<p>An Ambulatory Surgery Center in Los Angeles is in the need of a Medical Biller/Collections Specialist. This Medical Biller/Collections Specialist is ideal for someone who understands the full revenue cycle and can confidently manage claims, denials, and payer follow-up for surgical services. The right candidate for the Medical Biller/Collections Specialist role will bring healthcare billing experience, strong insurance knowledge, and the ability to keep accounts moving toward timely reimbursement.</p><p><br></p><p>Responsibilities:</p><p>• Manage end-to-end billing and collections activities for surgical services, from charge review through payment follow-up.</p><p>• Confirm patient coverage, authorization details, and payer information using available electronic records and insurance carrier resources before claims are submitted.</p><p>• Enter billing data and post charges accurately for surgical cases while maintaining complete and organized account documentation.</p><p>• Pursue outstanding third-party balances by conducting regular follow-up with commercial and government payers across multiple plan types.</p><p>• Investigate explanation of benefits, identify denial causes, correct claim issues, and resubmit claims to support reimbursement.</p><p>• Monitor assigned claim queues and worklists each day to address unresolved accounts, aging items, and billing exceptions in a timely manner.</p><p>• Review provider documentation, including urgent care and surgical records, to ensure charges are supported and billing can proceed accurately.</p><p>• Apply appropriate diagnosis, procedure, medication, and supply codes based on clinical documentation and operative reports completed by providers.</p><p>• Examine aged accounts and unresolved payer responses to resolve denials, appeals, and collection issues efficiently.</p>
<p><strong>Looking for a sophisticated litigation practice with exceptional mentorship and the flexibility of working remotely?</strong></p><p><br></p><p>One of our longstanding law firm clients is seeking a <strong>Litigation Associate (1+ years)</strong> to join its nationally respected healthcare litigation team. We've successfully placed multiple attorneys with this firm, and the feedback has been overwhelmingly consistent—they love the collaborative culture, hands-on training, transparency, and opportunity to develop into exceptional litigators.</p><p><br></p><p>This is <strong>not</strong> a high-volume insurance defense practice. Attorneys handle <strong>complex, high-value healthcare reimbursement and contract disputes</strong> on behalf of major healthcare plan providers involving matters ranging from single claims worth millions of dollars to large-scale arbitrations involving thousands of related claims.</p><p><br></p><p><strong>What You'll Work On</strong></p><p>This practice centers on representing healthcare plan providers in sophisticated disputes against hospitals and healthcare providers involving complex matters.</p><p><br></p><p><strong>Who Will Thrive Here?</strong></p><p>The firm is looking for someone who is:</p><ul><li>A hard-working associate eager to build an outstanding litigation foundation</li><li>Coachable and receptive to mentorship and constructive feedback</li><li>Exceptionally organized with strong attention to detail</li><li>A strong legal writer</li><li>Genuinely interested in building a long-term career in healthcare litigation</li></ul><p>They're less concerned with pedigree than potential. The partners consistently value intellectual curiosity, work ethic, humility, and practical judgment over prestige.</p><p><strong>Qualifications</strong></p><ul><li>1+ years of litigation experience</li><li>Arbitration, trial preparation, or deposition experience preferred</li><li>Strong legal writing and analytical skills</li><li>Excellent organizational abilities</li><li>Desire to specialize in healthcare litigation</li><li>Top 100 law school preferred (exceptional academic performance from other schools will absolutely be considered)</li></ul><p><strong>Why Attorneys Love This Firm</strong></p><ul><li><strong>100% remote</strong> within California</li><li><strong>1,800 annual billable requirement</strong></li><li>Outstanding mentorship from experienced litigators</li><li>Collaborative, communicative, and transparent culture</li><li>Tech-forward, highly efficient practice</li><li>Long-term career growth</li><li>Every attorney we've placed with this firm has been extremely happy with both the culture and quality of work.</li></ul><p><strong>Compensation & Benefits</strong></p><ul><li>Competitive compensation</li><li>Annual discretionary bonus</li><li>Medical, dental, and vision coverage (eligible after 30 days)</li><li>401(k)</li><li>10 days PTO</li></ul><p><strong>For a confidential conversation, please send your resume to Quidana.Dove< at >RobertHalf.< com ></strong></p>
<p>A healthcare company is looking for a detail-oriented <strong>UM Coordinator</strong> to support utilization management operations for a healthcare organization in Long Beach, California. This UM Coordinator opportunity is ideal for someone with experience in healthcare administration who can manage authorization workflows, maintain accurate records, and provide responsive support to providers. The UM Coordinator follows a Wednesday through Sunday schedule after training, with three days onsite and weekend work performed remotely.</p><p><br></p><p><strong>Key Responsibilities:</strong></p><p>• Review and process prior authorization submissions using the designated authorization platform while ensuring information is complete and accurate.</p><p>• Confirm member coverage, benefit details, and participating provider status before advancing requests for review.</p><p>• Maintain thorough documentation of case updates, outreach efforts, provider interactions, and authorization determinations in the appropriate systems.</p><p>• Track urgent and routine request timelines closely to help ensure compliance with internal standards and regulatory turnaround requirements.</p><p>• Respond to inbound calls, faxes, and portal inquiries from provider offices and route clinical matters to UM nursing staff when escalation is needed.</p><p>• Perform high-volume data entry and administrative support tasks with a strong focus on accuracy, organization, and timely follow-up.</p><p>• Coordinate communication across teams to help keep authorization activity moving efficiently and resolve issues that may delay processing.</p><p><br></p><p><strong>Benefits:</strong> Health, Dental, Vision, 401k, and Sick Time Off.</p>
