Top 273 claims supervisor Jobs in irvine, ca

Healthcare Revenue Cycle Manager
ProMedix Health —Santa Ana, CA
- $135,000 - $180,000 a year
- Full-time
- 5 years
- Office
- Organizational skills
- Health insurance
- Dental insurance
Quick Apply
14d
Revenue Cycle Manager - Healthcare (FQHC Community Clinic)
Hurtt Family Health Clinic —Tustin, CA
- $85,000 a year
- Full-time
- 5 years
- HIPAA
- Finance
- 403(b) matching
- Health savings account
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Product Manager- Medical Device
NeurOptics —Irvine, CA
- $120,000 - $160,000 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Marketing
- Paid holidays
- Health insurance
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Client Relationship Manager, Employee Benefits - IAS, West
The Baldwin Group —Irvine, CA
- $90,000 a year
- Full-time
- Hybrid work
- Microsoft Outlook
- HIPAA
- Mid-level
Sr Client Relationship Manager, Employee Benefits - IAS, West
The Baldwin Group —Irvine, CA
- $110,000 - $120,000 a year
- Full-time
- Hybrid work
- Finance
- Analysis skills
- Bachelor's degree
7d
Case Manager - Class Action Settlement Administrator
ILYM Group, Inc. —Tustin, CA
- From $80,000 a year
- Full-time
- Microsoft Excel
- Mid-level
- Bachelor's degree
- Health insurance
- 401(k)
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Worker's Compensation Case Manager
Minaie Law Group —Irvine, CA
- $65,000 - $75,000 a year
- Full-time
- Spanish
- Customer service
- Writing skills
- Health insurance
- Dental insurance
Quick Apply
1d
Workers' Compensation Case Manager
Chris and Frank Accident Attorneys —Newport Beach, CA
- $25 - $30 an hour
- Full-time
- Spanish
- Customer service
- Medical office experience
- Health insurance
- Dental insurance
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8h
Compliance Manager
Wismettac Asian Foods Inc —Santa Fe Springs, CA
- $88,764 - $110,955 a year
- Full-time
- Background check
- Microsoft Excel
- 6 years
- Health savings account
- Health insurance
Quick Apply
3d
Personal Injury Case Manager (2 Years of Experience Required)
MOET LAW GROUP —Irvine, CA
- $55,000 - $85,000 a year
- Urgently hiring
- Bilingual
- Research
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
On-Site Resident Manager (Community Manager)
Jamboree Management —Stanton, CA
- $17 an hour
- Part-time
- Background check
- Writing skills
- Mid-level
- 401(k)
- Flexible schedule
Quick Apply
7d
Case Manager Assistant - Personal Injury Law Firm
Pathway Law Firm —Costa Mesa, CA
- $20 - $35 an hour
- Full-time
- Spanish
- English
- Mid-level
- Free parking
- AD&D insurance
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General Manager
Rare Society —San Clemente, CA
- From $95,000 a year
- 12 hour shift
- Hospitality
- Microsoft Excel
- Management
- Health insurance
- Dental insurance
Quick Apply
2d
Senior Heavy Duty Personal Lines Manager
McGowan and Company —California
- $70,000 - $100,000 a year
- Full-time
- Remote
- Microsoft Word
- 7 years
- Microsoft Excel
- Health savings account
- Paid holidays
Quick Apply
Supply Chain Manager
Confidential —Buena Park, CA
- From $75,000 a year
- Full-time
- 7 years
- Oracle
- Inventory management
- Health insurance
- Dental insurance
Quick Apply
Human Resources Manager - Property Management - In office
Aperto Property Management —Irvine, CA
- $100,000 - $115,000 a year
- Full-time
- Background check
- Spanish
- 6 years
- Health insurance
- Dental insurance
Quick Apply
Resort General Manager - San Clemente Inn
Grand Pacific Resorts —San Clemente, CA
- $80,000 - $90,000 a year
- Weekends as needed
- Inventory management
- Business development
- Mentoring
- Health insurance
- Dental insurance
Quick Apply
2d
Personal Injury Case Manager
Avrek Law —Newport Beach, CA
- $26 - $60 an hour
- Full-time
- Spanish
- Mid-level
- 2 years
- Health insurance
- Dental insurance
Quick Apply
Project Manager - Commercial
Cupertino Electric, Inc. —Santa Fe Springs, CA
- $109,000 - $136,000 a year
- Full-time
- Construction site
- 5 years
- Office
7d
Case Manager
All Star Injury Attorneys Dba Core Family Law —Santa Ana, CA
- $70,000 - $120,000 a year
- 8 hour shift
- Spanish
- English
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
1d

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claims supervisor jobs near irvine, ca

Healthcare Revenue Cycle Manager

ProMedix Health -
Santa Ana, CA

Quick Apply

Job Details

Full-time
$135,000 - $180,000 a year
14 days ago

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance

Qualifications

Financial close processing
Contract management
Teamwork
Medicare
Operations management
Accounts receivable management
Overseeing healthcare denial management
Provider enrollment for medical credentialing
CMS
Regulatory compliance in claims processing
Contract management in healthcare
CMS regulatory compliance
Medicare regulations
Clinical documentation
Medical insurance appeals management
Organizational skills
Contracts
Revenue recognition
Centers for Medicare & Medicaid Services (CMS) billing regulations
Medical claims submission
Medical billing account reconciliation
Clinical documentation improvement
Clinical documentation standards
Month-end close
Medical claim denial management
Audit support
Senior leadership
Terms and conditions negotiation

Full Job Description

Director of Revenue Cycle & Compliance

Medicare RCM - CPT Billing - Payer Contracting - Multi-State Credentialing - Compliance

ProMedix Health · Southern California · On-Site · Full-Time

About ProMedix Health

ProMedix Health is a Medicare-focused virtual care company based in Southern California, delivering Chronic Care Management (CCM), Remote Patient Monitoring (RPM), and related programs to patients across medical practices, physician groups, and health systems. We are expanding rapidly across multiple states and payer environments and need a senior revenue cycle leader to own the financial integrity of our billing operations end to end.

