Victoria Levitz

Victoria Levitz is a highly experienced Healthcare Auditor at CalOptima, where she has been instrumental in ensuring the integrity and accuracy of high-dollar claims exceeding $10,000. In her current role, Victoria leverages her extensive expertise in Medical Insurance Billing, Medical Coding, and Provider Disputes to conduct comprehensive audits that uphold compliance with Medicare, Medi-Cal, and other contractual requirements. Her deep understanding of regulatory frameworks, including CMS guidelines and DHCS standards, allows her to identify discrepancies, prevent fraud, and optimize claims processing efficiency.

Victoria’s role involves collaborating closely with multiple departments such as Claims, GARS, and Utilization Management, providing critical insights that influence policy adjustments and improve overall operational workflows. She actively participates in meetings with federal and state agencies like CMS, DHCS, and DMHC, ensuring CalOptima remains aligned with evolving industry regulations. Her proficiency with medical software tools—including Medisoft, Medical Manager, EZ Cap, IDX, and Facets—enables her to perform detailed data analysis and streamline auditing processes. Additionally, her familiarity with CPT-4 coding and ICD-10 enhances her ability to accurately review medical documentation and coding practices.

Beyond technical skills, Victoria excels in fostering professional relationships through her excellent interpersonal communication abilities, which facilitate effective collaboration across multidisciplinary teams. Her leadership in developing audit protocols and her commitment to continuous improvement position her as a key contributor to CalOptima’s mission of delivering high-quality, compliant healthcare services. With her comprehensive industry knowledge and dedication to excellence, Victoria Levitz continues to be a vital asset in maintaining the integrity of the healthcare claims process.