<p>A Hospital system in Los Angeles is looking for an experienced Revenue Cycle Coding Manager. The Revenue Cycle Coding Manager will lead coding and charge capture performance, guide operational oversight, and partner with clinical and compliance stakeholders to strengthen accuracy, productivity, and reimbursement outcomes. The ideal Revenue Cycle Coding Manager candidate must bring deep knowledge of revenue cycle operations, medical coding standards, and team leadership within a fast-paced healthcare environment. This is a hybrid remote role Monday - Friday with equipment provided. </p><p><br></p><p>Responsibilities:</p><p>• Direct daily coding operations by assigning work, reviewing team output, and ensuring tasks are completed accurately, efficiently, and in alignment with established procedures.</p><p>• Analyze weekly and monthly performance results using key operational and quality indicators, then present trends and improvement opportunities to senior leadership.</p><p>• Supervise coding work queues and charge capture activity to confirm diagnosis, procedure, and billing details are properly documented and coded.</p><p>• Ensure urgent coding requests are prioritized and completed within required turnaround expectations.</p><p>• Partner with physicians, surgeons, and clinical leadership to address coding questions, resolve workflow issues, and escalate concerns when broader intervention is needed.</p><p>• Coordinate with compliance and coding leadership to support audits, communicate findings, implement corrective actions, and reinforce timely staff education.</p><p>• Lead team meetings, provide coaching on complex coding scenarios, and promote consistent adherence to departmental policies and quality standards.</p><p>• Oversee updates to charge documents, procedure listings, and code requests while supporting coding system conversions and related operational changes when required.</p><p>• Monitor regulatory updates, payer guidance, and industry developments, and communicate relevant coding changes to internal stakeholders.</p><p>• Conduct quality reviews, operational studies, and other assigned analyses to improve coding accuracy, team performance, and revenue cycle effectiveness.</p>
<p>A nationally recognized Hospital in Los Angeles is in the immediate need of a Medical Collector II. The Medical Collector II must be well versed with insurance collections preferably from Medi-Cal/Medicaid and CCS (California Children’s Services). The Medical Collector II is responsible for analyzing denied claims and appeal accordingly. The Medical Collector II also performs a variety of duties which may include answering in-coming telephone calls, documenting insurance information, verification of eligibility and billing/appealing claims to the various insurance carriers. This position is responsible for handling patient accounts in a high-performance team environment with a number of additional duties as needed for operational needs. </p><p><br></p><p><strong>This position is a Hybrid / Remote role requiring an employee to come in office 1 day per week. </strong></p><p><br></p><p>Essential Duties: </p><p>• Reviews claims to ensure all key components were submitted accurately to the correct payer. </p><p>• Review Medi-Cal/Medicaid and CCS (California Children’s Services) claims. </p><p>• Reviews correspondence and denial information to determine why claims have not been paid and takes appropriate actions to ensure the accurate and timely submission of claims. </p><p>• Researches and analyzes accounts and payments to determine whether charges were billed properly, and to resolve incorrect information on patient accounts; reverses balance to credit or debit if charges were improperly billed. </p><p>• Corrects and resubmits claims and identifies issues that require attention. Makes all the appropriate corrections in the system and submits appeals as appropriate, following </p><p>individual payer guidelines and including all supporting documentation. </p><p>• Contacts insurance companies and or patient/guarantor to verify insurance eligibility and resolve payment problems; provides information to expedite collection process. </p><p>• Prepares adjustments for charges which cannot be billed and processes or submits to the supervisor per adjustment guidelines. </p><p>• Ensures authorization, TARs/SARs are included in claim submissions to payers and follows appropriate steps to secure the authorization/retro authorization. </p>
<p>A healthcare company is looking for a detail-oriented <strong>Inpatient Care Coordinator</strong> to support care management efforts in Long Beach, California. This InPatient Care Coordinator role is ideal for someone who enjoys coordinating patient support activities, communicating with providers and patients by phone, and keeping clinical information accurate and up to date. The inpatient care coordinator role will help the team track patient needs after hospitalization, organize care-related information, and contribute to timely follow-up across a busy healthcare environment.</p><p><br></p><p><strong>Key Responsibilities:</strong></p><p>• Place outbound calls to patients and healthcare providers to coordinate follow-up care and gather needed information.</p><p>• Enter and update case information accurately while managing a steady daily volume of patient records and care activity.</p><p>• Review hospital discharge reports to identify patients who may need additional attention and escalate concerns to the appropriate care team members.</p><p>• Assist with health risk screening activities under the direction of nursing staff and document findings clearly.</p><p>• Maintain complete and organized patient records to support continuity of care and internal care management workflows.</p><p>• Provide coverage for fellow coordinators when needed to help the department maintain consistent service levels.</p><p>• Support appointment and scheduling-related coordination tasks that help patients move through post-discharge care plans efficiently.</p><p><br></p><p><strong>Benefits:</strong> Health, Dental, Vision, 401k, and Sick Time Off. </p>
