Audit and Appeals Recovery Specialist Medicaid/Medicare ICONMA, LLCAudit and Appeals Recovery Specialist Medicaid/MedicareCosta Mesa, CA$25.21–$28.22 / hourAs 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.
DRG Coding Auditor - MS-DRG and APR-DRG Elevance Health IncDRG 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 Health IncDiagnosis 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.
Home Health Quality Assuranc / Coding Specialist Green Meadows Home Health Care IncHome Health Quality Assuranc / Coding SpecialistSanta Ana, CAFull timeThe Home Health Quality Assurance (QA) / Coding Specialist is responsible for reviewing clinical documentation to ensure compliance with Medicare Conditions of Participation (CoPs), state and federal regulations, and agency policies. This position performs ICD-10 coding, OASIS review, chart audits, and quality assurance activities to support accurate reimbursement, regulatory compliance, and high-quality patient care.
Developer Services Specialist FirstService CorpDeveloper Services SpecialistIrvine, CA$26–$31.25 / hourThe Developer Services Department is a specialized, customer facing department that handles all developer related association matters for new developments, including new community phasing, processing initial sales, budget updates and implementation, billing unsold lots, and reviewing bond status. Requesting Information About the AEDT - NYC Local Law 144: Candidates who reside in New York City and are subject to NYC Local Law 144 may request information about the AEDT, including details on the type of data collected, the sources of such data, and our data retention policies.
Staff Accountant - Grants EVCHC WebsiteStaff Accountant - GrantsPomona, CaliforniaUnder the general management of the Accounting Manager, the Staff Accountant will be responsible for the grants administration, accounting and financial analysis, financial and project reporting, shared cost allocations, maintenance of financial records, budget development, ensuring compliance with the Uniform Guidance, funding agency guidance, and contract award terms and conditions. Performs contract and grant post-award functions, including budget and expense analysis, periodic invoicing, financial reporting, labor distribution changes and associated communications with customers, reconciliations, and re-budgeting; communicates with fiscal contacts at funding source for problem resolution and information gathering.
NewExhibitor Services Sr Specialist Freeman Decorating Services, Inc.Exhibitor Services Sr SpecialistAnaheim, CA$25–$29 / hourFill-in for Exhibitor Support team as needed by handling inbound phone calls, emails, chats, and leads and maintain the highest level of accuracy, efficiency, and excellent customer service. Responsible for the quality management of complex exhibitor orders by proactively reaching out to customers and coordinating with various departments to ensure successful delivery on-site.
Senior Claims Specialist Crum & ForsterSenior Claims SpecialistORANGE, CaliforniaRemoteWith our employee-first focus, the Company is consistently recognized as a great place to work, earning multiple workplace and wellness awards, including the Great Place to Work® Award, Fortune 100 Best Companies to Work For, Fortune Best Workplaces for Parents, Fortune Best Workplaces for Millennials, and many others. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions.
Senior Specialist Accounting Sage Oak Charter SchoolsSenior Specialist AccountingRedlands, CaliforniaRefers all formal disciplinary actions involving students and staff to school management ensuring compliance with the schools’ Uniform Complaint Policy and the schools’ Uniform Technology Policy; addressing and resolving complaints from students, parents, and staff in a timely manner; and complying with the provisions of California Penal Code Section 11166 (Child Abuse and Neglect Reporting Act). Position Summary: Under general direction, the Senior Specialist, Accounting performs highly responsible, independent, and advanced fiscal, budgetary, accounting, and financial analysis work that supports the organization's strategic and operational goals.
Claims Resolution Specialist Southern California EdisonClaims Resolution SpecialistRosemead, CAVisit our Candidate Resource (https://www.edisoncareers.com/page/show/candidate-resources) page to get meaningful information related to benefits, perks, resources, testing information, hiring process, and more! + Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advises as to proper course of action.
