20 Best jobs in Cypress, CA (Hiring Now!)

MSO Claims Manager
Innovative Management Systems, Inc. —Industry, CA
The MSO Claims Manager plays a pivotal role in overseeing the day-to-day operations of the Managed Service Organization (MSO) Claims Department, ensuring…
Estimated: $90,000 - $110,000 a year
Quick Apply
1h
Substitute Teacher K-12
Scoot Education —Norwalk, CA
Get hands-on teaching experience on your own schedule. $0 onboarding costs: We reimburse you for expenses related to state background checks.
Estimated: $180 - $275 a day
6d
Certified School Bus Driver. 10,000 Sign-on bonus
Zum SF Inc. —Los Angeles, CA
Comply with all applicable federal and state regulations regarding the operation of various types of vehicles in transporting pupils to and from school, special…
Estimated: $26.65 - $33.83 an hour
Administrator for Psychiatric Board and Care
EMC Hospice Inc. —Downey, CA
Licensed Administrator for Psychiatric Board and Care Facility. Must have experience and expertise in Marketing. Board and Care: 3 years (Required).
Estimated: From $80,000 a year
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1h
Cannabis Trimmer
GCC —Long Beach, CA
Execute tasks with precision, ensuring that the products are handled carefully as they near completion. Uphold safety protocols at all times, contributing to a…
$15.50 - $50.00 an hour
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Registered Behavior Technician (RBT)
Autism Partnership (US) —Seal Beach, CA
Possess a valid driver’s license, have access to reliable transportation, and provide proof of auto insurance. Must provide a TB test clearance.
Estimated: $22 an hour
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Criminal Investigator/Special Agent
United States Secret Service —California
Possess a current valid driver's license. Or J.D.) or two full years of progressively higher graduate education, in a related field, leading to such a degree…
$52,921 - $111,157 a year
Business Office Manager
Park View Estates Assisted Living and Memory Care Community —Fountain Valley, CA
Meet state-related requirements (if applicable to position). Live in the moment but plan for the future- Sunshine has a 401K plan and we offer company matching…
Estimated: $24 - $26 an hour
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Front Office Night Receptionist
Murphy, Murphy & Murphy, CPAs' —Cypress, CA
Answers incoming telephone calls, determines purpose of calls, and forward calls to appropriate personnel or Pod. Receives, sorts, and routes mail.
Estimated: $20 an hour
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2d
Front Desk Coordinator - West Dermatology
Platinum Dermatology Partners —Los Alamitos, CA
Employment decisions will comply with all applicable laws prohibiting discrimination in employment, including Title VII of the Civil Rights Act of 1964, The Age…
Estimated: $17 - $20 an hour
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3d
Forklift Operator - Warehouse ( 2nd Shift )
States Logistics Services, Inc. —Buena Park, CA
(Employees own 42% stock in the company.). Must be willing to do anything and everything needed to succeed, from picking orders to sweeping the floors.
Estimated: $18.00 - $24.50 an hour
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2d
Fire Alarm Construction Superintendent
Mission Critical Talent Partners —Los Angeles, CA
Supervision and Team Leadership:*Recruit, train, and supervise field crews, ensuring the adherence to safety protocols and delivering high-quality work.
Estimated: $35 - $47 an hour
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1h
Director of Housing
Southern California Health and Rehabilitation Program (SCHARP) —Lynwood, CA
Proven knowledge of local, state, and federal programs and resources critical to the supportive housing field and the challenge of ending homelessness …
Estimated: $85,000 a year
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6d
Dispatcher
Pearson Sales Company, Inc. —Pomona, CA
These problems normally include mechanical problems with trucks, delays due to traffic or weather challenges or changes requested by the customer.
Estimated: $17 - $25 an hour
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Registered Dietitian (Remote)
Fay —Irvine, CA
Proof you are a Registered Dietitian, certified by the Commission on Dietetic Registration. *New client referrals*: grow your clientele and book of business by…
Estimated: Up to $130 an hour
Quick Apply
Dishwasher
ichitaru ramen —Cypress, CA
We need a dishwasher for our restaurant, we have a dishwasher, it's easy work, cleanliness is required. 职位类型：兼职薪资： $16.50至$18.00（每小时）预计小时数：每周 25…
Estimated: $16.50 - $18.00 an hour
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1d
Remote Data Entry / Customer Service / Admin
Socket Telecom LLC —Los Angeles, CA
We’re looking for a Data Entry / Customer Service / Admin Assistant. High School Diploma or GED.
Estimated: $22 - $36 an hour
Quick Apply
4h
Food & Beverage Associates
Knott's Berry Farm —Buena Park, CA
Interact with our guests and make their day amazing through meaningful connections. Desire to be outdoors for extended periods in all weather conditions.
Estimated: $16 an hour
6d
Warehouse Worker
Downey Unified School District —Downey, CA
Valid California driver's license and acquisition of forklift certification within first five months of employment. Drive a District truck and operate forklift.
Estimated: $4,324 - $5,254 a month
6d
Full-Time Maintenance Worker - Weekend Day/Night Shift
City of Los Alamitos, CA —Los Alamitos, CA
~ Repair and maintain plumbing and electrical fixtures in City facilities. ~ Knowledge of plumbing and electrical parts and equipment.
Estimated: $4,035 - $4,900 a month
3d

