5 jobs found in Rancho Cucamonga

Medical Billing Specialist (Revenue Cycle Management) – Bilingual Spanish Preferred This is not a Remote position; it is in the Office Monday - Friday. This is not an entry-level role and requires independent ownership of revenue cycle processes. Position Summary Reliant Healthcare Group is seeking an experienced Medical Billing Specialist with demonstrated Revenue Cycle Management (RCM) expertise. This role is responsible for managing AR, payer follow-ups, and claim resolution to ensure timely reimbursement. Essential Duties & Responsibilities Manage full Revenue Cycle Management (RCM) processes Verify insurance eligibility and benefits for commercial and Medicaid MCO payers Follow up on Accounts Receivable exceeding 30 days Review AR aging reports and resolve outstanding balances Post payments and perform account reconciliations Obtain and manage insurance authorizations Review and correct claims to prevent denials Interpret payer contracts and reimbursement...

Location: Rancho Cucamonga, California, United StatesCompany: Inland Empire Health PlanPosted: Location: Rancho Cucamonga, California, United StatesCompany: Inland Empire Health PlanPosted: Location: Rancho Cucamonga, California, United StatesCompany: Inland Empire Health PlanPosted: Location: Rancho Cucamonga, California, United StatesCompany: Inland Empire Health PlanPosted: Location: Rancho Cucamonga, California, United StatesCompany: Inland Empire Health PlanPosted: Location: Rancho Cucamonga, California, United StatesCompany: Inland Empire Health PlanPosted: Inland Empire Health Plan (IEHP) seeks a Compliance Auditor II to conduct comprehensive audits across the Plan and delegates, ensuring adherence to Federal, State, and contract requirements. The role identifies risks, drafts findings and actionable recommendations, and evaluates operations for compliance and effectiveness.Responsibilities include developing audit tools, validating CAPs, and performing routine...

Inland Empire Health Plans is seeking a Compliance Auditor II to conduct comprehensive audits across the Plan, ensuring adherence to Federal, State, and contractual requirements. You will identify risks, draft findings, and recommend improvements to strengthen the control environment. The role involves evaluating operations and policies, issuing corrective action plans, and monitoring implementation while aligning with IEHP's quality initiatives like HEDIS, CAHPS, and NCQA Accreditation. #J-18808-Ljbffr

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Role Overview The Compliance Auditor II conducts comprehensive audits and reviews across the Plan, including assigned areas and Plan delegates, to ensure adherence to Federal, State, and contractual regulatory requirements. Identifies and assesses risks impacting overall compliance, drafts detailed audit findings and actionable recommendations, and evaluates operations, policies, and processes throughout the Plan. Conducts evaluations of operations, policies, and processes to validate compliance, evaluate effectiveness, and identify issues. Issues corrective action plans and reviews for acceptance to ensure that all compliance issues are appropriately addressed. Performs validation audits to determine if actions have been taken to mitigate identified risks and conducts routine monitoring...

IEHP is seeking a Compliance Auditor II to conduct comprehensive audits across the Plan, ensuring adherence to Federal, State, and contract requirements. You will identify risks, draft findings, and develop corrective action plans, overseeing reviews of operations, policies, and processes. The role requires strong knowledge of California managed care regulations, excellent written and verbal communication, and the ability to operate with minimal supervision. Hybrid work options available. #J-18808-Ljbffr