Staff Accountant - Grants EAST VALLEY COMMUNITY HEALTH CENTER INCStaff Accountant - GrantsPomona, CA$70,000–$77,000 / yearPOSITION PURPOSE: Under the general management of the Accounting Manager, the Staff Accountant will be responsible for the grants administration, accounting and financial analysis, financial and project reporting, shared cost allocations, maintenance of financial records, budget development, ensuring compliance with the Uniform Guidance, funding agency guidance, and contract award terms and conditions. MAJOR POSITION RESPONSIBILITIES AND FUNCTIONS: Performs contract and grant post-award functions, including budget and expense analysis, periodic invoicing, financial reporting, labor distribution changes and associated communications with customers, reconciliations, and re-budgeting; communicates with fiscal contacts at funding source for problem resolution and information gathering.
Staff Accountant - Grants East Valley Community Health CenterStaff Accountant - GrantsPomona, CA$70,000–$77,000 / yearPOSITION PURPOSE: Under the general management of the Accounting Manager, the Staff Accountant will be responsible for the grants administration, accounting and financial analysis, financial and project reporting, shared cost allocations, maintenance of financial records, budget development, ensuring compliance with the Uniform Guidance, funding agency guidance, and contract award terms and conditions. MAJOR POSITION RESPONSIBILITIES AND FUNCTIONS: Performs contract and grant post-award functions, including budget and expense analysis, periodic invoicing, financial reporting, labor distribution changes and associated communications with customers, reconciliations, and re-budgeting; communicates with fiscal contacts at funding source for problem resolution and information gathering.
NewNon-Clinical - Administrative - Customer Service Representative BesticaNon-Clinical - Administrative - Customer Service RepresentativeWhittier, CA4. Essential to the provision of community benefits as an expression of our charitable healthcare mission and purpose, each manager/supervisor is committed to the delivery of high quality, compassionate healthcare and is further committed to supporting the strategic direction of community benefits within PIH Health and its affiliates. 3. With consideration to age, employee utilizes the approved process to resolve biophysical, psychological, educational and environmental needs of patient/significant other when administering care.
Home Health Quality Assuranc / Coding Specialist CbHome Health Quality Assuranc / Coding SpecialistSanta Ana, CaliforniaThe Home Health Quality Assurance (QA) / Coding Specialist is responsible for reviewing clinical documentation to ensure compliance with Medicare Conditions of Participation (CoPs), state and federal regulations, and agency policies. This position performs ICD-10 coding, OASIS review, chart audits, and quality assurance activities to support accurate reimbursement, regulatory compliance, and high-quality patient care.
AR Specialist Ledgent Finance & AccountingAR SpecialistChino, California$22–$28 / hourAssist with day-to-day accounting operations, including invoicing, and general ledger entries, collections etc. The successful candidate may be required to perform additional tasks as needed to support the accounting department.
Hearing Representative - Workers' Compensation Ethos Risk ServicesHearing Representative - Workers' CompensationLake Forest, CAFull timeSkills: Excellent negotiation and conflict resolution skills Strong written and verbal communication Ability to analyze medical billing, reimbursement, and regulatory issues Excellent organizational, time management, and prioritization skills WORKING CONDITIONS:This position offers flexible work arrangements, including hybrid or full on-site options, based on business needs and management approval. This role is responsible for resolving complex lien disputes, negotiating settlements, preparing legal documentation, and supporting administrative hearings while partnering closely with providers, attorneys, claims professionals, and bill review teams.
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.
Risk Adjustment Coding Specialist II - Orange County Astrana Health, Inc.Risk Adjustment Coding Specialist II - Orange CountyOrange, California$70,000–$85,000 / yearPerform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines. Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements.
Accounts Receivable Specialist BelcanAccounts Receivable SpecialistIrvine, CA$28–$32 / hourSCOPE/SUPERVISION AND INTERACTION: The individual contributor will report to the Accounting Team Lead or Business Unit Controller and will routinely interact with Operations, Shipping, Planning, Production Support, and other internal teams to support day-to-day accounting invoicing activities. Ensure supporting documentation is gathered and communicated to customers (PODs, invoices, statements, etc.).· Provide regular updates on collection efforts, high-risk accounts, and expected cash receipts.