Government Audit Recovery Specialist Apidel TechnologiesGovernment Audit Recovery SpecialistCosta Mesa, CAContractorAs an essential role and focal point of all government audit activity, the Government Recovery Specialist is responsible for responding to correspondence from Government Agencies related to Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Targeted Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), Quality Improvement Organizations (QIO) and other Medicaid, Medi-Cal regulatory auditing body for pre and post payment audits. Experience working on government, Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Targeted Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), and other Medicaid, Medi-Cal and other regulatory audits.
Coder II Apidel TechnologiesCoder IICosta Mesa, CAContractorAs an essential role and focal point of all government audit activity, the Government Recovery Specialist is responsible for responding to correspondence from Government Agencies related to Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Targeted Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), Quality Improvement Organizations (QIO) and other Medicaid, Medi-Cal regulatory auditing body for pre and post payment audits. Utilization Management Process, Word, Comprehensive Error Rate Testing (Cert), Office Of Inspector General (Oig), Medicaid Audits, Medi-Cal Audits Outlook, Acute Care Experience, Government Audits, Coding, Medical Necessity Criteria, CMS Billing, payment methodologies, reimbursement methodologies, privacy regulations.
Biller/Collector III HireTalentBiller/Collector IIIIrwindale, CAMaintains superior understanding of CPT/HCPCS codes, ICD-10 codes, CMS 1500 form guidelines, eligibility and coverage requirements, remit and remark codes, payor/plan codes, claims management, third-party payer guidelines, state and federal regulations, claims clearinghouse workflow, and all other pertinent functions of the job. % Assists staff in identifying high-risk accounts and prioritizing resolution efforts; Ensures staff is researching high dollar accounts, high volume denials, credits, adjustments, and undistributed balances, etc. in adherence to internal policies and procedures.
Auditor Technical Trainer POS Cotiviti Holdings Inc. (Inactive)Auditor Technical Trainer POSCARemote$105,000–$125,000 / yearAssess job-specific needs and develop technical training plans with clear business objectives, including working with subject matter experts, developing training materials, and developing appropriate assessments and measurements of success. The individual will work collaboratively with subject matter experts in the Commercial & Government Audit Teams, Quality Assurance, Concept Development, and others to validate workflows and communication tools to enhance audit productivity, performance, and client satisfaction.
Medical Billing Negotiator 26-00226 Alura Workforce SolutionsMedical Billing Negotiator 26-00226Simi Valley, CA$24–$26 / hourOur client reviews medical bills tied to insurance claims, mainly workers' compensation and liability cases, making sure the charges are accurate and fair. Candidates must have minimum 1 year of experience in bill negotiations or California workers' compensation claims IEA certificate or California Certificate of Self Insurance a plus.
DRG Clinical Validation Lead Elevance HealthDRG Clinical Validation LeadCosta Mesa, CA$89,520–$161,136 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. How you will make an impact: Conducts pre-certification, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
Optometric Technician (Pre-Testing and Front Office) Santa Fe Springs OptometryOptometric Technician (Pre-Testing and Front Office)Santa Fe Springs, CAFull timeWork-up patients prior to seeing doctor Includes autorefraction, lensometry, retinal photos (Optos), intraocualar pressure assessment (using iCare), visual acuities, case history, medical history and recording all above tests in patient's electronic medical record (average 10 patients per day). When not working directly with patients, your role will be to assist the front office with answering phones and emails to communicate with our patients, as well as assist with medical billing and processing orders for glasses and contact lenses.
Health Claims Examiner Ultimate Staffing ServicesHealth Claims ExaminerPasadena, California$23–$27 / hourCommunicate professionally with members and providers to address inquiries, follow up on pended claims, and complete necessary corrections or adjustments. Strong working knowledge of medical terminology, billing practices, and coding systems, including CPT, ICD-9/ICD-10, HCPCS, DRG, and revenue codes.
Healthcare Claims Examiner Ultimate Staffing ServicesHealthcare Claims ExaminerEl Monte, California$25–$28 / hourResearch and resolve claim discrepancies, including making payment corrections, recovering overpayments, and reprocessing claims as needed. Evaluate claims for potential fraud, waste, abuse, Workers' Compensation, hospital-acquired conditions, and third-party liability; escalate issues appropriately.
Medical Collections Specialist Marquee StaffingMedical Collections SpecialistNewport Beach, CAWe are seeking an experienced Medical Collections Specialist to process and follow up on physician claims from various payer types (HMO, PPO, Medi-Cal, Medicare, etc.) to ensure timely payment for services rendered. Duties: Review and analyze medical documentation and patient records for accurate and timely billing entry; assign or reassign appropriate medical codes (ICD-10, CPT, HCPC) for diagnoses, procedures, and services rendered.
