Claims Examiner III (Medi-Cal Managed Care)

We are seeking an experienced Senior Claims Examiner with deep expertise in Medi-Cal Managed Care claims adjudication. The ideal candidate will have extensive knowledge of California Medi-Cal regulations, delegated risk arrangements, provider disputes, and complex facility claim processing. Experience with Medicare and Commercial claims is required, but this role is primarily focused on supporting and serving as a subject matter expert for Medi-Cal business. About Us All Care To You is a Management Service Organization providing our clients with healthcare administrative support. We provide services to Independent Physician Associations, TPAs, and Fiscal Intermediary clients. ACTY is a modern growing company which encourages diverse perspectives. We celebrate curiosity, initiative, drive and a passion for making a difference. We support a culture focused on teamwork, support, and inclusion. Our company is fully remote and offers a flexible work environment as well as schedules. ACTY offers 100% employer paid medical, vision, dental, and life coverage for our employees. We also offer paid holiday, sick time, and vacation time as well as a 401k plan. Additional employee paid coverage options available. Job Purpose The Claims Examiner III (Medi-Cal Managed Care) is responsible for the accurate processing, adjustment, adjudication, and release of complex hospital, ancillary, and professional claims with a primary focus on Medi-Cal managed care claims. This role requires extensive