<p>A healthcare organization in Long Beach, California is seeking an experienced <strong>Credentialing Specialist</strong> to support core credentialing and provider data operations. This role is responsible for managing provider onboarding, recredentialing, payer enrollment support, and provider record maintenance while ensuring compliance with regulatory, accreditation, and health plan requirements. The Credentialing Specialist will also collaborate with internal teams to improve workflows, maintain audit readiness, and promote accurate, consistent credentialing practices.</p><p><br></p><p><strong>Key Responsibilities:</strong></p><ul><li>Manage day-to-day credentialing activities for providers, including initial appointments, reappointments, and related follow-up tasks.</li><li>Coordinate provider onboarding, recredentialing cycles, payer enrollment support, and privileging documentation to ensure timely processing.</li><li>Maintain compliance with accreditation standards, delegated credentialing requirements, and applicable state and federal regulations.</li><li>Review credentialing files, provider rosters, and supporting documentation for completeness, accuracy, and timely updates.</li><li>Monitor credentialing volume, track turnaround times, and help resolve issues that may delay provider processing.</li><li>Conduct routine audits of credentialing records and assist with preparation for internal and external audits or delegated reviews.</li><li>Partner with leadership and cross-functional teams to support process improvements, policy updates, and reporting needs.</li><li>Maintain provider data integrity across systems to support accurate reporting, downstream operations, and compliance requirements.</li></ul><p><strong>Benefits:</strong> Health, Dental, Vision, 401k, and Sick Time Off.</p>
<p>A Hospital in Los Angeles is seeking an experienced Medical Insurance Collections Specialist to join its revenue cycle team. The Medical Insurance Collections Specialist role will focus on insurance follow-up and collections for HMO and PPO payers, with an emphasis on resolving outstanding balances, researching claim issues, and securing timely reimbursement. The ideal candidate for the Medical Insurance Collections Specialist role will also have experience working with UB04 claims in a hospital setting. </p><p><br></p><p><strong>Key Responsibilities:</strong></p><ul><li>Perform insurance collections follow-up on outstanding hospital claims with a focus on HMO and PPO payers. </li><li>Contact insurance companies and payers to obtain claim status, secure payment, and resolve unpaid or underpaid accounts. </li><li>Review and work hospital UB04 claims to ensure accurate billing and proper reimbursement..</li><li>Investigate and resolve claim denials, rejections, underpayments, and payment delays. </li><li>Submit corrected claims, supporting documentation, and appeals as needed to facilitate payment resolution. </li><li>Follow up on aged accounts receivable and maintain productivity in line with departmental goals. </li><li>Document all collection activity, account updates, and payer communications in the billing system.</li><li>Collaborate with billing, coding, and patient financial services teams to resolve claim discrepancies and improve reimbursement outcomes. </li><li>Monitor payer trends and escalate recurring issues impacting collections. </li></ul><p><br></p><p><strong>Qualifications:</strong></p><ul><li>3+ years of experience in medical insurance collections, insurance follow-up, or healthcare accounts receivable..</li><li>Hospital billing or collections experience required. </li><li>Strong knowledge of HMO and PPO insurance plans, payer guidelines, and reimbursement processes. </li><li>Experience working with UB04 claims required. </li><li>Familiarity with denial management, appeals, and claim resolution processes</li><li>Strong attention to detail, organizational skills, and ability to manage a high-volume workload..</li><li>Excellent communication and problem-solving skills..</li><li>Proficiency with hospital billing systems and electronic medical records preferred.</li></ul>
<p>Robert Half Legal is working with an extremely stable, well-established law firm based in Southern California with a growing Nevada presence. </p><p><br></p><p>The firm is looking for a Nevada attorney to come in join its tenured team. This attorney will be focused on healthcare litigation and work <strong>remotely</strong>. </p><p><br></p><p><strong><u>Responsibilities of Role</u>: </strong></p><ul><li>The firm will train on managing complex healthcare claims from A-Z as long as the attorney coming in has a good background in civil litigation.</li><li>Law & Motion.</li><li>Taking depositions.</li><li>Binding arbitration (AAA or JAMs), first as second-chair but eventually as first chair.</li><li>Lots of database claims- using database property software.</li><li>Negotiating with clients and hospitals.</li><li>Legal research.</li><li><u>Hours</u>: roughly 9-6, no billable hour requirement.</li></ul><p><br></p><p><strong><u>Perks of Firm</u></strong>:</p><ul><li>Small boutique firm, not a stressful environment. Healthy attitude and great culture.</li><li>Working hours are usually 9-6 – not your typical environment. No billable hour requirement!</li><li>Willing to train people on firm systems, healthcare litigation, understanding medical records/medical billing, understanding contracts</li><li>Will provide technology for people working remotely, they want to set people up to succeed.</li><li>Subscription to the highest level of WestLaw</li><li>Free parking and Bar and CLE paid for, all mileage reimbursed</li><li>Lots of opportunities for growth/diversity in practice. The firm operates in different states, they will encourage/help people to get that.</li><li>No set partnership track, but the firm brings people on as partner</li></ul><p><br></p>
