Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance wit…
Skills: Claims Processing, Appeals and Grievances, Medicare Guidelines, Medicaid Guidelines, Customer Service
Long Beach, California, United States · On-site
$22/hr–$24/hr
At Philz, we’re doing something bigger than coffee - we’re building culture and community. We believe that warmth, authenticity, kindness, positivity and passion can Better People’s Days — one cup and one customer at a t…
Skills: Supervision, Team Leadership, Customer Service, Drink Quality Control, Staff Scheduling
Long Beach, California, United States · On-site
$18/hr–$42/hr
JOB DESCRIPTION Job Summary Provides support for member enrollment activities including identifying, interviewing and screening prospective eligible members for Molina health insurance products, assisting with health pla…
Skills: Member Enrollment, Customer Service, Health Insurance Navigation, Community Outreach, Data Processing
Long Beach, California, United States · On-site
$12/hr–$26/hr
JOB DESCRIPTION Job Summary Provides support for pharmacy technician activities. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member…
Skills: Prior Authorization, Pharmacy Plan Criteria, Medication Health Care Outcomes, HIPAA Compliance, Microsoft Office
Long Beach, California, United States · On-site
We are looking for part time Car Wash Attendants who take pride in their work and drive customer satisfaction. As a part time Car Wash Attendant, you will be helping prepare vehicles to be ready for customer rentals. Thi…
Skills: Vehicle Cleaning, Vehicle Maintenance Checks, Driving, Customer Satisfaction, Time Management
Long Beach, California, United States · Remote Solely
$23/hr–$26/hr
Company Description Support veteran-focused healthcare where your pharmacy knowledge, customer service skills, and attention to detail help Veterans access medications and pharmacy support services from a remote role. At…
Skills: Prescription Processing, Customer Service, Pharmacy Operations, HIPAA Compliance, Medical Documentation
Long Beach, California, United States · On-site
POSITION SUMMARY Our jobs aren’t just about giving guests a clean room and a freshly made bed. Instead, we want to build an experience that is memorable and unique. Our Guest Environment Experts are skilled in a wide ran…
Skills: Housekeeping, Cleaning, Guest Relations, Time Management, Attention To Detail
Long Beach, California, United States · On-site
$26/hr–$33/hr
Where You’ll Work Founded in 1923, Dignity Health - St. Mary Medical Center is a 389-bed, acute care, nonprofit hospital located in Long Beach, California. Serving over 80,000 patients annually, the hospital offers a ful…
Skills: Patient Registration, Customer Service, Insurance Verification, Data Entry, Financial Processing
Long Beach, California, United States · On-site
$16/hr–$21/hr
From Aisle to Algorithm and for All Life’s Moments, at David’s Bridal, we empower our customers and our employees to stay true to their dreams and find the one, whether that means the event or the wedding dre…
Skills: Customer Service, Appointment Scheduling, Garment Pressing, Conflict Resolution, POS Systems
Long Beach, California, United States · On-site
$55k–$85k/yr
Travel Consultant Discovering the World- One Member at a Time! A love of travel attracts many people to the field, but to succeed a Travel Consultant must be passionate about travel and the endless opportunities it bring…
Skills: Sales Drive, Organizational Skills, Multi-tasking, Computer Proficiency, Written Communication
Long Beach, California, United States · On-site
$20/hr–$23/hr
You’ve invested a lot of time and energy in your education. Now you want the chance to make your mark. We offer challenging opportunities for you to learn and grow professionally. In our programs, you’ll be immersed in a…
Skills: Prescription Filling, Patient Counseling, Healthcare Collaboration, Health Screenings, Immunizations
Long Beach, California, United States · On-site
$37/hr–$65/hr
Why Wells Fargo: Are you looking for more? Find it here. At Wells Fargo, we're more than a financial services leader – we’re a global trailblazer committed to driving innovation, empowering communities, and helping our c…
Skills: Relationship Management, Financial Planning, Customer Acquisition, Risk Oversight, Credit Strategies
Long Beach, California, United States · On-site
$22/hr–$24/hr
Location This position is located at 6460 E Pacific Coast Hwy, Long Beach, California, 90803 United States Role Summary In collaboration with the store team, the Assistant Visual Manager supports the selling, service, an…
Skills: Visual Merchandising, Leadership, Team Management, Retail Operations, Customer Service
Long Beach, California, United States · On-site
We are hiring for buses, food runners and bar backs. Experienced only. This is for a high volume elevated bistro and lounge. This job description is for busser only but you may apply and we can discuss the other position…
Skills: Table Clearing, Dining Room Maintenance, Guest Support, Food Running, Sanitation Compliance
Long Beach, California, United States · On-site
$20/hr–$30/hr
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate…
Skills: Prescription Fulfillment, Patient Care, Inventory Management, Immunization Support, Customer Service
Long Beach, California, United States · On-site