Sr Bill Review Analyst MedRisk LLCSr Bill Review AnalystCAJob Purpose: Under moderate supervision, this position is responsible for analyzing incoming medical bills for fee schedule or usual and customary application as well as PPO interface while meeting contractual client requirements. Strong knowledge of Medical Terminology and CPT / ICD-9 / ICD-10 coding - Knowledge of multi-state fee schedules preferred.
Coder FT Days 8am-4:30pm AHMC HealthcareCoder FT Days 8am-4:30pmMonterey Park, CaliforniaUnder the direction of the Director of Health Information Management, Identifies and codes Newborns, Obstetrics, ER’s and outpatient records for the purpose of reimbursement, research, and compliance with Federal Regulations using the ICD-10-CM/CPT coding classification systems. Queries are formulated well; are clear, concise, and affect efficient assistance to the medical staff member for timely and accurate query response, complete documentation, and final coding.
Medical Billing / Frontdesk Kohan International FoundationMedical Billing / FrontdeskCULVER CITY, CAMedical Biller/Office Administrator (Full-Time, In-Person) We are a non-profit group therapy practice seeking a skilled and dedicated Medical Biller/Office Administrator to join our team immediately! Fluency in Tagalog/Filipino is A MUST to effectively serve our diverse clientele and team but not required.
DRG Coder Astrana Health, Inc.DRG CoderCA, CaliforniaRemote$28–$32 / hourIn an Independent Practice Association (IPA) and Management Services Organization (MSO) environment, the DRG Coder partners with utilization management, care management, finance, and provider network teams to support accurate payment, risk adjustment, quality reporting, and medical expense analysis. The DRG Coder is responsible for reviewing inpatient medical records and accurately assigning diagnosis and procedure codes using ICD-10-CM and ICD-10-PCS to determine the appropriate Diagnosis-Related Group (DRG) assignment.
Office Manager/Supervisor Skyline UrologyOffice Manager/SupervisorTarzana, CaliforniaThe Office Manager/Supervisor leads goals and objectives that will provide the efficient operation of the Physician/s practice by overseeing daily operations and staff. Oversees and approves medical office supply inventory, ensures that mail is opened and processed, and offices are opened and closed according to procedures.
Manager, Administrative Operations - Patient Accounting - Full Time 8 Hour Days (Exempt) (Non-Union) University of Southern CaliforniaManager, Administrative Operations - Patient Accounting - Full Time 8 Hour Days (Exempt) (Non-Union)Los Angeles, CA$99,507–$164,559 / yearWhen 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. It will also include oversight and tasks associated with vendor management, more specifically, controlling costs, reducing vendor related risks, facilitates all communications between the PFS Business Office and the vendors and ensures service delivery by creating vendor expectations.
Medical Office Supervisor Argus Medical Management, LLCMedical Office SupervisorNewport Beach, CA$22–$26 / hourFull timeNewport Children's Medical Group provides expert, compassionate pediatric care for children of all ages, from newborns to adolescents, at its locations in Newport Beach, Irvine, Costa Mesa, and Laguna Beach. Job Type: Full-Time, Direct HireHours: Mon-Fri, 8-hour shiftsPay: $22-26 per hourPosition Summary:To ensure all aspects of the medical office are managed effectively to comply with physician/company policies and procedure and state/federal regulations.
NewForward Deployed Engineer, Data Studio Revenue Cycle - Innovation_Delivery_Transformation DeloitteForward Deployed Engineer, Data Studio Revenue Cycle - Innovation_Delivery_TransformationLos Angeles, CA$105,400–$207,800 / yearWorking knowledge of the retrieval and knowledge layer behind agentic systems - RAG pipelines, embeddings and vector stores, and increasingly knowledge graphs - including how to ground use cases in large volumes of unstructured healthcare data (e.g., clinical notes, payer policies, contracts) alongside structured sources. Partner with Health Care consulting teams and Converge for Healthcare's account and product teams during the sales cycle - running technical discovery, demonstrations, and use-case fit assessments - such as denial prevention, prior authorization automation, or AR follow-up - that qualify client needs and shape a credible path to production value.
Revenue Cycle Supervisor Orthopaedic Institute for ChildrenRevenue Cycle SupervisorLos Angeles, California$113,000–$149,000Position Summary: The Revenue Cycle Supervisor is responsible for overseeing daily operations across key revenue cycle functions, including billing, collections, charge capture, and denial management for an orthopedic outpatient environment. Physical Requirements: Intermittent (25-35% of the time) walking, standing, bending, sitting and verbally communicating with patients and other OIC healthcare team members.
Kinnser Intake & Scheduler - Home Health CARE FIRST HOME HEALTH CARE INCKinnser Intake & Scheduler - Home HealthSimi Valley, CAPart timeThis role ensures newly referred patients are scheduled accurately, insurance authorizations are complete, and transition seamlessly into care services while supporting high-quality communication with referral partners and internal teams. The Intake & Scheduler oversees the entire patient intake process within a home health/hospice setting, using WellSky/Kinnser EMR .