Medical Customer Service ORANGE COUNTY OPHTHALMOLOGY MEMedical Customer ServiceGARDEN GROVE, CAFull timeOrange County Ophthalmology has been proudly serving the vision care needs of patients throughout the Garden Grove and greater Orange County community for years. Orange County Ophthalmology is looking for a friendly and detail-oriented Medical Customer Service representative to join our growing team in Garden Grove, CA.
Coding Manager Open Door Community Health CentersCoding ManagerCalifornia, CA$94,600–$111,294.12 / yearLeads strategic coding initiatives to improve net patient revenue, reduce denials, and enhance reimbursement across payer lines; Analyzes coding, documentation, and billing trends to identify revenue leakage and payer-specific risks; Develops and monitors coding performance metrics (e.g., accuracy, denial trends, documentation specificity) and reports outcomes to leadership; Partners with Finance, Revenue Cycle, and Clinical Leadership to align coding practices with organizational priorities; Drives improvements in documentation specificity to support reimbursement accuracy, risk adjustment, and quality reporting; Supports value-based care, risk adjustment, and quality initiatives impacting reimbursement and patient outcomes; Collaborates on payer audits, denials, and appeals to mitigate financial and compliance risk; Leads continuous improvement efforts through data analysis, workflow redesign, and system optimization; Operational & Compliance Oversight. QUALIFICATIONS: The successful candidate will possess experience and skills spanning a variety areas: Strong interpersonal and communication skills with the ability to collaborate across departments; Knowledge of coding regulations, documentation requirements, and payer guidelines; Ability to analyze complex information and translate it into actionable insights; Proficiency in EHR, practice management systems, and reporting tools; Coding Certification (COC, CPC, or CCS preferred); At least seven years of experience in coding, clinical documentation improvement, billing, or auditing; Experience in a community health center or similar healthcare environment; Preferred Strategic Competencies.
NewDRG Coding Auditor - Ms-Drg And Apr-Drg Elevance HealthDRG Coding Auditor - Ms-Drg And Apr-DrgCosta Mesa, CA$92,880–$160,218 / yearRequires at least one of the following certifications: RHIA certification as a Registered Health Information Administrator, RHIT certification as a Registered Health Information Technician, CCS as a Cert Coding Specialist, CIC as a Certified Inpatient Coder, or Certified Clinical Documentation Specialist (CCDS). Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred.
Diagnosis Related Group Clinical Validation Auditor-Rn (Cdi, Ms-Drg, Ap-Drg And Apr-Drg) Elevance HealthDiagnosis Related Group Clinical Validation Auditor-Rn (Cdi, Ms-Drg, Ap-Drg And Apr-Drg)Costa Mesa, CA$86,560–$155,808 / 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. Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would provide an equivalent background.
Denial Specialist - Business Office - Full Time - Days - 8hr Emanate Health Medical CenterDenial Specialist - Business Office - Full Time - Days - 8hrGlendora, CA$25.53–$38.29 / hourThe Denial Specialist will possess and apply thorough knowledge of collections and the ability to apply the knowledge to all aspects of a patient account that is involved in the audit and appeals process to accurately complete accounts receivable reconciliation. On Glassdoor's list of "Best Places to Work" in 2021, Emanate Health was named the #1 ranked health care system in the United States, and the #19 ranked company in the country.
Transplant Financial Coordinator - Kidney Acquisition - Full Time 8 Hour Days (Non-Exempt) (Non-Union) University of Southern CaliforniaTransplant Financial Coordinator - Kidney Acquisition - Full Time 8 Hour Days (Non-Exempt) (Non-Union)Los Angeles, CAObtain and document detailed patient insurance benefit information, limitations and exclusions to determine appropriateness for transplantation services and financial criteria of program, including, but not limited to, all aspects of the transplant process: transplant surgery, organ acquisition, follow-up clinic visits, admissions, cost of labs, diagnostic testing, co-payments of outpatient prescription drugs and travel/housing benefits. Engage non-contracted health plans and medical groups to interface with Keck Hospital and USC Care contracting departments to obtain LOA, or other financial guarantees, to effectively cover transplant services from a fiduciary standpoint.
Lead, Transplant Financial Coordinator - Liver Acquisition - Full Time 8 Hour Days (Non-Exempt) (Non-Union) University of Southern CaliforniaLead, Transplant Financial Coordinator - Liver Acquisition - Full Time 8 Hour Days (Non-Exempt) (Non-Union)Los Angeles, CA$29–$45.20 / hourObtain and document detailed patient insurance benefit information, limitations and exclusions to determine appropriateness for transplantation services and financial criteria of program, including, but not limited to, all aspects of the transplant process: transplant surgery, organ acquisition, follow-up clinic visits, admissions, cost of labs, diagnostic testing, co-payments of outpatient prescription drugs and travel/housing benefits. When 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.
Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment Hybrid UCLA Health SystemClinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment HybridLos Angeles, CA$95,400–$208,300 / yearAs the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and documentation, working closely with physicians, IPA coders, and risk adjustment teams associated with the health plan. As 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.
Claim Operations Specialist The Travelers Companies IncClaim Operations SpecialistDiamond Bar, CA$45,400–$74,900 / yearCLAIM OPERATIONAL SERVICE AND PARTNERSHIPS: Partners with claim professionals in multiple departments to assist with the timely resolution of claims, which may include: Properly documents claim files, including notes and diaries, Requests reports and records, and reviews medical bills, mail and wage statements. CLAIM PAYMENTS AND EXPENSE PROCESSING: Ensures the proper handling of financial transactions to include: Processes and issues claim payments including outside vendor invoices, attorney expenses, and medical processing fees.
