Jr. Quality Improvement Coder Astiva Health, Inc.Jr. Quality Improvement CoderOrange, CAIn this role, the Junior QI Coder will partner with the Director to collaborate with network providers and IPA's to improve the quality of care through quality improvement activities that will include RAF, HEDIS, CMS Star Ratings and other health plan reporting. Apply official CPT/HCPCS and ICD10 coding guidelines, internal guidelines, and state specific Medicare/Medicaid coding instructions to review and analyze professionally coded services and coding queries.
NewSenior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)CA$46,988–$112,200 / yearThis position will routinely handle high profile or highly sensitive matters involving cases that are national in scope, as well as, complex cases involving multi-lines of business, multiple subjects, or intricate healthcare fraud schemes. Strong communication skills, both written and oral, are necessary for the development and implementation of professional presentations for internal and external stakeholders regarding healthcare fraud matters and Enterprise approach to FWA.
Patient Care Coordinator Upperline HealthPatient Care CoordinatorOrange City, CaliforniaUpperline Health providers coordinate patients’ care among a team of physician specialists, nurse practitioners, care navigators, nutritionists, social workers, and pharmacists for integrated treatment that addresses patients’ immediate and long-term health needs. The Patient Care Coordinator will be responsible for medical front desk receptionist duties including greeting patients in a friendly manner, and ensuring patients are accurately checked in and prepared for their appointments in a timely manner.
Dental Office Manager Empower Dental GroupDental Office ManagerRancho Cucamonga, CAFull timeAs we scale, we're looking for a creative, resourceful, and driven staff to help us share our story, strengthen our brand, and engage our growing network of patients and team members. Collaborate with dentists, hygienists, assistants, and front office staff for coordinated patient care.
Medical Records Universal Community Health CenterMedical RecordsLos Angeles, CAReporting to the Director of Operations, the coordinator will be responsible for accessing third-party portals, managing medical records email correspondence, updating electronic medical record (EMR) systems, scheduling appointments, coordinating pre-op clearances, and facilitating communication between patients, providers, and specialists. The Medical Records Care Coordinator plays a crucial role in ensuring the efficient management and accessibility of medical records essential for patient care and administrative processes.
NewLead, Clinical Validation Reviewer (RN) Molina Healthcare IncLead, Clinical Validation Reviewer (RN)CARequires a minimum of 3 years of experience in payment integrity medical claim review, including DRG validation, itemized bill review, clinical validation, or coding/reimbursement-focused claim review, and experience working with ICD-10, MS-DRG, AP-DRG and APR-DRG, CPT, HCPCS, revenue codes, and related coding, billing, and reimbursement guidelines; or any combination of education and experience which would provide an equivalent background. Performs advanced focused clinical reviews of claims to verify that coded diagnoses, procedures, revenue codes, billed charges, and corresponding reimbursement methodologies accurately reflect the patient's documented clinical condition, services rendered, and applicable coding, billing, payer policy, and regulatory requirements.
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.
Co-Founder & CEO - AI Clinical Documentation Compliance FutureSightCo-Founder & CEO - AI Clinical Documentation ComplianceLos Angeles, CARemoteYou’ll co-create with a proven studio team, led by John Carbrey (4x entrepreneur, $100M ARR), Krista LaRiviere (3x exited, E&Y Top Women Entrepreneur), Alan Smith (Strategyzer co-founder, $120M in products built), Prathna Ramesh (former MD of Maple Leaf Angels, $275M in follow-on capital), and Johnny Tong (0-to-1 builder, acquired by SAP and Stripe) bring a rare combination of operator exits, institutional investing, and AI product depth. The market signal is incredibly strong: Unprompted Product Pull: Every single lead described the exact product we want to build: a pre-billing, real-time, EHR-integrated flagging layer that checks documentation against payer-specific rules before claims are submitted.
Medical Billing Specialist- Collector Men's Health Foundation USAMedical Billing Specialist- CollectorLos Angeles, CAExtensive experience with Commercial insurance, Medicare, Medi-Cal/Medicaid, Medicare Advantage, Medi-Cal Managed Care, HMO, PPO, and other third-party payers. The Medical Collector / Accounts Receivable Representative is responsible for professional provider-side insurance collections, Accounts Receivable (AR) follow-up, denial resolution, reconsiderations, and appeals.
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.
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.
Senior Medical Billing Specialist – Multi-Specialty (PM&R Focus) HEALTH ATLAST WEST LASenior Medical Billing Specialist – Multi-Specialty (PM&R Focus)Los Angeles, CA$20–$28 / hourFull timeWe are hiring a seasoned Medical Billing Specialist with direct, hands-on experience billing PM&R-based services in an outpatient, multi-provider environment. Health Atlast is a high-volume, integrated, multi-disciplinary healthcare organization in West Los Angeles.
