Senior Claims Examiner (50714) Western GrowersSenior Claims Examiner (50714)Irvine, CAProficient in medical terminology, contract and benefit interpretation, UB-04 and HCFA 1500 forms (837/5010 format), medical coding, CPT, ICD10, HCPCS, DRG, National Correct Coding Initiative (NCCI) edits or Medically Unlikely Edits (MUE), with working knowledge of Federal, State and Self-funded insurance plans. Assist leadership team improve turnaround times, processes, or staff training identifying errors through data analysis and auditing, and working with various teams to ensure those errors are corrected in both the short and long term.
Facility Inpatient Surgical and Claims Edit Auditor Cedars-Sinai Medical CenterFacility Inpatient Surgical and Claims Edit AuditorLos Angeles, CARemoteMaintains appropriate open communication with internal and external partners and peer departments such as Coding Operations, Clinical Documentation Integrity (CDI), Payor Revenue Management (PRM), and Compliance Revenue Integrity (CRI). Auditors evaluate compliance with all coding guidelines including but not limited to: Internal Coding policies/procedures/handbook, American Hospital Association (AHA) and American Medical Association (AMA) coding references, local, State, and Federal Coding Guidelines.
Facility Outpatient Surgical and Claims Edit Auditor (Remote) Cedars-Sinai Medical CenterFacility Outpatient Surgical and Claims Edit Auditor (Remote)Los Angeles, CARemoteMaintains appropriate open communication with internal and external partners and peer departments such as Coding Operations, Clinical Documentation Integrity (CDI), Payor Revenue Management (PRM), and Compliance Revenue Integrity (CRI). Auditors evaluate compliance with all coding guidelines including but not limited to: Internal Coding policies/procedures/handbook, American Hospital Association (AHA) and American Medical Association (AMA) coding references, local, State, and Federal Coding Guidelines.
Implementation Auditor (50487) Western Growers AssociationImplementation Auditor (50487)Irvine, CAUsing close and comprehensive analyses, verify new and existing plans loaded on the Company's claim management system against the appropriate Summary Plan Description to determine the accuracy of present and future claims payments. This position will ensure that all new and existing health (medical/dental) insurance plans underwritten by the Western Growers Assurance Trust (WGAT) and those of Pinnacle, Inc. (PCMI) are in compliance with the respective employers' summary plan descriptions.
Plan Coder (50456) Western Growers AssociationPlan Coder (50456)Irvine, CAThis position will ensure that all new and existing health (medical/dental/pharmacy) insurance plans underwritten by Western Growers Assurance Trust (WGAT) and those of Pinnacle Claims Management, Inc. (PCMI) are in compliance with the respective employers' summary plan descriptions. Do everything possible to help members succeed by being curious and striving to understand what others are trying to achieve, planning, and executing work helpfully and collaboratively.
NewDecision Scientist - Clinical Informatics (Clinical Data Standards) CVS Health CorpDecision Scientist - Clinical Informatics (Clinical Data Standards)CA$64,890–$158,620 / yearA&BC leverages advanced analytics, clinical informatics, and hypothesis-driven approaches to transform data into actionable, customer-centric insights that drive growth, improve health outcomes, and expand access to healthcare across all CVS Health businesses. Collaborate with data engineering teams to inform data pipeline development, ensuring clinical data is ingested, transformed, and stored in ways that support downstream analytics needs.
Senior Manager, Claims Adjustments L.A. Care Health PlanSenior Manager, Claims AdjustmentsLos Angeles, CAThe Senior Manager, Claims Adjustments manages all adjustment-related operational workflows, including provider disputes, escalated claim reviews, complex adjustments, and litigation-related claim support. Ensures all provider adjustments meet Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), Centers for Medicare and Medicaid Services (CMS), and contractual (TAT) requirements.
Quality Analyst Home Health, Lead Assistant Manager ExlService Holdings IncQuality Analyst Home Health, Lead Assistant ManagerCA$60,100–$98,700 / yearContinuous Improvement/Education actively participates with team to ensure alignment and sustained results; attends training (assigned or self-initiated) to improve performance or capitalize on new overpayment trends; keeps up with CMS, OIG, and other publications related to our business. EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates.
Cancer Registry abstractor IV - 100 Remote UCLA Health SystemCancer Registry abstractor IV - 100 RemoteCARemote$41.70–$55.03 / hourAs a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer. Strong oral and written communication skills for the purposes of conveying information to individuals at various organizational levels and the general public and in completing concise documentation.
Financial Clearance Specialist III - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union) University of Southern CaliforniaFinancial Clearance Specialist III - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)Los Angeles, CaliforniaWhen extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations. If you are a current USC employee, please apply to this USC job posting in Workday by copying and pasting this link into your browser: https://wd5.myworkday.com/usc/d/inst/1$9925/9925$140078.htmld
Financial Clearance Specialist IV - Admitting - Full Time 8 Hour Variable Shift (Non Union) University of Southern CaliforniaFinancial Clearance Specialist IV - Admitting - Full Time 8 Hour Variable Shift (Non Union)Glendale, CaliforniaWhen extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations. Minimum (3) years of experience in a hospital, health plan or Physician office environment with extensive knowledge of contracted and non-contracted payers, division of financial responsibility, including the ability to articulate benefit negotiations as required when adjudicating a letter of agreement with a non-contracted payer.