Chief Financial Officer Universal Community Health CenterChief Financial OfficerLos Angeles, CA$175,000–$215,000 / yearThe Chief Financial Officer (CFO) is responsible for providing strategic and operational leadership for all financial functions of the organization, including accounting, budgeting, revenue cycle management, grants management, financial reporting, compliance, reimbursement, payroll, purchasing, and financial risk management. The CFO oversees financial planning and analysis, develops internal controls and compliance systems, supports payer and reimbursement strategies, and ensures accurate and timely reporting to executive leadership, the Board of Directors, regulatory agencies, funders, and other stakeholders.
NewSr. Government Biller/Collector Sherman Oaks HospitalSr. Government Biller/CollectorSherman Oaks, California$25.78–$29.39 / hourFull timeThis includes maintaining the deficiency lists used to obtain missing documents from internal or external entities, resolving claim rejections, packaging claims, including global billing with attachments of professional fee claims, performing proactive follow up with payers and other entities and securing payment of accounts. Responsibilities: The Senior Government Payer Biller/Collector is responsible for both billing and collections, gathering and securing all information needed for billing, follow up, and payment of accounts in accordance with the specific payer guidelines, policies, procedures, and compliance regulations for Government payers.
NewInsurance AR Specialist OneOncology IncInsurance AR SpecialistCARemoteWe are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve. OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases.
Data Engineer TebraData EngineerCorona del Mar, CARemoteYou'll partner closely with Machine Learning Engineers, Data Scientists, and Software Engineers to transform complex healthcare data into high-quality datasets and real-time features that enable machine learning models. Designed to replace the clunky, fragmented tools built for corporate systems, Tebra connects EHR software, billing, automation, telehealth solution, and marketing — so providers can spend less time on admin and more time with patients.
A/R Specialist Insight Investments, LlcA/R SpecialistIrvine, CAbillings related to new lease contracts such as pro-rata and interim rent, freight re-bills, recycle fees, admin fee, chargebacks and upfront sales tax rebills attaching the supporting documentation back-up when applicable. Participate in month-end close process ensuring billing including renewals and rewrites, contract billing adjustments, changes and/or amendments are completed and posted to the appropriate accounting period.
Financial Specialist II, Endoscopy Cedars-Sinai Medical CenterFinancial Specialist II, EndoscopyBeverly Hills, CAThe core responsibilities of a Financial Specialist II is to support patients' billing inquires as it relates to explanation of benefits, financial assistance, patient disputes, insurance verification, credit card payments and other billing inquiries. This position also holds additional responsibilities with respect to off line management tasks, employee training, assisting with policies and procedures, supervisory calls, and other managerial support needed for the call center.
Revenue Cycle Specialist II (Commercial Collections) Cedars-Sinai Medical CenterRevenue Cycle Specialist II (Commercial Collections)Los Angeles, CAWhat you will be doing in this role: Under general supervision and following established practices, policies, and guidelines, provides commercial collections support to Patient Financial Services, performing duties which may include reviewing and resubmitting claims to third party payors, performing account follow-up activities, updating information on account, etc. Cedars Sinai was awarded the National Research Corporation's Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles.
Charge Description Master Specialist - Full time, Day, Remote Providence Health & ServicesCharge Description Master Specialist - Full time, Day, RemoteCalifornia, CARemoteRequsition ID: 431486 Company: Providence Jobs Job Category: Patient Financial Services Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 4001 SS RC CHARGE DECR MSTR Address: CA Apple Valley 18300 Hwy 18 Work Location: St Mary Medical Center-Apple Valley Workplace Type: Remote Pay Range: $See Posting - $See Posting The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. As a member of the PSJH System Revenue Integrity Chargemaster (RICDM) team, the CDM Specialist shall ensure that the Chargemaster (CDM) is consistent with all coding and billing regulations and accurately represents services provided.
NewAccount Resolution Specialist Collector Prime Healthcare Services IncAccount Resolution Specialist CollectorLynwood, CA$23–$28 / hourThe 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. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually.
Specialist, Payroll & Benefits United Sports BrandsSpecialist, Payroll & BenefitsCosta Mesa, CA$70,300–$83,000 / yearPHYSICAL DEMANDS/WORK ENVIRONMENT: Candidate must be able to successfully perform the essential functions of this job with ability to: be in a stationary position 50% of the time; occasionally move about inside the office to access fine cabinets, office machinery (such as a calculator, copy machine, printer, etc.); constantly operate a computer; occasionally ascend/descend stairs; constantly position self to maintain files in file cabinets; the ability to communicate information and ideas so others will understand; must be able to exchange accurate information in these situations; the ability to observe details at close range (within a few feed of the observer); and frequently move boxes weighing up to 10 pounds across office for various needs. Payroll activities include: managing and executing a bi-weekly multi-state corporate payroll (2 EINs) for 140 employees and a semi-monthly Canadian payroll for 7 employees.
Clinical Nurse Specialist RN Neonatal ICU CommonSpirit HealthClinical Nurse Specialist RN Neonatal ICUGlendale, CAEvery day you will collaborate on comprehensive screenings, conduct critical risk assessments, provide vital preventative health education, and expertly coordinate care for diverse patient populations, leveraging technology to streamline processes. Serving over 70,000 patients annually, the hospital offers a full complement of services including a Level III NICU, heart care, wound care and surgical services.