Top 231 Liaison Jobs in Vacaville, Ca

Claims Resolution Coordinator
Partnership HealthPlan of California —Fairfield, CA
- $37.22 - $46.53 an hour
- Full-time
- Computer literacy
- Mid-level
- Office
Manager, Inventory Control
Gotham Greens —Davis, CA
- $75,000 - $90,000 a year
- Full-time
- Mid-level
- Microsoft Office
- 3 years
Quick Apply
Executive Assistant
Partnership HealthPlan of California —Fairfield, CA
- $88,154.59 - $110,193.23 a year
- Full-time
- Research
- Mid-level
- Office
Director of Housing & Services, Northern Region
Abode Services —Napa, CA
- $135,000 - $148,000 a year
- Clean driving record
- Microsoft Excel
- 5 years
- Dental insurance
- Paid time off
Quick Apply
Academic Specialist
CALRegional —Fairfield, CA
- $21 - $26 an hour
- Full-time
- Customer service
- Mid-level
- 2 years
Quick Apply
Security and Loss Prevention Expert, NA
Amazon.com Services LLC —Vacaville, CA
- $70,400 - $86,700 a year
- Full-time
- Up to 50% travel
- Inventory management
- Military
- AD&D insurance
- Health insurance
Case Manager
Friends Outside —Vacaville, CA
- $22 - $23 an hour
- Full-time
- Classroom
- Spanish
- Writing skills
Quick Apply
4d
Service Coordinator
FPM - Affordable Housing —Vacaville, CA
- $25 an hour
- Urgently hiring
- Microsoft Outlook
- Experience working with individuals with disabilities
- Writing skills
- Paid holidays
- Health insurance
Quick Apply
Environmental Health Safety Coordinator
MARIANI PACKING CO INC —Vacaville, CA
- $33 - $38 an hour
- Spanish
- Customer service
- Engineering
Care Manager - CA
Independent Living Systems —Napa, CA
- $26.00 - $43.81 an hour
- Full-time
- Spanish
- CPR Certification
- Nursing
Quick Apply
LVN Hospital Liaison, Home Health, Davis and Amador
Sutter Health —Davis, CA
- $39.78 - $55.69 an hour
- 8 hour shift
- Nursing
- LVN
- Hospital
Chancellor's Residence and Events Manager (EVENTS SUPV 2)
University of California, Davis —Davis, CA
- $88,100 - $162,100 a year
- Weekends as needed
- Hybrid work
- Background check
- Pass drug screening
- Residential
- Continuing education credits
- Paid holidays
7d
Apartment Manager
FPM - Affordable Housing —Vacaville, CA
- $27 an hour
- Weekends as needed
- Customer service
- Adults
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
4d
Special Agent: National Security, Criminal, & Intelligence Background
Federal Bureau of Investigation —California
- $103,236 - $133,200 a year
- Full-time
- Mid-level
- Bachelor's degree
- Travel
1d
Medical Director - Hospice on-site Full time
VITAS Healthcare —Fairfield, CA
- $280,000 - $320,000 a year
- Full-time
- Medicine
- Inpatient
- Home Health
- Disability insurance
- Health insurance
Quick Apply
Operations Associate
Gordian Wealth Advisors —Fairfield, CA
- $40,000 - $60,000 a year
- Full-time
- Background check
- Mid-level
- Office
- Health insurance
- Dental insurance
Quick Apply
Child Care FCCHEN Coach & Behavior Specialist Part-Time
A PLACE 2 GROW CARE & EDUCATION SYSTEM INC —Solano County, CA
- $24 - $32 an hour
- Full-time
- Background check
- Classroom
- Current TB test
- Paid holidays
- Paid time off
Quick Apply
Home Care Community Liaison & Marketer
HOME MATTERS CAREGIVING Napa —Napa, CA
- $65,000 - $78,000 a year
- Full-time
- Background check
- Skilled nursing facility
- Hospital
Quick Apply
Client Relations Coordinator
Benchmark Wine Group —Napa, CA
- $20 an hour
- 8 hour shift
- Microsoft Excel
- Microsoft Outlook
- Office
- Paid holidays
- Health insurance
Quick Apply
12d
Design Consultant
Rockwood Shutters —Vallejo, CA
- $75,000 - $100,000 a year
- Urgently hiring
- Background check
- Microsoft Excel
- Computer literacy
- Paid training
- Health insurance
Quick Apply

