Top 18 Rac Jobs in La Verne Ca

RAC Manager
Prime Healthcare Management Inc —Ontario, CA
- $71,760.00 - $94,619.20 a year
- Full-time
- Mid-level
- Master's degree
- Bachelor's degree
- Health insurance
- Dental insurance
4d
Seasonal Retail Sales Associate - SAC SacBook Rac B2324
Follett —Walnut, CA
- $18.50 an hour
- Weekends as needed
- 18 years or older
- Computer literacy
- Merchandising
- Flexible schedule
5d
Office Systems Associate 1
Konica Minolta Business Solutions, U.S.A., Inc. —Riverside, CA
- Full-time
- Commercial
- Paid training
- Paid holidays
AR Area Manager/AR Consultant
Rockwell Care —Ontario, CA
- $130,000 - $140,000 a year
- Full-time
- Skilled nursing facility
- Mid-level
- Residential
- Health insurance
- Dental insurance
Quick Apply
Regulatory Affairs Coordinator
University of California, Irvine —Orange, CA
- $37.56 - $61.91 an hour
- Full-time
- Background check
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Retirement plan
Mental Health Worker
Clear Behavioral Health —El Monte, CA
- $21 - $25 an hour
- Full-time
- Addiction Medicine
- Mid-level
- Residential
Quick Apply
Staff International Regulatory Affairs Specialist
Stryker —Irvine, CA
- $110,100 - $183,400 a year
- Full-time
- Engineering
- Mid-level
- Office
- Health savings account
- AD&D insurance
10h
Participant Recruitment Agent
Altasciences —Cypress, CA
- Communication skills
Director of Nursing - Covina Skilled Nursing Facility
Masonic Home: Covina —Covina, CA
- $145,000 - $178,000 a year
- Full-time
- Nursing
- Skilled nursing facility
- RN License
- Tuition reimbursement
- Opportunities for advancement
Quick Apply
13d
Program Manager
Clear Behavioral Health —Anaheim Hills, CA
- $25 - $30 an hour
- Full-time
- CPR Certification
- Addiction Medicine
- BLS Certification
- Paid holidays
- Disability insurance
Quick Apply
Clinical Research Technician I (CPT or MA)
Altasciences —Cypress, CA
5d
Physician Assistant
Altasciences —Cypress, CA
- On call
- Paid holidays
- Health insurance
Licensed Vocational Nurse
Altasciences —Cypress, CA
Denials Manager RN
AHMC Healthcare —San Gabriel, CA
- From $53.10 an hour
- Full-time
- Nursing
- RN License
- Hospital

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RAC Manager

Prime Healthcare Management Inc -
Ontario, CA

Apply Now

Job Details

Full-time
$71,760.00 - $94,619.20 a year
4 days ago

Benefits

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

Qualifications

Master's degree

Full Job Description

Overview:

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

Responsibilities:

The RAC Manager serves as the primary contact and representative handling the data/documentation requests received based on the Government audits and manage the appeals process as part of the denial management. Is knowledgeable in the specific functions of the clerical positions and serves as a resource for co-workers. Is responsible for maintaining integrity of tracking Government review audits (RAC, MAC, CERT, OIG, Pre/Post Probes, HSAG and M-Cal), and others as they are created. Working with the Supervisor(s), a RAC manager functions as a subject matter expert (SME) for the appeals process and takes an active role in managing the process and coordinating with the RAC team, Corporate Utilization Review and Clinical appeals team. Provides supervision and direction for Medicare and Medicaid Appeals process along with analysis, resolution, monitoring & reporting of clinical denials. Facilitates peer to-peer following appeals submission for Fair Hearing for Medicaid audits. Serves as a liaison between Case management, Business office and Coding teams to ensure timely reporting and tracking/ follow up of denials. Reviews and determines appropriate strategy in response to reimbursement denials. Coordinates data analytics to determine denial trends and reasons that could be reviewed with administration / CMO wherever applicable. In tandem with the Training Supervisor keeps abreast with the ongoing education/training to stay current with emerging industry trends on denials management. Performs ongoing audits; to monitor ADR requests and appeal/denial process and develops process improvement plans for identified deficiencies. Able to work independently and use sound judgment. Knowledge of Federal, State, and intermediary guidelines related to inpatient, acute care hospitalization, as well as lower levels of care for the continuity of treatment. Performs other duties as assigned.

Qualifications:

Required qualifications:

Master’s in healthcare with one year experience in denial management.

Preferred qualifications:

ECFMG Certification And/or Bachelor’s or higher from a US-based accredited institution in a Health and Human Services field is highly preferred.
Extensive knowledge of nursing care, clinical measurement tools, and clinical outcomes; ability to establish cooperative working relationship with diverse groups and individuals, the medical staff, and other healthcare disciplines; program and database development a plus
1+ year of clinical experience in acute care setting preferred.
Excellent written and verbal communication skills. Excellent critical thinking skills.
Excellent interpersonal skills to build effective partnering relationships with physicians, nurse staff, coding staff and hospital management staff.

Pay Transparency:

Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more 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 $71,760.00 to $94,619.20 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.

Employment Status: Full Time Shift: Days Equal Employment Opportunity:

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

Privacy Notice:

Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf

Apply Now

Refine Your Search

rac jobs in la verne ca

RAC Manager

Seasonal Retail Sales Associate - SAC SacBook Rac B2324

Office Systems Associate 1

AR Area Manager/AR Consultant

Regulatory Affairs Coordinator

Mental Health Worker

Staff International Regulatory Affairs Specialist

Participant Recruitment Agent

Director of Nursing - Covina Skilled Nursing Facility

Program Manager

Clinical Research Technician I (CPT or MA)

Physician Assistant

Licensed Vocational Nurse

Denials Manager RN

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