Financial Clearance Specialist III - Prearrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union) University of Southern CaliforniaFinancial Clearance Specialist III - Prearrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)Los Angeles, CA$22–$34.18 / hourWhen extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations. Preferred Qualifications: Required Licenses/Certifications: Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date.
Full-Time STS Clinical Data Abstractor Hourly Non-Exempt Carta Healthcare Inc.Full-Time STS Clinical Data Abstractor Hourly Non-ExemptCARemotePaid Holidays: "Full-time hourly employees receive six paid holidays per year: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, and Christmas Day, paid at their regular hourly rate. Carta Healthcare is dedicated to building a diverse and inclusive company because we serve health systems across the country; we've seen how our product and impact are strengthened the more we reflect that diversity.
Full-Time Cath PCI Clinical Data Abstractor Hourly Non-Exempt Carta Healthcare Inc.Full-Time Cath PCI Clinical Data Abstractor Hourly Non-ExemptCARemotePaid Holidays: "Full-time hourly employees receive six paid holidays per year: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, and Christmas Day, paid at their regular hourly rate. Carta Healthcare is dedicated to building a diverse and inclusive company because we serve health systems across the country; we've seen how our product and impact are strengthened the more we reflect that diversity.
ED, Risk Adjustment Strategy & Transformation Kaiser PermanenteED, Risk Adjustment Strategy & TransformationPasadena, CAThrough collaborative leadership, shared accountability, and enterprise-wide partnership, the Executive Director will help strengthen member outcomes, enhance provider and patient experiences, improve operational effectiveness, support reimbursement integrity, and advance Kaiser Permanentes long-term clinical and financial performance. Working through established governance structures, including the Care Delivered, Value Captured, Unrivaled Experience (CDVCUE) Board and its cross-functional stakeholders, the Executive Director will facilitate collaboration, support strategic alignment, promote transparency, and help ensure coordinated execution across interconnected initiatives.
Clinical Data Abstractor - STS / Adult Cardiac - Part Time Carta Healthcare Inc.Clinical Data Abstractor - STS / Adult Cardiac - Part TimeCARemote$28–$32.10 / hourCarta Healthcare is dedicated to building a diverse and inclusive company because we serve health systems across the country; we've seen how our product and impact are strengthened the more we reflect that diversity. In addition, we have found and strongly believe that diverse teams are higher-performing, and we embrace the varied perspectives that our team members share with each other.
Nurse Practitioner / Physician Assistant, Adult Medicine Tiburcio Vasquez Health Center IncNurse Practitioner / Physician Assistant, Adult MedicineCA$69.39–$87.91 / hourFederal and State Loan Programs: TVHC is designated as both a Medically Underserved Area (MUA) and a Health Professional Shortage Area (HPSA), making employees eligible to apply for the National Health Service Corps (NHSC) and other federal and state loan repayment and forgiveness programs available to qualifying healthcare professionals. Performs health assessments, including a thorough history and physical examination, ordering or performing certain diagnostic tests, medication orders, evaluation of psychosocial and family aspects of the situation sufficient to make a general health assessment, and diagnose the nature of common acute and chronic conditions, and any necessary follow-up care.
Per Diem HIM CODER/Technician University Health Services IncPer Diem HIM CODER/TechnicianChino, CASupports the Health Information Management Department through variety of clerical, technical, and related support services Qualifications QUALIFICATIONS: Certified Coding Specialist (C.C.S. ) REQUIRED Minimum one year experience with ICD-10 and CPT in a medical or psychiatric facility preferred; ICD-10 training required, basic computer experience required; Use of an encoder software product for code assignment preferred; Experience with ICD- 10-CM procedures and use of DSM V coding procedures required. POSITION SUMMARY The HIM coder analyzes, abstracts and codes the diagnosis and procedural information for inpatient and outpatient medical records utilizing the International Classifications of Diseases (ICD-10) and Current Procedural Terminology (CPT) in accordance with regulatory agencies and hospital specific guidelines.
Principal AI Developer Experience Architect SentinelOne IncPrincipal AI Developer Experience ArchitectCA$216,000–$260,000 / yearAs a Principal AI Developer Experience Architect, you will serve as the technical authority for the AI engineering layer at SentinelOne, designing how enterprise-grade AI coding assistants and LLM platforms integrate into our engineering workflows. Partner with the AI Champions Network and Learning & Development to define curricula, hands-on labs, and "day‑in‑the‑life" workflows that level up prompt engineering and AI‑assisted development skills across developer organizations.
Telehealth Nurse Practitioners (Remote) UrrlyTelehealth Nurse Practitioners (Remote)Los Angeles, CARemote$600–$720 / yearPreferred Availability: We are looking for providers who can consistently work weekday/daytime hours , with Thursday and Friday availability strongly preferred . Ability to consistently work weekday/daytime hours , with Thursday and Friday availability preferred .