Healthcare Fee Configuration Expert

3 days ago


Los Angeles, California, United States MedPOINT Management Full time
Healthcare Fee Configuration Expert

MedPOINT Management offers a competitive salary for this challenging position as a Healthcare Fee Configuration Expert. In this role, you will be responsible for creating, updating, and maintaining provider dictionaries, vendor contracts, fee schedules, reading and interpreting contracts and/or contract summaries. You will work closely with the Provider Database Management & Rates Configuration, Sr Supervisor to ensure accurate system setup for adjudication of claims based on contractual language and rate terms. Your expertise will be critical in maintaining Medicare and Medicaid fee schedules and assigning the appropriate fee schedules to providers based on contract terms. Additionally, you will build and maintain all relevant logs for fee schedules and fee set assignment implementation, and audit EZ-CAP Providers/Vendor configuration.

Responsibilities:
  • Create and maintain provider dictionaries and custom fee schedules based on contract terms.
  • Maintain Medicare and Medicaid fee schedules.
  • Assign the appropriate fee schedules to providers including writing and determining hierarchy of conditions and exceptions to the primary fee schedule based on the terms of the provider's contract.
  • Built and maintain all appropriate logs for fee schedules and fee set assignment implementation.
  • Auditing of EZ-CAP Providers/Vendor configuration (fee schedule, fee set assignments, etc.).

Skills and Qualifications:
The ideal candidate will have 3+ years of Managed Care or Healthcare experience in Rate Configuration, Terms and Conditions, Reimbursement or Claims Auditing field. EZ-CAP knowledge and experience required. Thorough understanding of ICD-9, CPT and HCPCS codes, Medicare and Medi-Cal fee schedules, RVUs and ASA reimbursement. Advanced knowledge of medical terminology and ability to read and interpret contracts and/or contract summaries. Intermediate Proficiency in Microsoft Office Suite (Access, Word, Excel, PowerPoint, Outlook), Crystal Reports, SQL. Substantive knowledge of basic Internet terminology and functionality.

  • Los Angeles, California, United States Sinclair Talent Solutions Full time

    **Job Description:** Workday Configuration Expert**Location:** Los Angeles, San Francisco, or D.C.**Estimated Salary:** $85,000 - $115,000 per yearWe are seeking a skilled Workday Configuration Expert to join our team at Sinclair Talent Solutions. In this role, you will be responsible for designing, implementing, and optimizing Workday configurations to meet...


  • Los Angeles, California, United States eTek IT Services, Inc. Full time

    Job OvervieweTek IT Services, Inc. is looking for an experienced Compensation Configuration Expert to help implement and support advanced compensation solutions in Workday HCM. The ideal candidate will have strong hands-on configuration experience and be able to design and deliver solutions that meet business requirements.


  • Los Angeles, California, United States Eleven Recruiting Full time

    About Eleven RecruitingWe are a specialized technology staffing agency supporting professional and financial services companies. Our unique approach sets us apart in the industry. We listen to our candidates, act as advisors, and advocate for best pay, diversity in tech, and job-fit.A national law firm is seeking an experienced Talent Systems Administrator...


  • Los Angeles, California, United States Journal Tech Full time

    About the Position: Journal Technologies is seeking a highly skilled Software Configuration Expert to join our eCourt team. As a key member of our project delivery team, you will be responsible for configuring and implementing case management software solutions for our clients. Your expertise in software implementation, data conversion, and training will...


  • Los Angeles, California, United States MedPOINT Management Full time

    Job OverviewWe are seeking a highly skilled Rates Configuration Specialist to join our team at MedPOINT Management, a large MSO in the San Fernando Valley.The ideal candidate will have 3+ years of experience in Rate Configuration, Terms and Conditions, Reimbursement or Claims Auditing field. They will be responsible for creating, updating and maintaining...


  • Los Angeles, California, United States Cyborgwave Full time

    Job SummaryCyborgwave seeks an experienced SAP HCM Payroll professional to lead the optimization of our Payroll processes. As a key member of our team, you will be responsible for configuring and maintaining SAP HCM Payroll modules, providing technical support, and designing custom solutions to enhance payroll efficiency.This is a challenging role that...


  • Los Angeles, California, United States DirectedLink Full time

    Job OverviewWe are seeking an experienced Enterprise Software Configuration Specialist to join our team at DirectedLink. This is a full-time contract position with an estimated salary of $63,000 - $73,500 per year.About the RoleThe successful candidate will work closely with various departments to set up and configure our enterprise software systems,...


  • Los Angeles, California, United States MedPOINT Management Full time

    We're MedPOINT Management, a prominent healthcare management organization based in the San Fernando Valley. As a Provider Dictionary Coordinator, you'll be responsible for updating and maintaining provider dictionaries, vendor contracts, fee schedules, and capitation tables. This role requires 1+ years of experience in Managed Care or Healthcare,...


