Medical Biller Advantage AmbulanceMedical BillerRiverside, CAFull timeThe Biller’s primary function is to produce clean claims that can be forwarded to perspective insurance companies for the purpose of receiving optimum reimbursement for services provided by Advantage Ambulance and/or its subcontractors. Amenities…our CEO has been quoted saying “I want this place to be supportive, fun, inviting, comfortable, and stocked with snacks and refreshments…a place that everyone wants to come to each day.”.
Dermatology Office Manager Bespoke Dermatology & AestheticsDermatology Office ManagerRancho Cucamonga, California$26–$35The ideal candidate is a strong leader who can oversee daily front office operations, support and develop staff, optimize workflows, and maintain a smooth and efficient workplace while ensuring an exceptional experience for both patients and employees. The Front Office Manager plays a critical role in maintaining accurate patient registration, insurance verification, financial screening, and the protection of Protected Health Information (PHI) in accordance with HIPAA regulations.
Senior Revenue Integrity Specialist - Clinical Rev Integrity - Full Time 8 Hour Days (Remote) (Exempt) (Non-Union) University of Southern CaliforniaSenior Revenue Integrity Specialist - Clinical Rev Integrity - Full Time 8 Hour Days (Remote) (Exempt) (Non-Union)Alhambra, CARemote$99,507–$130,000 / yearThe Senior RI Specialist also coordinates with Keck Medical Center of USC Administration, IS, Compliance, Clinical Informatics and Integration personnel on technology projects impacting charge entry, charge dictionaries, and charge, and provides data derived from multiple entities of Keck Medical Center of USC for the management and support of critical decisions and functions related the Chargemaster, CDM Maintenance, and the improvement of charge capture. As a subject matter expert in the area of compliance and pricing of services, the Senior RI Specialist responds to inquiries regarding Chargemaster issues and is responsible for supervising meetings for projects associated with educating and communicating to clinical revenue generating departmental staff regarding the CDM Maintenance process, coding updates, compliance issues, and charge capture improvement.
Senior Revenue Integrity Specialist - Clinical Rev Integrity - Full Time 8 Hour Days (REMOTE) (Exempt) (Non-Union) University of Southern CaliforniaSenior Revenue Integrity Specialist - Clinical Rev Integrity - Full Time 8 Hour Days (REMOTE) (Exempt) (Non-Union)Alhambra, CaliforniaRemoteThe Senior RI Specialist also coordinates with Keck Medical Center of USC Administration, IS, Compliance, Clinical Informatics and Integration personnel on technology projects impacting charge entry, charge dictionaries, and charge, and provides data derived from multiple entities of Keck Medical Center of USC for the management and support of critical decisions and functions related the Chargemaster, CDM Maintenance, and the improvement of charge capture. As a subject matter expert in the area of compliance and pricing of services, the Senior RI Specialist responds to inquiries regarding Chargemaster issues and is responsible for supervising meetings for projects associated with educating and communicating to clinical revenue generating departmental staff regarding the CDM Maintenance process, coding updates, compliance issues, and charge capture improvement.
Temp - Eligibility Specialist Community Health Systems Inc (US)Temp - Eligibility SpecialistRiverside, CAJOB SUMMARY: The Eligibility Specialist has the responsibility for reviewing patients' insurance to verify their eligibility for qualifying insurance coverage prior patient's visit and updating the insurance information into patients' profile. This position will assist the management team with oversight of both the patient eligibility and patient application processes by serving as a liaison between the client and other departments.
Temporary Special Investigations Unit Specialist LanceSoft IncTemporary Special Investigations Unit SpecialistRancho Cucamonga, CA$27.43 / hourUtilize advanced Microsoft Excel tools (e.g., pivot tables, Power Query, conditional formatting, formulas, macros) to organize and analyze referral data, generate reports, and support trend identification. Accredited Healthcare Fraud Investigator (AHFI), Certified Professional Coder (CPC), or similar certification related to healthcare fraud, coding, and billing is preferred.
Healthcare Compliance Specialist 26-00251 Alura Workforce SolutionsHealthcare Compliance Specialist 26-00251Rancho Cucamonga, CA$27.43 / hourUtilize advanced Microsoft Excel tools (e.g., pivot tables, Power Query, conditional formatting, formulas, macros) to organize and analyze referral data, generate reports, and support trend identification. The Specialist organizes, analyzes, and reports referral data, and utilizes the Plan's case management application and FWA analytics tools to support the SIU in proactive FWA detection.
Temporary Special Investigations Unit Specialist Impresiv HealthTemporary Special Investigations Unit SpecialistRancho Cucamonga, CA$27.43–$35.66 / hourThe SIU Specialist plays a critical role in the early stages of FWA case management, including documenting referrals, conducting preliminary analysis, assessing risk, and prioritizing cases based on potential impact. Impresiv Health is seeking a Special Investigations Unit (SIU) Specialist to support the intake, assessment, coordination, and management of Fraud, Waste, and Abuse (FWA) referrals for a healthcare organization.