<p>A healthcare company is looking for a Community Center Associate to support members and local older adults at our community center locations in Koreatown Los Angeles. This Community Center Associate position is ideal for someone who enjoys delivering thoughtful customer service, guiding individuals through healthcare-related questions, and building strong relationships within diverse communities. The Community Center Associate role combines front-facing member support, outreach, event coordination, and operational oversight to help create a welcoming and informative environment. Candidates should be comfortable working a regular schedule of 40 hours per week and available to work occasional Saturdays.</p><p><br></p><p><strong>Key Responsibilities:</strong></p><p>• Welcome members and visitors to the community center, resolve service questions, and provide a positive day-to-day experience for older adults and guests.</p><p>• Assist individuals in their preferred language with understanding plan benefits, accessing care, and navigating Medicare-related questions with clarity and professionalism.</p><p>• Represent the organization at community gatherings, educational sessions, and outreach events while promoting available services and strengthening local visibility.</p><p>• Organize wellness programs, classes, and center events by managing scheduling, logistics, materials, and coordination with internal partners.</p><p>• Monitor inventory levels for office materials, equipment, and promotional items to keep the center properly stocked and ready for daily operations.</p><p>• Oversee the use of community center space for activities and trainings, maintaining a clean, safe, and orderly setting for participants.</p><p>• Track visitor activity and service usage to help evaluate engagement trends and support informed planning decisions.</p><p>• Conduct routine checks of equipment and report maintenance or repair needs to the appropriate facilities contact in a timely manner.</p><p>• Help develop programs and activities that reflect community interests and create meaningful value for members and local older adults.</p><p>• Support additional operational, customer service, or outreach tasks as needed to meet team and center objectives.</p><p><br></p><p><strong>Benefits:</strong> Health, Dental, Vision, 401k, and Sick Time Off.</p>
<p>A healthcare company is looking for an experienced <strong>Credentialing Specialist</strong> to lead credentialing and provider data activities for a healthcare organization in Long Beach, California. The Credentialing Specialist is responsible for managing provider onboarding, recredentialing, payer enrollment support, and provider record maintenance while ensuring compliance with regulatory, accreditation, and health plan requirements. The Credentialing Specialist will also collaborate with internal teams to improve workflows, maintain audit readiness, and promote accurate, consistent credentialing practices.</p><p><br></p><p><strong>Key Responsibilities:</strong></p><ul><li>Manage day-to-day credentialing activities for providers, including initial appointments, reappointments, and related follow-up tasks.</li><li>Coordinate provider onboarding, recredentialing cycles, payer enrollment support, and privileging documentation to ensure timely processing.</li><li>Maintain compliance with accreditation standards, delegated credentialing requirements, and applicable state and federal regulations.</li><li>Review credentialing files, provider rosters, and supporting documentation for completeness, accuracy, and timely updates.</li><li>Monitor credentialing volume, track turnaround times, and help resolve issues that may delay provider processing.</li><li>Conduct routine audits of credentialing records and assist with preparation for internal and external audits or delegated reviews.</li><li>Partner with leadership and cross-functional teams to support process improvements, policy updates, and reporting needs.</li><li>Maintain provider data integrity across systems to support accurate reporting, downstream operations, and compliance requirements.</li></ul><p><strong>Benefits:</strong> Health, Dental, Vision, 401k, and Sick Time Off.</p>
<p>A Healthcare Company is looking for an experienced <strong>Human Resources (HR) Benefits Administrator</strong> to support a hospital-based human resources team in California. This HR Benefits Administrator focuses on managing employee benefit and retirement programs while serving as a knowledgeable resource for staff questions and enrollment needs. The Benefits Administrator will bring strong HR administration experience, sound judgment, and the ability to maintain accurate records in a regulated healthcare environment.</p><p><br></p><p><strong>Key Responsibilities:</strong></p><p>• Oversee the day-to-day administration of employee medical, insurance, and retirement benefit programs for hospital staff.</p><p>• Guide employees through benefit eligibility, coverage options, enrollment activity, and claim-related questions with clear and attentive support.</p><p>• Maintain organized and up-to-date benefits documentation, employee records, and required forms to ensure accurate program participation.</p><p>• Prepare and process benefit transactions, status updates, and supporting paperwork related to new hires, life events, and ongoing coverage changes.</p><p>• Review benefit practices and program details to help identify compliance needs, market trends, and opportunities for plan improvement.</p><p>• Assist with audits, reporting, and policy reviews to support adherence to applicable regulations and internal standards.</p><p>• Partner with HR team members on onboarding and employee relations matters connected to benefits communication and enrollment.</p><p>• Use HRIS tools to track data, update records, and support efficient administration of benefit functions.</p><p>• Provide flexible support as needed to meet operational demands and employee service expectations.</p><p><br></p><p><strong>Benefits:</strong> Health, Dental, Vision, 401k, and Sick Time Off.</p>
