Teams at North East Medical Services (NEMS)

Review, audit, investigate and adjudicate professional medical claims to established guidelines (Medi-Cal/Medicare), meet production targets, correct processing errors, respond to provider/member inquiries, support delegation oversight audits and report issues to supervisors and system teams.

Greet and check in patients, schedule appointments, verify insurance, collect co-payments, manage patient communications (phone and portal), assist with MyChart and outreach, update registration and demographic data, comply with HIPAA, and rotate coverage across clinic sites.

Designs and governs enterprise Zero-Trust security architecture across on-premises, clinic, and cloud environments. Leads IAM, endpoint protection, EDR, patching, network segmentation, security policy development, risk and vulnerability assessments, incident response, SOC coordination, and compliance with NIST and HIPAA. Mentors team members and liaises with external vendors and auditors.