Claims Auditor

2 weeks ago

Orange, United States Prospect Medical Holdings Full time
About Us

With approximately 9,000 physicians to serve our 260,000 members, Prospect Medical Systems is proud to be among the most innovative medical systems in California, Texas and Rhode Island. Our extensive care services range from primary care and specialty physician services to acute care hospital and skilled nursing facilities to behavioral health and wellness services. Each of our Independent Physician Associations (IPAs) and networks support the use of advanced diagnostic and treatment tools to provide our members with convenient access to state-of-the-art healthcare. For 25+ years, Prospect Medical has been focused on our mission of supporting independent physicians where, through risk arrangements, we work closely together with health plans, facilities and healthcare physicians for the benefit of every person who comes to us for care. We provide quality healthcare services that are designed to offer our patients highly coordinated, personalized care and that help them live healthier lives. Prospect Medical Systems manages highly successful IPAs by leveraging our best-practices, results-driven administrative services to manage patients under risk arrangements with health plans/CMS.

  • Claims Recovery Specialist

    2 weeks ago

    Orange, United States Alta Hospitals Full time

    The Claims Recovery Specialist is responsible for recovering incorrect claims payment to providers. Coordinates and ensures all outstanding over payments are being pursued for recovery purposes. Communicate and explain incorrect claims payments to external providers. With approximately 9,000 physicians to serve our 260,000 members, Prospect Medical Systems...