<p>A Healthcare Company is looking for a<strong> Provider Data Coordinator</strong> to support a healthcare organization in Long Beach, California. This Provider Data Coordinator opportunity is well suited for someone who enjoys working with information, ensuring records remain accurate, and collaborating across teams to keep provider data current and compliant. </p><p><br></p><p><strong>Key Responsibilities:</strong></p><p>• Enter, update, and maintain provider information in organizational databases with a high level of accuracy and consistency.</p><p>• Review records regularly to identify missing details, inconsistencies, or compliance concerns, and take appropriate corrective action.</p><p>• Reach out to providers to confirm demographic, credentialing, or other required information when updates are needed.</p><p>• Work closely with departments such as network operations, claims, and customer support to investigate and resolve data-related issues.</p><p>• Monitor data quality through recurring checks and audits to help ensure information remains reliable and complete.</p><p>• Organize and prioritize multiple assignments effectively while meeting deadlines in a busy onsite work environment.</p><p><br></p><p><strong>Benefits: </strong>Medical, Dental and Vision Insurance. 401K Retirement, Sick Time Off and Tuition Reimbursement.</p>
<p>We are seeking a detail-oriented Medical Claims Examiner to join our team. In this role, you will review, analyze, and process medical claims accurately and efficiently while ensuring compliance with company policies, client requirements, and regulatory guidelines. The ideal candidate will have strong knowledge of claims adjudication, medical terminology, and healthcare insurance processes. Experience with EZ-CAP is a plus, and grievances experience is highly preferred.</p><p>Key Responsibilities:</p><ul><li>Review and process medical claims for accuracy, completeness, and eligibility</li><li>Analyze claims to determine coverage, payment, and denial outcomes</li><li>Research and resolve claim discrepancies, adjustments, and pended claims</li><li>Interpret provider contracts, benefit plans, and reimbursement guidelines</li><li>Ensure timely adjudication of claims in accordance with turnaround standards</li><li>Investigate and respond to inquiries related to claims status, denials, and escalations</li><li>Maintain accurate documentation of claim actions and decisions</li><li>Collaborate with internal departments, providers, and health plan representatives to resolve complex claims issues</li><li>Assist with appeals and grievance-related cases as needed</li><li>Stay current on policies, procedures, and regulatory requirements affecting claims processing</li></ul><p><br></p>
<p><strong>A healthcare organization in the Torrance area is seeking a Collections Specialist to join its team. The Collections Specialist will be responsible for managing outstanding accounts and securing payments from external healthcare-related organizations, including drug testing facilities, health screening facilities and various businesses. </strong></p><p><br></p><p><strong>The ideal candidate will have prior experience in collections, B2B collections, strong communication skills, and the ability to manage account follow-up in a high-volume environment.</strong></p><p><br></p><p><strong>Key Responsibilities:</strong></p><p><br></p><ul><li>Collect payments and copayments from outside healthcare organizations</li><li>Make outbound calls to follow up on outstanding invoices and secure prompt payment</li><li>Review client accounts and initiate communication regarding account cleanup</li><li>Maintain accurate account notes and payment follow-up activity</li><li>Handle a daily call volume of approximately 18 to 20 calls to outstanding accounts</li><li>Work collaboratively with internal teams to resolve billing and payment discrepancies</li></ul><p><strong>Work Arrangement:</strong> In-office initially, transitioning to a hybrid schedule after training</p>
<p>A Hospital in Los Angeles is looking for a Medical Coder with experience in Surgery experience. The Medical Coder role will focuses on accurate coding for surgical and related outpatient services, helping ensure clean claims, reliable reimbursement, and strong compliance with payer and regulatory standards. The person in the Medical Coder role will work closely with revenue cycle partners, clinical teams, and leadership to resolve coding issues, improve documentation quality, and maintain consistent coding performance. This position is a remote Monday - Friday. CPC or CCS licence is a MUST for consideration. This role is remote Monday - Friday with equipment provided.</p><p><br></p><p>Responsibilities:</p><p>• <u>Orthopedic Surgical Coding, Surgical Abstracting, and MediCal & CCS coding and billing guidelines (Top Requirements) </u></p><p>• Examine surgical charge documentation and clinical records to assign accurate diagnosis, procedure, and modifier codes for billing and reimbursement activities.</p><p>• Validate charge capture details, correct coding discrepancies, and confirm proper linkage between diagnoses and procedures before claims move forward.</p><p>• Apply ICD-10 and CPT coding standards to surgical and designated diagnostic cases, including review of complex encounters requiring careful interpretation.</p><p>• Manage daily claim and coding work queues, monitor ticket volume, and help maintain timely and accurate claim submission processes.</p><p>• Review scanned charge documents for completeness and coding accuracy, escalating unusual or high-risk issues when necessary.</p><p>• Support reporting and trend analysis by tracking coding errors, identifying recurring issues, and sharing findings with management for process improvement.</p><p>• Collaborate with revenue cycle staff, physicians, clinicians, and departmental leadership to address questions, resolve escalations, and strengthen coding quality.</p><p>• Maintain working knowledge across multiple specialties and remain current on payer rules, Medi-Cal guidance, CCS, Medicare requirements, and other compliance expectations.</p><p>• Participate in audits, department meetings, and ongoing education activities while assisting with coding records management and other assigned duties.</p><p><br></p><p>TO APPLY, ONLY send resume directly to Mike Romero at Mike [dot] Romero [at] RobertHalf [dot] [com]</p>