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate…
Skills: Prescription Fulfillment, Patient Care, Inventory Management, Immunization Support, Customer Service
Long Beach, California, United States · On-site
Celebrating our 23rd anniversary, Ono Hawaiian BBQ is a fast-casual restaurant known for its authentic Hawaiian Plate Lunches and other island specialties. Ono Hawaiian uses the freshest ingredients, prepared from scratc…
Skills: Customer Service, POS Operation, Cash Handling, Food Safety, Communication Skills
Long Beach, California, United States · On-site
At UK St. Claire, our staff is our greatest asset in the mission to create a healthier and more prosperous population. We strive to foster the talent and potential of our employees and prioritize safe working conditions …
Skills: Patient Scheduling, Data Entry, Customer Service, Clinical Coordination, Resource Optimization
Long Beach, California, United States · On-site
$16/hr–$24/hr
Compensation Pay Range: $16.90 - $24.90 The actual hourly rate will equal or exceed the required minimum wage applicable to the job location. Additional compensation includes annual, quarterly performance, or premiums ma…
Skills: Safe Driving, Fleet Management Devices, Customer Service, Cash Handling, Inventory Management
Long Beach, California, United States · On-site
$24/hr–$28/hr
Our secret to leading the way in hospitality? We put our people first! At Shake Shack, our mission is to Stand For Something Good in all that we do. From our teams to our neighborhoods, we're committed to always doing th…
Skills: Restaurant Leadership, Team Supervision, Problem Solving, Written Communication, Verbal Communication
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Responsible for researching and resolving member and provider appeals, disputes, and grievances in compliance with CMS and regulatory standards. This includes reviewing medical records, analyzing claims payment errors, and composing formal written responses.
Requires at least 2 years of managed care experience in claims, appeals, or a call center environment. Candidates must have knowledge of Medicare/Medicaid regulatory guidelines and proficiency in health claims processing.
Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS).
Essential Job Duties
• Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or regulatory timelines are met.
• Researches claims appeals and grievances using support systems to determine appropriate appeals and grievance outcomes.
• Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina guidelines.
• Meets claims production standards set by the department.
• Applies contract language, benefits and review of covered services to claims review process.
• Contacts members/providers as needed via written and verbal communications.
• Prepares appeal summaries and correspondence, and documents findings accordingly (includes information on trends as requested).
• Composes all correspondence, appeals/disputes and/or grievances information concisely, accurately and in accordance with regulatory requirements.
• Researches claims processing guidelines, provider contracts, fee schedules and systems configurations, to determine root causes of payment errors.
• Resolves and prepares written response to incoming provider reconsideration requests related to claims payment, requests for claim adjustments, and/or requests from outside agencies.
Required Qualifications
• At least 2 years of managed care experience in a call center, appeals, and/or claims environment, or equivalent combination of relevant education and experience.
• Health claims processing experience, including coordination of benefits (COB), subrogation and eligibility criteria.
• Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for appeals and denials.
• Customer service experience.
• Strong organizational and time management skills; ability to manage simultaneous projects and tasks to meet internal deadlines.
• Effective verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Molina Healthcare is a FORTUNE 500 company that is focused exclusively on government-sponsored health care programs for families and individuals who qualify for government sponsored health care. Molina Healthcare contracts with state governments and serves as a health plan providing a wide range of quality health care services to families and individuals. Molina Healthcare offers health plans in Arizona, California, Florida, Idaho, Illinois, Kentucky, Massachusetts, Michigan, Mississippi, Nevada, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Virginia, Washington and Wisconsin. Molina also offers a Medicare product and has been selected in several states to participate in duals demonstration projects to manage the care for those eligible for both Medicaid and Medicare.
Offices: 200 Oceangate, Long Beach, California 90802, US
There are currently 540 open customer service & support positions in Long Beach, CA listed on Clera. New openings are added daily as companies post roles.
Companies currently hiring include Molina Healthcare, Domino's, Starbucks, CVS Health, Lowe's Companies, Inc., among others. Browse the listings above to see every active employer.
Yes — 57 of the 540 open customer service & support positions offer remote or hybrid work (39 remote, 18 hybrid).
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.
