Clinical Documentation Integrity Specialist (Hybrid, White Memorial) Adventist HealthClinical Documentation Integrity Specialist (Hybrid, White Memorial)Los Angeles, CAJob Summary: Reviews, evaluates and assesses medical records of patients, looks for specificity of an illness, the accuracy of the clinician's documentation, coding requirements and documentation of important medical details to ensure the overall quality and completeness of clinical documentation of the patient medical record and ensure it is in compliance with government and other regulations. Essential Functions: Evaluates and assesses medical records of patients, looks for specificity of an illness, the accuracy of the clinician's documentation, coding requirements and documentation of important medical details to ensure the overall quality and completeness of clinical documentation of the patient medical record.
Senior Professional Fee Medical Coder UCSF Medical CenterSenior Professional Fee Medical CoderCACertified Professional Coder (CPC), Certified Coding Specialist-Physician Based (CCS-P), Certified Coding Associate (CCA), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or licensure equivalent to be evaluated by FPRMO management. Stay current on upcoming coding audits, regulations, trends, OIG initiatives, and applicable carrier initiatives as they pertain to the subspecialties led by the coder to provide pertinent information and tools to the team, minimize risk, and enhance education efforts.
Utilization Management Policy Initiatives Registered Nurse Macpower Digital Assets Edge Private LimitedUtilization Management Policy Initiatives Registered NurseLos Angeles, CARemote$102,183–$132,838 / yearThis role ensures that the day to day functions of Utilization Management initiatives comply with regulatory and accreditation requirements such as those stated in contracts, CalAIM Population Health Management (PHM) Policy Guide, National Committee on Quality Assurance (NCQA) Department of Health Care Services (DHCS) All Plan Letters (APLs), and Centers for Medicare and Medicaid Services (CMS) Model of Care (MOC) through sound clinical policy maintenance. Non-negotiable requirements of this position: Direct past experience with Health Care / Medical Policy work specifically within a Managed Care Plans environment; experience with the ongoing development of the Medical Policy review process including clinical and utilization data analysis; Assisted in developing training documents and presentations for new and/or revised Medical Policies to internal stakeholders.
Data Integration Analyst AI & Risk Adjustment ReveleerData Integration Analyst AI & Risk AdjustmentCARemoteWe especially welcome candidates transitioning from academic or research careers, for example, graduate study or research experience in fields such as molecular biology, genetics, physics, chemistry, or other quantitative sciences, who want to apply their talents in a fast-moving, high-impact commercial environment. With regulatory expertise and transparent, human-in-the-loop AI at its core, Reveleer supports organizations working to advance care quality, strengthen documentation integrity, and sustain the operational readiness needed to navigate audits with confidence.
Specialty Physician Coder ICONMA, LLCSpecialty Physician CoderFountain Valley, CA$38.53–$41.57 / hourThis role is responsible for reviewing and accurately coding office, hospital, and surgical/procedures for reimbursement and ensuring accurate and compliant medical coding for inpatient and outpatient services, diagnostic tests, and other medical services rendered to patients. Analyze and interpret medical information in the medical record and assign and sequence the correct ICD-10-CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient, and/or outpatient medical records according to established coding guidelines.
Certified Medical Coder Feed My People Food BankCertified Medical CoderLos Angeles, CaliforniaRemoteAfter work, you will find things to do in every season, including beaches, outdoor recreation, unique restaurants, world-class wineries, arts and entertainment. Under general supervision, according to established policies, procedures and protocols, codes all disease and operations according to accepted classifications.
NewSpecialty Physician Coder IconmaSpecialty Physician CoderFountain Valley, CA$38.53–$41.57 / hourThis role is responsible for reviewing and accurately coding office, hospital, and surgical/procedures for reimbursement and ensuring accurate and compliant medical coding for inpatient and outpatient services, diagnostic tests, and other medical services rendered to patients. Analyze and interpret medical information in the medical record and assign and sequence the correct ICD-10-CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient, and/or outpatient medical records according to established coding guidelines.