<p>A Medical Claims Organizations is in the immediate need of Medical Claims Examiner with experience in grievances and appeals to join the team. The Medical Claims Examiner is responsible for reviewing, investigating, and resolving member and provider grievances and appeals in compliance with regulatory requirements and internal policies. The Medical Claims Examine candidate will have hands-on experience working within EZ-CAP and a solid understanding of health plan operations.</p><p><br></p><p>Key Responsibilities:</p><p><br></p><ul><li>Review, research, and process member and provider grievances and appeals accurately and within required turnaround times</li><li>Use EZ-CAP to document, track, and manage case activity</li><li>Analyze case details, benefits, claims, authorizations, and supporting documentation to determine appropriate resolutions</li><li>Ensure all grievances and appeals are handled in accordance with health plan policies, CMS, DMHC, and other applicable regulatory guidelines</li><li>Communicate with internal departments, providers, and members regarding case status and resolution</li><li>Prepare written correspondence for grievance and appeal determinations</li><li>Maintain complete, accurate, and audit-ready documentation</li><li>Identify trends or recurring issues and escalate as needed</li></ul>
<p>A Healthcare Plan in San Bernardino is in need of a Grievance and Appeals Specialist with strong health plan industry experience to join their team. The Grievance and Appeals Specialist is responsible for reviewing, investigating, and resolving member and provider grievances and appeals in compliance with regulatory requirements and internal policies. The Grievance and Appeals Specialist candidate will have hands-on experience working within EZ-CAP and a solid understanding of health plan operations.</p><p><br></p><p>Key Responsibilities:</p><ul><li>Review, research, and process member and provider grievances and appeals accurately and within required turnaround times</li><li>Use EZ-CAP to document, track, and manage case activity</li><li>Analyze case details, benefits, claims, authorizations, and supporting documentation to determine appropriate resolutions</li><li>Ensure all grievances and appeals are handled in accordance with health plan policies, CMS, DMHC, and other applicable regulatory guidelines</li><li>Communicate with internal departments, providers, and members regarding case status and resolution</li><li>Prepare written correspondence for grievance and appeal determinations</li><li>Maintain complete, accurate, and audit-ready documentation</li><li>Identify trends or recurring issues and escalate as needed</li></ul>
<p>We are looking for a Customer Service Representative to support member enrollment operations for a healthcare organization in Huntington Beach, California. This Long-term Contract opportunity is ideal for someone who enjoys helping customers, managing detailed information, and ensuring accurate member records. In this role, you will assist with enrollment-related questions, process eligibility updates, and work across internal teams to deliver a smooth and timely experience for new and existing members.</p><p><br></p><p>Responsibilities:</p><p>• Provide prompt support to members, clients, and internal partners by handling enrollment-related questions through phone, email, and other service channels.</p><p>• Review applications and enter enrollment information into company systems with a high level of accuracy and attention to detail.</p><p>• Process new enrollments, disenrollments, and eligibility updates while ensuring all records remain current and complete.</p><p>• Investigate rejected transactions and coordinate with team members to resolve discrepancies affecting member enrollment status.</p><p>• Confirm coverage and enrollment details with clients and respond to issues involving claims, tracking records, or account updates.</p><p>• Maintain organized documentation within eligibility and enrollment databases to support compliance and operational accuracy.</p><p>• Perform routine file reconciliations on a daily and monthly basis to identify mismatches and correct data issues.</p><p>• Compare submitted information against source documents to validate completeness, accuracy, and proper system entry.</p><p>• Collaborate with colleagues to resolve exception cases and take timely action to ensure members are enrolled correctly.</p>
We are looking for a detail-oriented Receptionist to support daily operations at a community-focused healthcare center in Westminster, California. This Long-term Contract opportunity is ideal for someone who enjoys assisting older adults, managing front-desk interactions, and providing service in a multicultural environment. The role combines customer support, community engagement, and administrative coordination to help visitors access programs, resources, and healthcare information. Candidates who are organized, bilingual, and comfortable working onsite with occasional Saturday availability will be well suited for this position.<br><br>Responsibilities:<br>• Welcome members, visitors, and community guests while creating a helpful and detail-oriented front-desk experience at the center.<br>• Respond to incoming calls, route inquiries appropriately, and provide clear information about services, appointments, and center activities.<br>• Assist members in their preferred language with questions related to benefits, care access, and available Medicare-related resources.<br>• Coordinate community wellness programs, classes, and special events by managing schedules, logistics, and day-of support.<br>• Monitor office and center supply levels, promotional materials, and equipment so daily operations remain organized and fully stocked.<br>• Communicate facility maintenance needs and follow up with the appropriate internal teams to help keep the space safe and functional.<br>• Track visitor traffic and service usage to support reporting and improve center engagement.<br>• Help organize room usage for trainings, activities, and community programs while maintaining cleanliness and readiness of shared spaces.<br>• Represent the organization at outreach activities, educational events, and local gatherings to build community awareness and support enrollment conversations.