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MSO Claims Manager

Innovative Management Systems, Inc. Industry, CA

Quick Apply

Job Details

Full-time $90,000 - $110,000 a year 1 hour ago

Benefits

Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Flextime
Employee assistance program
Vision insurance
Flexible schedule
Life insurance
Retirement plan

Qualifications

Management
Medicare
Organizational skills

Full Job Description

POSITION SUMMARY

The MSO Claims Manager plays a pivotal role in overseeing the day-to-day operations of the Managed Service Organization (MSO) Claims Department, ensuring compliance with CMS, Medicare/Medi-Cal, state, federal, and other regulatory requirements. As the head of the Claims Department, the Claims Manager will take the lead in training and mentoring Claims employees and addressing various Claims MSO operational requirements. This position involves managing Claims Examiners and includes responsibilities such as creating, maintaining, and updating Claims policies and procedures, as well as optimizing overall claims operations, identifying, and resolving any gaps, and reporting data needed for Health Plan Audits and any other data requested by internal/external stakeholders. This role requires the ability to quickly adapt and understand a new database system, QuickCap, and the capacity to work independently while contributing effectively to a team environment. The successful candidate will demonstrate a strong proficiency in establishing key performance indicators (KPIs) and managing and maintaining accurate data within the database system.

THE SPECS.

Exempt
Full-Time
Hybrid: remote and in-office
Management Level
Benefits-Eligible: PTO, PSL, Holidays, Medical, Dental, Vision, Etc.
Salary: 90k - 110k, depending on experience.

MAJOR DUTIES AND RESPONSIBILITIES

· Oversee Claims Department and Claims Examiner by being proactive and involved in the department, which include mentoring, training, maintaining day-to-day operations and employees.

· Recruit, train and supervise Claims staff, being involved in any areas that employees may need assistance or troubleshooting, and/or covering areas that need more focus.

· Coordinate, monitor, and maintain daily claims operations, overseeing policies and procedures are upheld and/or updated accordingly to promote efficiency.

· Conduct daily audits following Claims Department Policies and Procedures and offer support and training as required.

· Responsible for putting together data reports and any reporting data metrics for Health Plan audits and/or requested by any internal/external stakeholders.

· Compliance with CMS, DMHC, MediCare/Medi-Cal, state, and federal regulatory guidelines.

· Involvement in direct audit preparations, review risk areas, and ability to present findings to senior management and/or other internal/external stakeholders as needed.

· Perform, process, and assist in processing facility claims and other claim payments according to department policies and procedures.