NewPatient Service Rep, Sea View - Irvine Children's Hospital of Orange CountyPatient Service Rep, Sea View - IrvineIrvine, CaliforniaBending, Carry Objects, Climbing, Keyboard use/repetitive motion, Pinching/fine motor activities, Push/Pull, Reaching forward, Reaching overhead, Sitting, Squat/kneel/crawl (Squad & Knee), Standing, Talk or hear, Taste or smell, Twisting, Walking, Wrist position deviation Physical Activity Lifting . Lifting (Floor to waist level) - Constant 67 or more%, Lifting (Floor to waist level)- Frequent 36-66%, Lifting (Floor to waist level) - Occasional 0-35%, Lifting (Waist level and above) - Constant 67 or more%, Lifting (Waist level and above)- Frequent 36-66%, Lifting (Waist level and above) - Occasional 0-35% Sensory Requirements:
Cardiologist, Outpatient Welcome HealthCardiologist, OutpatientLos Angeles, California$400,000–$600,000 / yearThe role will be primarily based at our Bell clinic, with the opportunity to support additional clinic locations across Los Angeles, Orange, and Riverside Counties as the practice grows. Built on the principles of geriatric medicine and backed by SCAN Group, Welcome Health delivers care that meets patients where they are, including in home, in clinic, and virtual visits.
Senior Director, Strategic Analytics Tendo Systems IncSenior Director, Strategic AnalyticsCARemote$2,024–$2,025This person will combine deep clinical informatics expertise with hands-on Databricks engineering and AI/ML skill to build algorithms that do two things simultaneously: (1) close documentation and coding gaps that affect risk adjustment, mortality index, and quality attribution, and (2) identify gaps and variation in the actual clinical processes of care that drive the metrics used by national hospital ranking and rating programs (e.g., CMS Star Ratings, U.S. News & World Report, Leapfrog, Vizient, Healthgrades, IBM Watson Health/Chartis 100 Top Hospitals). Maintain expert-level, current knowledge of major hospital ranking, rating, and benchmarking methodologies, including but not limited to: CMS Hospital Compare/Star Ratings, CMS Value-Based Purchasing and Hospital-Acquired Condition programs, U.S. News & World Report Best Hospitals methodology, Leapfrog Hospital Safety Grade, Vizient quality and safety benchmarking, Healthgrades, and payer-specific quality programs.
Special Investigation Unit Investigative Analyst III L.A. Care Health PlanSpecial Investigation Unit Investigative Analyst IIILos Angeles, CAUses knowledge of healthcare coding conventions, fraud schemes, and general areas of vulnerability, reimbursement methodologies, and relevant laws to find suspicious patterns in claims data, provider enrollment data, and other sources. Care's mission is to provide access to quality health care for Los Angeles Countys vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
Decision 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.
Business Analyst - REMOTE Molina Healthcare IncBusiness Analyst - REMOTECARemoteCommunicates requirement interpretations and changes to health plans/product team and various impacted corporate core functional areas for requirement interpretation alignment and approvals as well as solution traceability through regular meetings and other operational process best practices. Self-organized reporting to ensure health plans/product team and other leadership are aware of work efforts and impact for any prospective or retrospective requirement changes that can impact financials.
