<p>We are seeking a skilled IT Audit & Compliance Analyst to support our client based in Tustin, CA. This position is instrumental in evaluating IT environments, maintaining compliance with regulatory requirements, and ensuring the effectiveness of internal controls. The ideal individual will work cross-functionally to enhance risk management efforts and align technology practices with broader business goals.</p><p><strong>Key Responsibilities:</strong></p><ul><li>Execute end-to-end IT audits to assess internal controls, operational processes, and security protocols</li><li>Conduct thorough risk evaluations to uncover system vulnerabilities and process gaps</li><li>Maintain compliance with established frameworks including SOX, COBIT, and other relevant standards</li><li>Design and manage audit plans that support organizational objectives and compliance mandates</li><li>Track and validate remediation activities to ensure audit findings are addressed in a timely manner</li><li>Act as a primary point of contact for external auditors during reviews and regulatory assessments</li><li>Drive improvements to compliance programs, governance structures, and internal policies</li><li>Work alongside IT and cybersecurity teams to reinforce data protection and security best practices</li><li>Monitor evolving regulatory landscapes and evaluate their impact on current processes</li><li>Recommend and implement process enhancements to improve audit effectiveness and efficiency</li></ul><p><br></p>
We are looking for a meticulous and organized Insurance Authorization Coordinator to join our team on a contract basis in San Bernardino, California. In this role, you will be responsible for managing retroactive insurance authorizations and ensuring compliance with healthcare regulations. The ideal candidate will have hands-on experience with the Treatment Authorization Request (TAR) process and a strong background in healthcare billing and insurance coordination.<br><br>Responsibilities:<br>• Process and submit retroactive insurance authorizations for hospital services, ensuring accuracy and timeliness.<br>• Monitor and follow up on pending and denied authorizations to secure approvals efficiently.<br>• Collaborate with clinical and administrative teams to collect and verify required medical documentation.<br>• Communicate with insurance companies to resolve issues and obtain necessary approvals.<br>• Maintain compliance with hospital policies, as well as state and federal healthcare regulations.<br>• Accurately record and update information within hospital information systems.<br>• Stay informed on updates and best practices related to the Treatment Authorization Request (TAR) process.<br>• Assist with administrative tasks, such as scanning and organizing documentation, to support the authorization process.<br>• Handle inbound and outbound calls related to authorization inquiries and resolutions.
<p>We are looking for an experienced Medical AR Insurance Specialist its team. In this role, the Medical AR Insurance Specialistwill focus on medical collections and insurance claims, ensuring accurate follow-up and resolution of outstanding balances. This is an excellent opportunity for a Medical AR Insurance Specialist to contribute your expertise in managed care and medical billing within a dynamic healthcare environment.</p><p><br></p><p>Responsibilities:</p><p>• Conduct thorough follow-ups on accounts aged 120 to 210 days to recover outstanding balances.</p><p>• Investigate and resolve written-off accounts to maximize revenue recovery.</p><p>• Process approximately 50-60 claims per day with attention to detail and accuracy.</p><p>• Collaborate with managed care providers such as LA Care, Kaiser, and others to address billing issues.</p><p>• Handle medical denials and appeals, ensuring timely and effective resolution.</p><p>• Review and manage accounts associated with various insurance carriers.</p><p>• Analyze and document collection efforts for reporting and compliance purposes.</p><p>• Maintain up-to-date knowledge of relevant medical billing and insurance policies.</p><p>• Communicate effectively with internal teams to coordinate account resolution strategies.</p>
<p>We are looking for an experienced Medical AR Insurance Specialist its team. In this role, the Medical AR Insurance Specialist will focus on medical collections and insurance claims, ensuring accurate follow-up and resolution of outstanding balances. This is an excellent opportunity for a Medical AR Insurance Specialist to contribute your expertise in managed care and medical billing within a dynamic healthcare environment. This role is a hybrid tole.</p><p><br></p><p>Responsibilities:</p><p>• Conduct thorough follow-ups on accounts aged 120 to 210 days to recover outstanding balances.</p><p>• Investigate and resolve written-off accounts to maximize revenue recovery.</p><p>• Process approximately 50-60 claims per day with attention to detail and accuracy.</p><p>• Collaborate with managed care providers such as LA Care, Kaiser, and others to address billing issues.</p><p>• Handle medical denials and appeals, ensuring timely and effective resolution.</p><p>• Review and manage accounts associated with various insurance carriers.</p><p>• Analyze and document collection efforts for reporting and compliance purposes.</p><p>• Maintain up-to-date knowledge of relevant medical billing and insurance policies.</p><p>• Communicate effectively with internal teams to coordinate account resolution strategies.</p>