<p>Contract Recruiter</p><p><strong>Location:</strong> Downtown Los Angeles, CA – Hybrid</p><p><strong>Employment Type:</strong> Temporary / Contract</p><p><strong>Duration:</strong> Expected through the end of 2026</p><p>Position Overview</p><p>We are seeking an experienced <strong>Contract Recruiter</strong> to provide additional recruiting support to a growing Talent Acquisition team. This individual will work closely with the Sr. Talent Acquisition Partner to help manage recruiting needs across multiple locations and ensure open positions continue moving efficiently through the hiring process.</p><p>The ideal candidate is a hands-on recruiter who can quickly step into an active recruiting environment, manage multiple requisitions, and build strong relationships with candidates and hiring managers. Experience recruiting within <strong>nonprofit, social services, healthcare, or other credential/licensure-focused environments</strong> is highly preferred.</p><p>This position will be based in <strong>Downtown Los Angeles and offer a hybrid work schedule</strong>. The recruiter may support hiring needs across <strong>California, Arizona, and Hawaii</strong>.</p><p>Key Responsibilities</p><ul><li>Manage and support full-cycle recruiting for a variety of open positions</li><li>Partner with the Sr. Talent Acquisition Partner and hiring managers to understand staffing needs and position requirements</li><li>Source and identify qualified candidates through job boards, databases, networking, referrals, and other recruiting channels</li><li>Review resumes and conduct candidate screenings to evaluate experience, qualifications, and overall fit</li><li>Coordinate interviews and maintain consistent communication with candidates and hiring teams throughout the hiring process</li><li>Develop and maintain candidate pipelines for current and anticipated hiring needs</li><li>Support recruiting for positions that may require specific licenses, credentials, certifications, or industry experience</li><li>Manage multiple requisitions and recruiting priorities across different locations</li><li>Maintain accurate candidate and recruiting information within applicant tracking systems and internal records</li><li>Provide timely updates regarding candidate pipelines, recruiting activity, and hiring progress</li><li>Deliver a professional and positive candidate experience throughout the recruitment process</li><li>Assist with additional Talent Acquisition projects and recruiting initiatives as needed</li></ul>
<p>Contract Recruiter</p><p><strong>Location:</strong> Downtown Los Angeles, CA – Hybrid</p><p><strong>Employment Type:</strong> Temporary / Contract</p><p><strong>Duration:</strong> Expected through the end of 2026</p><p>Position Overview</p><p>We are seeking an experienced <strong>Contract Recruiter</strong> to provide additional recruiting support to a growing Talent Acquisition team. This individual will work closely with the Sr. Talent Acquisition Partner to help manage recruiting needs across multiple locations and ensure open positions continue moving efficiently through the hiring process.</p><p>The ideal candidate is a hands-on recruiter who can quickly step into an active recruiting environment, manage multiple requisitions, and build strong relationships with candidates and hiring managers. Experience recruiting within <strong>nonprofit, social services, healthcare, or other credential/licensure-focused environments</strong> is highly preferred.</p><p>This position will be based in <strong>Downtown Los Angeles and offer a hybrid work schedule</strong>. The recruiter may support hiring needs across <strong>California, Arizona, and Hawaii</strong>.</p><p>Key Responsibilities</p><ul><li>Manage and support full-cycle recruiting for a variety of open positions</li><li>Partner with the Sr. Talent Acquisition Partner and hiring managers to understand staffing needs and position requirements</li><li>Source and identify qualified candidates through job boards, databases, networking, referrals, and other recruiting channels</li><li>Review resumes and conduct candidate screenings to evaluate experience, qualifications, and overall fit</li><li>Coordinate interviews and maintain consistent communication with candidates and hiring teams throughout the hiring process</li><li>Develop and maintain candidate pipelines for current and anticipated hiring needs</li><li>Support recruiting for positions that may require specific licenses, credentials, certifications, or industry experience</li><li>Manage multiple requisitions and recruiting priorities across different locations</li><li>Maintain accurate candidate and recruiting information within applicant tracking systems and internal records</li><li>Provide timely updates regarding candidate pipelines, recruiting activity, and hiring progress</li><li>Deliver a professional and positive candidate experience throughout the recruitment process</li><li>Assist with additional Talent Acquisition projects and recruiting initiatives as needed</li></ul>