Location

Southern California - On-site full-time (no remote or hybrid)

Employment Type

Full-Time, Exempt

The Opportunity

ProMedix Health is looking for a Director of Revenue Cycle & Compliance who owns the full revenue cycle across our chronic care management programs - from claims submission and denial management through collections, payer contract negotiations, and multi-state credentialing. This is a senior leadership role requiring deep Medicare billing expertise, strong compliance knowledge, and the ability to operate across a complex and growing payer environment that includes both fee-for-service and capitated arrangements.

This role carries joint accountability with the Controller for ensuring all RCM data is audit-ready at month-end. Deep healthcare industry experience in a Medicare-focused organization is required.

Core Responsibilities

Revenue Cycle Management

Own the end-to-end revenue cycle across all CCM, RPM, and related programs - from charge capture and claims submission through collections and AR management
Ensure all claims are submitted accurately, completely, and on time - zero tolerance for preventable denials caused by documentation gaps or coding errors
Lead denial management - analyze denial patterns by payer and code, implement corrective actions, and track improvement
Oversee medical billing staff - set performance standards, monitor accuracy, and hold the billing function accountable to defined KPIs
Ensure all RCM data is audit-ready at each month-end close - AR balances reconciled, claim statuses current and documented, and revenue recognition inputs aligned with the Controller's financial reporting requirements

Medicare Billing, CPT Coding & Billing Compliance

Maintain deep working knowledge of Medicare CCM, RPM, CoCM, TCM, and related billing requirements - documentation standards, time thresholds, and CMS compliance
Ensure CPT coding accuracy across all programs - identify and correct miscoding, undercoding, and compliance risks
Ensure billing and coding compliance with CMS requirements across all programs - maintain audit-ready documentation standards and work in close collaboration with clinical and legal counsel on broader regulatory compliance matters
Stay current on Medicare billing policy changes and CMS guidance - implement changes proactively

Payer Contracting & Relationship Management

Lead payer contract negotiations with Medicare Advantage plans, IPAs, and managed care organizations - including both fee-for-service and capitated arrangements
Actively manage the financial implications of capitation versus fee-for-service across the payer mix
Develop and maintain productive relationships with key payers - resolve disputes and reduce denial rates
Evaluate and negotiate new payer agreements as the company expands into new markets

Multi-State Credentialing & Market Expansion

Own Medicare credentialing across all active and target states - manage the process to support market launch timelines
Maintain current credentialing status across all states and all payers - proactively manage renewals
Stay ahead of state-specific Medicare enrollment requirements as new markets are activated

Financial Reporting & Collaboration

Deliver regular RCM performance reporting to the CEO - claims, collections, denial rates, AR aging, and reimbursement per enrolled patient by program
Work closely with the Controller to ensure RCM data accurately supports financial reporting, revenue recognition, and audit readiness
Identify and proactively address operational leakage in the billing and collections process

What We Are Looking For

Required

Minimum 5 years of RCM experience with at least 3 years in a senior role in a Medicare-focused organization
Deep expertise in Medicare CCM, RPM, or chronic care management billing - CPT coding, documentation requirements, and CMS compliance standards
Demonstrated experience with both fee-for-service and capitated reimbursement arrangements
Proven experience negotiating payer contracts with Medicare Advantage plans, IPAs, or managed care organizations
Multi-state Medicare credentialing experience across more than one state
Strong denial management and AR management track record with measurable results
Demonstrated month-end close experience from an RCM perspective - audit-ready AR reconciliations and revenue recognition data delivered to finance on a defined monthly schedule
Deep healthcare industry experience required - minimum 5 years in a Medicare-focused organization with direct familiarity with CMS requirements, payer dynamics, and healthcare compliance standards

Why ProMedix

Own a critical revenue function at a company growing rapidly across multiple markets and programs
A complex and intellectually engaging RCM environment spanning multiple payer types, programs, and states
Competitive compensation and benefits
A mission-driven company improving outcomes for Medicare patients managing chronic conditions

Salary Disclaimer - Pay Transparency

ProMedix Health offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our benefits package includes, but is not limited to, paid time off, a 401(k) retirement plan, medical, dental, and vision coverage, and other voluntary benefit options. Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary.

A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $135,000 to $180,000 on an annualized basis. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

To Apply

Submit your resume and a brief cover letter describing your Medicare RCM experience - specifically your background with CCM or RPM billing, payer contracting, and multi-state credentialing. We review applications on a rolling basis and move quickly for strong candidates.

ProMedix Health is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Pay: $135,000.00 - $180,000.00 per year

Work Location: In person

Quick Apply

Refine Your Search

claims supervisor jobs in irvine, ca

Healthcare Revenue Cycle Manager

Revenue Cycle Manager - Healthcare (FQHC Community Clinic)

Product Manager- Medical Device

Client Relationship Manager, Employee Benefits - IAS, West

Sr Client Relationship Manager, Employee Benefits - IAS, West

Case Manager - Class Action Settlement Administrator

Worker's Compensation Case Manager

Workers' Compensation Case Manager

Compliance Manager

Personal Injury Case Manager (2 Years of Experience Required)

On-Site Resident Manager (Community Manager)

Case Manager Assistant - Personal Injury Law Firm

General Manager

Senior Heavy Duty Personal Lines Manager

Supply Chain Manager

Human Resources Manager - Property Management - In office

Resort General Manager - San Clemente Inn

Personal Injury Case Manager

Project Manager - Commercial

Case Manager

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