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: Appeals and grievances, Claims processing, Managed care, Medical records review, Regulatory compliance
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Molina Health Plan Provider Network Contracting jobs are responsible for the value-based payments (VBP) network strategy and development with respect to financial performance and operational p…
Skills: Provider contracting, Value-based payments, Contract negotiation, Managed health care, Alternative payment models
Long Beach, California, United States · Hybrid
$7k–$8k/mo
Position: Assistant Professor of Nutrition and Dietetics Effective Date: August 17, 2027 (Fall Semester) Salary Range: The Assistant Professor (Academic Year) classification salary is $6,221 to $13,224/per month (12 mont…
Skills: Clinical nutrition, Food service management, Community nutrition, Teaching, Research
Long Beach, California, United States · On-site
$32/hr–$43/hr
Why Join Sunrise Senior Living At Sunrise Senior Living, we believe meaningful work starts with purpose. Our team members are passionate about making a positive difference in the lives of residents every day. At Sunrise …
Skills: Facilities Management, Housekeeping Operations, HVAC Maintenance, Plumbing, Electrical Systems
Long Beach, California, United States · On-site
$75k–$159k/yr
Job Number: 560248 Position: Assistant Professor of Health Disparities/Health Psychology Effective Date: August 17, 2027 (Fall Semester) Salary Range: The Assistant Professor (Academic Year) classification salary is $74,…
Skills: Health Psychology, Health Disparities, Teaching, Mentoring, Research
Long Beach, California, United States · Remote Solely
$18/hr
Job DetailsJob Location: Long Beach, CA 90806Position Type: Full TimeSalary Range: $18.00 - $18.00 HourlyTravel Percentage: NoneAdvanced Medical Reviews (AMR) is looking for a Remote Clerical Quality Assurance Coordinato…
Skills: Quality Assurance, Data Entry, HIPAA Compliance, Microsoft Word, Microsoft Outlook
Long Beach, California, United States · Remote Solely
$18/hr
Job DetailsJob Location: Long Beach, CA 90806Position Type: Full TimeSalary Range: $18.00 - $18.00 HourlyTravel Percentage: NoneAdvanced Medical Reviews (AMR) is looking for a Remote Clerical Quality Assurance Coordinato…
Skills: Quality Assurance, Data Entry, HIPAA Compliance, Medical Records Management, Microsoft Word
Long Beach, California, United States · On-site
$26/hr–$30/hr
About Us At Sprinter Health, our mission is to reimagine how people access care by bringing high-quality care directly into the home. Using the same technology that powers leading marketplace platforms, we deliver care w…
Skills: Phlebotomy, Venipuncture, Specimen collection, Diabetic foot screenings, Retina exams
California State University, Office of the ChancellorLong Beach, California, United States · Hybrid
$6k–$13k/mo
Position: Assistant Professor of Nutrition and Dietetics Effective Date: August 17, 2027 (Fall Semester) Salary Range: The Assistant Professor (Academic Year) classification salary is $6,221 to $13,224/per month (12 mont…
Skills: Clinical Nutrition, Food Service Management, Community Nutrition, Teaching, Research
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Provides support for implementation of health plan provider engagement strategies and activities to drive necessary quality and risk adjustment outcomes. Uses a consultative approach, emphasiz…
Skills: Provider engagement, HEDIS, Risk adjustment, Quality improvement, Data analysis
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Provides screening, preventive primary care and medical care services to members - primarily in non-clinical settings where members feel most comfortable, including in-home, community and nurs…
Skills: Primary care, Care coordination, Physical exams, Medical diagnosis, Diagnostic testing
Long Beach, California, United States · On-site
JOB DESCRIPTION Family Care with My Choice Wisconsin Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team…
Skills: Care management, Care coordination, Assessment, Care planning, Motivational interviewing
Long Beach, California, United States · Remote OK
***Remote with travel throughout Chippewa & Eau Claire Counites, WI for member visits*** JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific …
Skills: Care management, Care coordination, Member assessments, Waiver enrollment, Care planning
Long Beach, California, United States · On-site
$27/hr–$38/hr
Description Now is the time to join Downtown Long Beach Dentistry. You will have opportunities to learn new skills from our team of experienced professionals. If you're ready to take your career to the next level and gai…
Skills: Operations management, Team leadership, Financial management, Coaching, Mentoring
Long Beach, California, United States · Hybrid
$106k–$183k/yr
Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we sti…
Skills: AI platform architecture, Agentic orchestration, Workflow automation, Context engineering, Azure AI Studio
Long Beach, California, United States · Hybrid
$106k–$183k/yr
Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we sti…
Skills: Artificial intelligence, Large language models, Retrieval-augmented generation, Python, Azure AI services
Akua Mind BodyLong Beach, California, United States · On-site
Description Position: Clinical Technician Type: Hourly, Full-Time, Non-Exempt Compensation: $23 hourly Benefits: Health Insurance (Medical, Vision, Dental) PTO (Vacation, Sick) Equity Shares (ESOP) Available Shifts: Mond…
Skills: Direct Client Care, Crisis Intervention, Medication Observation, Group Facilitation, Documentation
Long Beach, California, United States · Hybrid
$91k–$154k/yr
Your Role The Group Medicare team is responsible for Client & Stakeholder Management, Retiree & Member Support Operations, Project Management & Execution, Compliance, Quality, & CMS Readiness, Data, Reporting & Continuou…
Skills: Project Management, Program Management, Healthcare Administration, Medicare Advantage, CMS Regulations
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: Endocrinology, Healthcare, Patient Care, Clinical Practice
Long Beach, California, United States · On-site
$95k–$115k/yr
About Us Hydrafacial is a global category-creating company focused on bringing innovative products to market and delivering beauty health experiences by reinventing our consumer’s relationship with their skin, their bodi…
Skills: Supplier quality management, New product introduction, FDA 21 CFR Part 820, ISO 13485:2016, Lead auditor
Long Beach, California, United States • On-site
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Facilitate the research and resolution of member and provider appeals, grievances, and complaints in accordance with CMS and regulatory standards. Review medical records and claims data to determine appropriate outcomes and ensure timely communication with all involved parties.
Requires at least 2 years of experience in managed care, claims, or appeals environments with knowledge of Medicare and Medicaid guidelines. Proficiency in Microsoft Office and strong organizational skills are essential for managing multiple projects and meeting regulatory deadlines.
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 725 open healthcare positions in Long Beach, CA listed on Clera. New openings are added daily as companies post roles.
Companies currently hiring include Molina Healthcare, SCAN, Lorian Health, Ascendiun, St. Mary Medical Center, among others. Browse the listings above to see every active employer.
Yes — 185 of the 725 open healthcare positions offer remote or hybrid work (72 remote, 113 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.