<p>A Community Center in Rowland Heights is in the need of a bilingual in Cantonese or Mandarin for a Front Office Associate position. The Bilingual Cantonese/Mandarin Front Office Associate will support members and local older adults at our community center locations by delivering thoughtful customer service, guiding individuals through healthcare-related questions, and building strong relationships within diverse communities. The Cantonese/Mandarin Front Office Associate combines front-facing member support, outreach, event coordination, and operational oversight to help create a welcoming and informative environment. Candidates should be comfortable working a regular schedule of 40 hours per week and available to work occasional Saturdays.</p><p><br></p><p>Responsibilities:</p><p>• Welcome members and visitors to the community center, resolve service questions, and provide a positive day-to-day experience for older adults and guests.</p><p>• Assist individuals in their preferred language with understanding plan benefits, accessing care, and navigating Medicare-related questions with clarity and professionalism.</p><p>• Represent the organization at community gatherings, educational sessions, and outreach events while promoting available services and strengthening local visibility.</p><p>• Organize wellness programs, classes, and center events by managing scheduling, logistics, materials, and coordination with internal partners.</p><p>• Monitor inventory levels for office materials, equipment, and promotional items to keep the center properly stocked and ready for daily operations.</p><p>• Oversee the use of community center space for activities and trainings, maintaining a clean, safe, and orderly setting for participants.</p><p>• Track visitor activity and service usage to help evaluate engagement trends and support informed planning decisions.</p><p>• Conduct routine checks of equipment and report maintenance or repair needs to the appropriate facilities contact in a timely manner.</p><p>• Help develop programs and activities that reflect community interests and create meaningful value for members and local older adults.</p><p>• Support additional operational, customer service, or outreach tasks as needed to meet team and center objectives.</p>
<p>Our client is seeking an experienced <strong>Grievance and Appeals Specialist</strong> with strong health plan industry experience to join their team. The Grievance and Appeals Specialist is responsible for reviewing, investigating, and resolving member and provider grievances and appeals in compliance with regulatory requirements and internal policies. The Grievance and Appeals Specialist candidate will have hands-on experience working within EZ-CAP and a solid understanding of health plan operations.</p><p>Key Responsibilities:</p><ul><li>Review, research, and process member and provider grievances and appeals accurately and within required turnaround times</li><li>Use EZ-CAP to document, track, and manage case activity</li><li>Analyze case details, benefits, claims, authorizations, and supporting documentation to determine appropriate resolutions</li><li>Ensure all grievances and appeals are handled in accordance with health plan policies, CMS, DMHC, and other applicable regulatory guidelines</li><li>Communicate with internal departments, providers, and members regarding case status and resolution</li><li>Prepare written correspondence for grievance and appeal determinations</li><li>Maintain complete, accurate, and audit-ready documentation</li><li>Identify trends or recurring issues and escalate as needed</li></ul><p><br></p>
<p>A Community Center in Monterey Park is in the need of a bilingual in Cantonese or Mandarin for a Front Office Associate position. The Bilingual Cantonese/Mandarin Front Office Associate will support members and local older adults at our community center locations by delivering thoughtful customer service, guiding individuals through healthcare-related questions, and building strong relationships within diverse communities. The Cantonese/Mandarin Front Office Associate combines front-facing member support, outreach, event coordination, and operational oversight to help create a welcoming and informative environment. Candidates should be comfortable working a regular schedule of 40 hours per week and available to work occasional Saturdays.</p><p><br></p><p>Responsibilities:</p><p>• Welcome members and visitors to the community center, resolve service questions, and provide a positive day-to-day experience for older adults and guests.</p><p>• Assist individuals in their preferred language with understanding plan benefits, accessing care, and navigating Medicare-related questions with clarity and professionalism.</p><p>• Represent the organization at community gatherings, educational sessions, and outreach events while promoting available services and strengthening local visibility.</p><p>• Organize wellness programs, classes, and center events by managing scheduling, logistics, materials, and coordination with internal partners.</p><p>• Monitor inventory levels for office materials, equipment, and promotional items to keep the center properly stocked and ready for daily operations.</p><p>• Oversee the use of community center space for activities and trainings, maintaining a clean, safe, and orderly setting for participants.</p><p>• Track visitor activity and service usage to help evaluate engagement trends and support informed planning decisions.</p><p>• Conduct routine checks of equipment and report maintenance or repair needs to the appropriate facilities contact in a timely manner.</p><p>• Help develop programs and activities that reflect community interests and create meaningful value for members and local older adults.</p><p>• Support additional operational, customer service, or outreach tasks as needed to meet team and center objectives.</p>