experience in an HMO, medical group, affiliated model, hospital or medical office/clinic setting. License / Certification: * Current licensed Clinical Social ...... Apply Now>>

38 Medical Billing Specialist - Collector Beverly Hills, CA, USA Perform billing functions and extensive knowledge in claims generation, charge review, denial management, and appeals processes for HMO, Medi-Cal, Medicare and PPO. * Review pre-certification ...... Apply Now>>

39 Referral Coordinator Eureka, CA, USA Obtains authorization for procedures on both non-HMO as well as HMO/managed care patients. Under the direction of the CMS department is responsible for gathering additional clinical information ...... Apply Now>>

40 Administrative-Medical Director/CEO - Physician Assistant Phoenix, AZ, USA This includes those who may have Medicare, Medicaid, HMO or private insurance to cover their stay at various units. Discharge planning is coordinated with physicians, Nursing, patient and significant ...... Apply Now>>



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