  • Los Angeles, California, United States ActiveSoft, Inc Full time

    Job Title: Cloud Supply Chain ExpertEstimated Salary: $120,000 - $180,000 per yearThe successful candidate will be a seasoned Oracle Cloud SCM consultant with extensive experience in Service Logistics and Project-Driven Supply Chain implementations. ActiveSoft, Inc. is seeking a highly skilled professional to drive innovative solutions and deliver successful...


  • Los Angeles, California, United States eTek IT Services, Inc. Full time

    Job OvervieweTek IT Services, Inc. is seeking a highly skilled Senior Guidewire Integration Expert to support our Integration and Configuration efforts for Guidewire PolicyCenter 10.0.


  • Los Angeles, California, United States TWO95 International Full time

    Location: Los Angeles, CAType: Fulltime / Permanent - 100 % Office basedJob Title: VM / VCP Engineers / System ExpertsEstimated Salary Range: $120,000 - $160,000 per yearWe are seeking a highly skilled VM / VCP Engineer / System Expert to join our team at TWO95 International.The ideal candidate will have professional certifications such as VCP or VCP-DTM and...

  • Cloud Security Expert

    2 weeks ago


    Los Angeles, California, United States Embakire Full time

    We are looking for a Cloud Security Expert to join our team at Embakire. As a Cloud Security Expert, you will be responsible for designing and implementing secure identity solutions using Azure Active Directory B2C.Key ResponsibilitiesDesign and configure user flows and custom policies to address various customer needs, such as registration, authentication,...


  • Los Angeles, California, United States eTek IT Services, Inc. Full time

    About eTek IT Services, Inc.eTek IT Services, Inc. is a leading provider of cutting-edge IT solutions. Our team of experts delivers top-notch services to clients across the globe.Job OverviewThis is a 6+ month remote opportunity as a Sr. Oracle HCM Comp Analyst. We are seeking an experienced professional to work alongside our internal team and Deloitte (SI)...


  • Los Angeles, California, United States Enterprise Engineering Full time

    About the RoleAs a Healthcare Utilization Expert at Enterprise Engineering, you will be responsible for reviewing patient records and providing recommendations to ensure quality, cost-effective outcomes.This position is ideal for a UM Nurse with a passion for medical management and a desire to work remotely.Our competitive salary is $83,000 per year, plus...


  • Los Angeles, California, United States ShiftCode Analytics Full time

    Job Overview:ShiftCode Analytics seeks a highly skilled Salesforce Platform Expert to lead our CRM implementation. As a key member of our team, you will be responsible for configuring, managing, and enhancing our Salesforce platform to drive business growth.About the Role:This is a remote opportunity that requires relocation to Southern California in the...


  • Los Angeles, California, United States HIKINEX Full time

    HIKINEX is seeking a skilled Web Application Migration Expert to join our team. This is a 3-month contract opportunity, fully remote.We are looking for someone with experience in managing IIS on Windows Server, who can troubleshoot issues and keep web environments running smoothly. You will be responsible for configuring servers, securing web traffic, and...


  • Los Angeles, California, United States Ampcus Full time

    About the Role:As a Wireless Network Solutions Architect, you will be responsible for providing expert technical advice on Wi-Fi technology and wireless network deployments. Your expertise in configuring and deploying Cisco and Aruba Wireless LAN Controllers and Access Points will be instrumental in ensuring seamless connectivity for our clients.


  • Los Angeles, California, United States GQR Healthcare Full time

    Nuclear Medicine Provider WantedWe're looking for an experienced Nuclear Medicine provider to join our team at GQR Healthcare. As a key member, you'll play a vital role in delivering high-quality patient care and contributing to our organization's success.Key AccountabilitiesAdminister nuclear medicine procedures to diagnose and treat patientsCollaborate...

  • Data Management Expert

    11 hours ago


    Los Angeles, California, United States WekaIO Full time

    Are you a tech-savvy individual looking for a new challenge? WekaIO is seeking a highly skilled Data Management Expert to join our sales team. As a key member of our organization, you will partner with customers to understand their needs and requirements, providing them with tailored solutions that leverage the value and performance of WekaIO's...

  • Healthcare AI Expert

    2 weeks ago


    Los Angeles, California, United States UnitedHealth Group Full time

    About the OpportunityWe are looking for a talented Healthcare AI Expert to join our team. As a key member of our AI/ML team, you will drive the development of cutting-edge AI/ML solutions for healthcare. Your expertise in machine learning, deep learning, and NLP will enable you to design, develop, and deploy innovative solutions that improve patient...