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Career Opportunities

 


SOUTHERN CALIFORNIA PHYSICIANS MANAGED CARE SERVICES
CURRENT CAREER OPENINGS (As of 03/19/2018)


Southern California Physicians Managed Care Services is San Diego's premier provider of medical administrative services including claims payment, contracting and utilization management.

Current Career Opportunities:

Southern California Physicians Managed Care Services has the following career opportunities available:

CERTIFIED CODER

Job Description: The Certified Coder will educate providers on improved coding, develop tools to improve coding accuracy, and audit records to ensure accurate documentation and coding.
Skills/Requirements: This position requires strong presentation skills and training/teaching experience. Minimum 3 years coding experience and knowledge of HCC and RADV audits a plus. Local travel is necessary.
Pay Rate: Salary is based on qualifications and experience
Job Status: Full time - Four-Day 10 hour days, Monday - Thursday
Location: Mira Mesa, San Diego
Date Posted: 03/19/2018


Provider Disputes Analyst – Four Day Workweek

Job Description: Provider Disputes Analyst reviews and resolves claims payment disputes from providers. Ensures that provider disputes are handled as per contractual, state, and federal guidelines.
Skills/Requirements: This position requires a minimum of 3 years experience in processing HMO claims or equivalent. Must have a clear understanding of all aspects of the managed care environment, including Medical Management, Eligibility, and Customer Service. Previous experience with unbundling software and other software applications for claims, such as EZ-CAP is preferred. Must be proficient in claims terminology and knowledgeable of CPT, ICD-9, ICD-10, and HCPC coding procedures.
Pay Rate: Salary is based on experience and qualifications.
Job Status: Full time - Four-Day 10 hour days, Monday - Thursday
Location: Mira Mesa, San Diego
Date Posted: 03/19/2018


Claims Assistant

Job Description: Claims Assistant prepares requested documents required by Claims & Compliance Manager for health plan audits. Scans and maintains member denial letter documentation. Scans and maintains all review documentation. Assists the Claims Department as needed with various clerical support duties vital to the functioning of the department.
Skills/Requirements: This position requires minimum two years clerical experience. Ability to work independently with the ability to communicate and work with others to resolve issues. Must be detailed oriented, organized and able to handle multi-tasks. Familiar with Microsoft Office.
Pay Rate: Salary is based on experience and qualifications.
Job Status: Full time - Four-Day 10 hour days, Monday - Thursday
Location: Mira Mesa, San Diego
Date Posted: 03/19/2018


CLIENT SERVICES REPRESENTATIVE

Job Description: The Client Services Representative provides internal and external clients with information related to managed care services; such as Utilization Management, Claims Processing, IPA Management, Eligibility and Contracting.
Skills/Requirements: This position requires two years experience in a health care setting. Additional requirements include claims/billing experience, knowledge of managed care, CPT, ICD-10 codes, and excellent verbal communication skills. Familiarity with Microsoft Office products. Bi-Lingual (English/Spanish) a plus.
Pay Rate: Salary is based on experience, qualifications and internal equity.
Job Status: Part-Time (9 a.m. – 4:00 p.m.), Monday - Thursday
Location: Mira Mesa, San Diego
Date Posted: 03/19/2018


Outpatient Case Manager

Job Description: Outpatient Case Manager reviews contracted Medical Group’s authorization requests for medical necessity.
Skills/Requirements: This position requires prior experience in managed care or recent acute care. Computer proficient with MS Office. Other requirements include an active unrestricted California RN License.
Pay Rate: Salary is based on qualifications and experience
Job Status: Full time - Four-Day 10 hour days, Monday - Thursday
Location: Mira Mesa, San Diego
Date Posted: 03/19/2018


Utilization Management Representative

Job Description: The Utilization Management Representative performs data entry of referral requests; completes benefit and medical policies verification using on-line resources.
Skills/Requirements: This position requires knowledge of medical terminology, ICD-10 and CPT coding; and proficiency with computer programs (MS Office preferred).
Pay Rate: Salary is based on qualifications and experience
Job Status: Full time - Four-Day 10 hour days, Monday - Thursday
Location: Mira Mesa, San Diego
Date Posted: 03/19/2018