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liaison jobs near vacaville, ca

Claims Resolution Coordinator

Partnership HealthPlan of California -
Fairfield, CA

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Job Details

Full-time
$37.22 - $46.53 an hour

Qualifications

ICD-9
Driver's License
Typing

Full Job Description

Overview:

To research and resolve complex claims issues which cross interdepartmental lines and communicate the outcome to providers and affected Partnership managers. Develops and maintains provider training materials for all lines of business. Conducts provider trainings across Partnership departmental lines in group or individual provider settings.

Responsibilities:

Answers customer service lines as necessary and responds to provider inquiries either by phone, email, or in person regarding claims related questions.
Reviews, researches, and works with various departments to resolve complex provider inquiries, appeals, and grievances.
Acts as a resource and provides support to customer service staff, as well as Provider Relations staff for complex Provider questions regarding claims and payments.
Coordinates with Claims, Member Services, Health Services departments, the development, maintenance, and training of ongoing educational materials and tips for inclusion on the PHC website. Incorporates educational materials into the PR Manual and update on a quarterly basis.
Processes CIF's and adjustments as needed.
Writes and runs reports in Business Objects to obtain needed claim data.
Tracks and analyzes provider trends with denials and CIF's to provide support to providers with an opportunity to improve. Distributes provider scorecards.
Tracks complaints, appeals, and grievances by program. Reports activities on a quarterly basis to IQI, PHC Compliance Coordinator, and Claims Director.
Presents findings and recommendations for ongoing, long term resolutions to issues. Identifies items to address the “provider hassle factor.”
Acts as liaison and meets with designated staff from Claims, Health Services, Member Services, and QI departments to identify ongoing provider issues.
Coordinates system issues with Claims Configuration staff, IT staff, and PR Lead Project Specialist/Auditor. Leads or participates in special projects as needed.
Other duties as assigned

Qualifications:

Education and Experience

Minimum 1 year of experience in claims examining or customer service within healthcare, insurance, finance, or managed care environment; or equivalent combination of relevant experience and education.

Special Skills, Licenses and Certifications

Familiarity with Medi-Cal and/or managed care claims processing. Knowledge of CPT, HCPC procedure coding, and ICD-9 diagnostic coding. Knowledge of Partnership Claim Policy and Procedures, Medi-Cal provider manual guidelines, Title 22 regulations and any other required policies, procedures, regulations, and manuals. Typing speed 30 wpm and proficient use of 10-key calculator. Valid California driver’s license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business .

Performance Based Competencies

Ability to analyze and research claims issues. Excellent written and oral communication skills. Ability to present statistical and technical data in a clear and understandable manner. Good organization skills. Ability to work on multiple assignments simultaneously, prioritize work and complete projects within established time frames. Use good judgment in making decisions within scope of authority and handle sensitive issues with tact and diplomacy.

Work Environment And Physical Demands

Ability to use a computer keyboard. More than 60% of work time is spent in front of a computer monitor. When required, ability to move, carry or list objects of varying size, weighing up to 5 lbs.

All HealthPlan employees are expected to:

Provide the highest possible level of service to clients;
Promote teamwork and cooperative effort among employees;
Maintain safe practices; and
Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

HIRING RANGE:

$ 37.22 - $ 46.53

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Apply Now

Refine Your Search

liaison jobs in vacaville, ca

Claims Resolution Coordinator

Manager, Inventory Control

Executive Assistant

Director of Housing & Services, Northern Region

Academic Specialist

Security and Loss Prevention Expert, NA

Case Manager

Service Coordinator

Environmental Health Safety Coordinator

Care Manager - CA

LVN Hospital Liaison, Home Health, Davis and Amador

Chancellor's Residence and Events Manager (EVENTS SUPV 2)

Apartment Manager

Special Agent: National Security, Criminal, & Intelligence Background

Medical Director - Hospice on-site Full time

Operations Associate

Child Care FCCHEN Coach & Behavior Specialist Part-Time

Home Care Community Liaison & Marketer

Client Relations Coordinator

Design Consultant

I want to receive the latest job alert for liaison in vacaville, ca

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