Clinical Documentation Improvement Specialist (CDI) II - Full Time, Days (CBO Culver City) NOR Healthcare SystemsClinical Documentation Improvement Specialist (CDI) II - Full Time, Days (CBO Culver City)Culver City, CAFull timeRequired QualificationsCDIP or CCDS Medical Graduate, Physician Assistant or Registered Nurse (Current CA License) Minimum 1 year of previous practical floor CDI experience in an acute care setting Ability to multitask and maintain a work pace appropriate to workload Must demonstrate customer service skills appropriate to the job Excellent written and verbal communication skills in English Ability to effectively communicate with physicians in a clear and concise manner Computer literacy and proficiency Hospital Fire and Life Safety Card (Los Angeles City Employees only) Preferred QualificationsCCS Physical RequirementsIndicate physical requirements for performing the essential functions of the job by double clicking and selecting ‘checked’ on the boxes below. Standing - Frequently Walking - Frequently Sitting - Frequently Reaching with Hands and Arms - Occasionally Climb or Balance - Occasionally Stooping, Kneeling, Crouching, or Crawling - Occasionally Talking - Frequently Hearing - Constantly Seeing - Constantly Performing repetitive motions with arms or hands - Frequently Lifting, carrying, pushing or pulling up to 10 lbs - Constantly Lifting, carrying, pushing or pulling up to 25 lbs - Occasionally Lifting, carrying, pushing or pulling up to 50 lbs - None Lifting, carrying, pushing, or pulling greater than 50 lbs - None Driving - None Essential Job Functions / Major Areas of ResponsibilityThe essential functions below are not intended to be an exhaustive list of all duties that may be assigned to this position, nor does it restrict the duties which may be assigned to this position if such duties reasonably relate to the position.
Hospitalist Physician - Remote YO AI LabsHospitalist Physician - RemoteLos Angeles, CARemoteWe are seeking experienced Hospitalist Physicians to contribute their medical expertise to a project focused on inpatient care, clinical documentation, and medical record quality . In this role, you will review clinical records, evaluate documentation for accuracy and completeness, and apply your clinical expertise to support high-quality medical data and AI training.
Sr Hospitalist Clinical Reviewer - Remote YO AI LabsSr Hospitalist Clinical Reviewer - RemoteLos Angeles, CARemoteWe are seeking experienced Senior Hospitalist Clinical Reviewers to support a high-impact project focused on inpatient clinical quality, documentation accuracy, and medical review . In this role, you will apply your hospitalist expertise and clinical judgment to evaluate inpatient cases, identify complex or ambiguous clinical scenarios, and provide clear, well-reasoned feedback.
Clinical Documentation Integrity Specialist UCLA Health SystemClinical Documentation Integrity SpecialistLos Angeles, CARemote$100,161.36–$218,718 / yearThis role involves daily review of high-acuity patient records to identify potential and active payer denials, assess clinical validity, and to support denial prevention, analysis, and appeals across inpatient and outpatient settings; continuously communicating with department staff; educating physicians, residents, and mid-levels; and assisting with appropriate documentation strategies. You will prepare and submit high quality appeal letters supported by clinical evidence, regulatory guidelines, and payor-specific medical necessity criteria, while identifying denial trends and root causes and provide feedback to the CDI and Clinical teams.
BioMed Tech I PHS Bio-Medical ServicesBioMed Tech IInglewood, California$25–$34.91 / hourFull timeOverview: Join our team of dedicated professionals who provide services and operational support to award winning hospitals through roles in supply chain, IT and cybersecurity, clinical engineering, capital procurement, medical coding, project management and more. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
Clinical Documentation Integrity Specialist University of CaliforniaClinical Documentation Integrity SpecialistLos Angeles, CARemote$100,161.36–$218,718 / yearThis role involves daily review of high-acuity patient records to identify potential and active payer denials, assess clinical validity, and to support denial prevention, analysis, and appeals across inpatient and outpatient settings; continuously communicating with department staff; educating physicians, residents, and mid-levels; and assisting with appropriate documentation strategies. You will prepare and submit high quality appeal letters supported by clinical evidence, regulatory guidelines, and payor-specific medical necessity criteria, while identifying denial trends and root causes and provide feedback to the CDI and Clinical teams.
Nurse Itemized Bill Reviewer IBR Analyst MachinifyNurse Itemized Bill Reviewer IBR AnalystCA$80,000–$90,000 / yearAt Machinify, we're constantly reimagining what's possible in our industry-creating disruptively simple, powerfully clear ways to maximize our clients' financial outcomes today and drive down healthcare costs tomorrow. As part of the Complex Payment Solutions team, you will, as a Nurse Itemized Bill Reviewer (IBR Analyst), be responsible for reviewing facility insurance claims to determine true and accurate charges.