Non-Clinical - Finance/Accounting - Financial Administrative Representative BesticaNon-Clinical - Finance/Accounting - Financial Administrative RepresentativeWhittier, CAPart time 11P-730A (Minimum guaranteed hours - 56 hours every 2 weeks) Rotating Weekends and Holidays Onsite Requirements: * Minimum High School Diploma or GED * Preferred - Evidence of continuing education in Finance, Accounting or Business Administration * 2 years experience in front office/medical billing and/or current hospital registration/admitting * 2 years experience in insurance verification and/or medical/hospital billing * EPIC EHR experience Skills: Demonstrates a clear understanding of PIH Health mission and values Ability to work directly with the insurance company, healthcare provider, and patients Ability to generate revenue with POS collections, establishing payment arrangements, along with collecting on all Self-Pay and/or high liability accounts at the point of registration. Ability to follow directions as outlined in policies or given by supervisor Strong computer skills to include typing 45+ wpm minimum and in MS office programs Excellent organizational skills Ability to exercise independent judgment at times of need and emergency situations Bilingual preferred Interacts with all levels of hospital and outside vendor staff and knowledge of government regulations Ability to multi-task in a fast and high-pressure environment Stringent adherence to all privacy policies and procedures and as required by state and federal law including and not limited to the HIPPA Security and Privacy Rules Strong analytical skills, problem solving.
Audit and Appeals Recovery Specialist - Medicaid/Medicare Iconma LLCAudit and Appeals Recovery Specialist - Medicaid/MedicareCosta Mesa, CAAs 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.
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.
NewMedical Biller Premier Health GroupMedical BillerIrvine, CAYou will work closely with patients, insurance companies, and internal teams to resolve discrepancies and ensure timely payment of services. Collaborate with patients or customers, third-party institutions, and other team members to identify and resolve billing inconsistencies and errors.
Lien Reduction Specialist TORKLAWLien Reduction SpecialistIrvine, CA$60,000–$70,000 / yearThis role offers the opportunity to play an important part in helping clients maximize their recovery while working alongside an experienced and dedicated legal team. We’re looking for professionals who: take ownership, communicate with confidence and empathy, thrive in a collaborative environment, and are passionate about achieving outstanding results for clients.
NewPersonal Injury Lien Specialist TORKLAWPersonal Injury Lien SpecialistIrvine, CAThis role offers the opportunity to play an important part in helping clients maximize their recovery while working alongside an experienced and dedicated legal team. We’re looking for professionals who: take ownership, communicate with confidence and empathy, thrive in a collaborative environment, and are passionate about achieving outstanding results for clients.
Insurance Specialist (Remote) - Mountain and Pacific Time Zones MeduitInsurance Specialist (Remote) - Mountain and Pacific Time ZonesCaliforniaRemoteboth in-person and by telephone to register patients, gather or update information, obtain referrals and pre-authorizations, complete appropriate forms, conduct evaluations, determine benefits and eligibility (insurance, public programs, etc.), determine financial responsibility and/or to identify sources of payment for servicesâ¯. You will utilize your expertise in patient billing, claims submission, and payer guidelines (Medicare, Medicaid, &, commercial insurers) to effectively work with insurance companies, resolve issues, and ensure accurate and timely payments.
Manager, Special Investigations Unit Medical Record Audit Inland Empire Health PlanManager, Special Investigations Unit Medical Record AuditRancho Cucamonga, California$118,601.60–$157,144 / yearFull timeUnder the direction of the Vice President of Compliance, and in close partnership with the Special Investigations Unit (SIU) Manager, the SIU Medical Record Audit Manager provides leadership and strategic direction for IEHP’s prepayment and post-payment medical record audit functions within the Fraud, Waste, and Abuse (FWA) framework. Prepayment Review Performance Lead end to end prepayment medical record review operations, including documented criteria for placing and releasing providers, turnaround compliance within claims payment timeframes, yield optimization, false positive monitoring, inventory aging, and scheduled reassessment and exit decisions.
Authorization Specialist Aveanna Healthcare Holdings IncAuthorization SpecialistSeal Beach, CA$22–$24 / hourAs an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate. The Authorization Specialist facilitates the coordination between healthcare providers, clinical teams, and insurance carriers to ensure that necessary approvals are obtained, and payment processes are streamlined.
Commercial Insurance Specialist AHMC HealthcareCommercial Insurance SpecialistRiverside, CaliforniaOverview: Performs various clerical billing and follow up functions, but not limited to items listed in the Performance Criteria. Reviews payor contracts to ensure correct contractual adjustments are posted as per individual payor agreement.
Medical Assistant Specialist Chaparral Medical GroupMedical Assistant SpecialistPomona, CA$22–$25 / hourAs part of the Akido medical network, we are currently responsible for more than 250,000 patients in Southern California, with plans to expand into new markets across the U.S. We care deeply about the communities we serve and are committed to providing accessible, high quality healthcare that helps our patients and communities live their fullest lives. Responsible for maintaining smooth patient flow by accurate assessment of patients' needs thorough attention to physician orders and properly scheduling and follow-up of tests and procedures performed on patient.
NewMedical Assistant Specialist AkidoMedical Assistant SpecialistOntario, CA$22–$25 / hourServing 500K+ patients across California, Rhode Island, and New York, Akido offers primary and specialty care in 26 specialties—from serving unhoused communities in Los Angeles to ride-share drivers in New York. Responsible for maintaining smooth patient flow by accurate assessment of patients' needs thorough attention to physician orders and properly scheduling and follow-up of tests and procedures performed on patient.