Senior Medical Billing Specialist – Multi-Specialty (PM&R Focus) Health Atlast West LaSenior Medical Billing Specialist – Multi-Specialty (PM&R Focus)Los Angeles, California$20–$28 / hourCompensation: $22.00 - $30.00 per hour After seeing many patients placed on multiple medications by numerous providers without much coordination, HEALTH ATLAST founders Stephanie and Wayne Higashi, both doctors of chiropractic, found a need to create a multi-disciplinary approach to healing where doctors work together as one to optimize a patient's health. Role Summary (Read Carefully) We are hiring a seasoned Medical Billing Specialist with direct, hands-on experience billing PM&R-based services in an outpatient, multi-provider environment.
Billing Reimbursement Specialist II NeoGenomics IncBilling Reimbursement Specialist IICANow that you know what we're looking for in talent, let us tell you why you'd want to work at NeoGenomics: As an employer, we promise to provide you with a purpose driven mission in which you have the opportunity to save lives by improving patient care through the exceptional work you perform. They will work with Third Party insurance bills (HMO, PPO, IPA, TPA Indemnity, Medicare, and Government) responsible for processing independent laboratory claims and Patient Billing.
Podiatrist - Part-Time | FQHC The Staff PadPodiatrist - Part-Time | FQHCPomona, CaliforniaReporting to the Chief Medical Officer, this role is responsible for diagnosing, treating, and preventing conditions affecting the foot, ankle, and related structures while delivering high-quality, patient-centered care. The Podiatrist collaborates closely with primary care providers and other healthcare professionals to improve patient outcomes and enhance mobility, independence, and overall quality of life.
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.
NewPhysical Therapist Confluent Health LLCPhysical TherapistUpland, CA$48–$54 / hourHow Confluent Health Supports You: LIFT (Loan Incentive for Therapists) program - eligible clinicians may receive up to $25,000 in student loan repayment, paid directly to the lender. If so, then All Star Physical Therapy in Upland, CA is looking for a driven and compassionate Physical Therapist (PT) to join our close-knit, outpatient orthopedic team.
SIU Investigator Centene Corporation GroupSIU InvestigatorCA$56,200–$101,000 / yearLicenses/Certifications: Accredited Healthcare Fraud Investigator (AHFI), Certified Fraud Examiner (CFE), Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), or other related investigative, auditing, or compliance certification preferred. Collaborates with internal business partners, compliance, legal, provider and payment integrity teams, and external agencies to coordinate investigative activities, support corrective actions, recoveries, and case resolution efforts.
Specialty Physician Coder ICONMA, LLCSpecialty Physician CoderFountain Valley, CA$38.65–$41.69 / hourAnalyze and interpret medical information in the medical record and assign and sequence the correct ICD10CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient, and/or outpatient medical records according to established coding guidelines. Participate in developing, implementing, and reviewing programs for coding compliance monitoring, benchmark comparisons, organizational policies and procedures, and physician clinical documentation improvement programs.
Clinical Documentation Improvement Specialist (Remote), Day Shift, Clinical Documentation Shady Grove Adventist HospitalClinical Documentation Improvement Specialist (Remote), Day Shift, Clinical DocumentationCARemote$77,313.60–$115,980.80 / weekWe do this by offering: Work life balance through nonrotating shifts Recognition and rewards for professional expertise Free Employee parking Medical, Prescription, Dental, and Vision coverage for employees and their eligible dependents effective on your date of hire Employer-paid Short & Long-Term Disability, Basic Life Insurance and AD&D, (short-term disability buy-up available) Paid Time Off Employer retirement contribution and match after 1-year of eligible employment with a 3-year vesting period Voluntary benefits include flexible spending accounts, legal plans, and life, pet, auto, home, long term care, and critical illness & accident insurance Subsidized childcare at participating childcare centers Tuition Reimbursement * Employee Assistance Program (EAP) support As a faith-based organization, with over a century of caring for the communities in the Maryland area, Adventist HealthCare has earned a reputation for high-quality, compassionate care. Education and Experience: Doctor of Medicine (MD), Doctor of Osteopathy (DO), Foreign Medical Graduate (FMG), Registered Nurse (RN), Pharmacist, Doctor of Physical Therapy RHIA, RHIT, or related clinical/allied health degree Minimum of 5 years inpatient clinical experience 2+ years of clinical documentation, coding, case management, utilization review, or acute-care clinical experience Experience interpreting physician documentation, lab results, imaging, and clinical indicators.