· Ability to manage or put together presentations or information on claims submission, new claims programs, and billing guidelines.

· Quickly learn and adapt to organizational culture, practices, and procedures of MSO environment.

· Identify KPIs of the department to effectively manage and maintain data of Claims Department.

· Meet Claims Processing Turn-Around Time (TAT) and that claims processing TAT meets specified goals and compliance.

· Monitor and troubleshoot any Medicare Claim payments, and the ability to handle or delegate responses accordingly, as needed.

· Analyze EOBs, adjust claims according to processing criteria, and perform pre-check run audits on check run schedules.

· Serve as the subject matter expert, representing Claims Department at any audit and/or interdepartmental meetings.

· Act as a resource for other departments on claims issues, participating in meetings and maintaining a fair work environment, while executing additional duties assigned by management.

· Provide backup supporting claim processing as needed.

· Schedule employee meetings accordingly to address any program/processing changes and training issues.

· Conduct daily audits following Claims Department Policies and Procedures and offer support and training as required.

· Generate comprehensive reports from audit findings, identify trends, and implement strategies to enhance business processes and maintain quality standards.

· Lead appeals to insurance carriers, monitor accounts for accurate fee postings to optimize office collections while minimizing adjustments.

· Respond and justify appeals as to why claims, services, or treatment should be paid.

· Communicate issues and suggestions for process improvements and resolve claims in compliance with CMS guidelines and Company Policies.

· Utilize and resolve claims based on CCI edit report to comply with CMS guidelines.

· Conduct internal reviews to ensure compliance with regulatory and contractual standards in the claims system.

· To contribute to a fair and positive work environment by treating peers, superiors, subordinates, clients, and vendors with professionalism and respect.

· Assist development of standardized audit procedures for recovery opportunities in collaboration with relevant departments.

· Foster a culture of teamwork and productive relationships to facilitate cohesive and efficient operations throughout the organization.

· Effectively communicate audit discoveries and propose solutions across all organizational levels.

· Performs other duties as assigned by management.

IMS offers competitive compensation depending on experience. We are an equal opportunity employer and seek diversity in our workforce. IMS is also an E-Verify Employer. To learn more about E-Verify and your rights and responsibilities, please visit: https://www.e-verify.gov/employees/employee-rights-and-responsibilities .

Job Type: Full-time

Pay: $90,000.00 - $110,000.00 per year

Benefits:

401(k)
Dental insurance
Employee assistance program
Flexible schedule
Flexible spending account
Health insurance
Life insurance
Paid time off
Retirement plan
Vision insurance

Physical setting:

Office

Schedule:

8 hour shift
Day shift
Monday to Friday

Application Question(s):

Please describe your experience working with Medicare/Medi-Cal and Managed Care Claims.
What Health Plan, Managed Service Organization, and/or IPA experience do you have?
Please elaborate on your experience working with medical facility claims and high dollar claims.
What is your experience with DOFRs (Division of Financial Risk)?
This position is hybrid, defined as in-office and remote. Do you have reliable transportation to go into office located in City of Industry?

Work Location: Hybrid remote in Industry, CA 91746

Quick Apply

jobs in Cypress, CA

MSO Claims Manager

Substitute Teacher K-12

Certified School Bus Driver. 10,000 Sign-on bonus

Administrator for Psychiatric Board and Care

Cannabis Trimmer

Registered Behavior Technician (RBT)

Criminal Investigator/Special Agent

Business Office Manager

Front Office Night Receptionist

Front Desk Coordinator - West Dermatology

Forklift Operator - Warehouse ( 2nd Shift )

Fire Alarm Construction Superintendent

Director of Housing

Dispatcher

Registered Dietitian (Remote)

Dishwasher

Remote Data Entry / Customer Service / Admin

Food & Beverage Associates

Warehouse Worker

Full-Time Maintenance Worker - Weekend Day/Night Shift

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