NewRisk Adjustment Compliance Coding Specialist, Consultant Blue Cross and Blue Shield AssociationRisk Adjustment Compliance Coding Specialist, ConsultantOakland, CAProvider Collaboration: Engage with physicians, advanced practice providers, and clinical staff to clarify ambiguous documentation, provide education on best practices, and resolve coding questions to ensure accurate capture of patient acuity. Education and Training: Develop and deliver training sessions and educational materials to coding staff, providers, and ancillary teams on risk adjustment principles, compliant documentation, and the significance of accurate coding for organizational success.
After School Kids Coding Instructor Code Sensei Computer Science Code Ninjas - Tracy Mountain HouseAfter School Kids Coding Instructor Code Sensei Computer ScienceTracy, CADeliver Code Ninjas’ curriculum, including block-based coding for younger students and syntax-based coding for older students, such as JavaScript, Microsoft MakeCode, Godot, and C#/Unity. Code Ninjas is the nation’s fastest-growing kids coding center, where kids ages 5-14 learn to code by building games in a fun and non-intimidating way.
Outpatient Coding Assistant Director UCSF Medical CenterOutpatient Coding Assistant DirectorEmeryville, CADemonstrated leadership and managerial skills, with the ability to create and maintain a goal-oriented climate of teamwork and cooperation across departments for effective problem solving, conflict resolution, support for organizational values, and consistent achievement of targets and objectives. Under the direction of UCSF HIMS Leadership and in partnership with the Clinical Documentation Integrity program and related Apex Programs, this position is accountable for driving the implementation of the organizational best practices at UCSF HIMS Health to achieve optimum overall performance.
Clinical Documentation Specialist - Coding Pyramid Consulting, IncClinical Documentation Specialist - CodingOakland, CARemote$45–$50 / hourKey Requirements and Technology Experience: Minimum of four (4) years of clinical nursing experience in inpatient care, clinical documentation, discharge planning, or case management. Collaborate with physicians and medical coding staff to identify and clarify additional diagnoses impacting severity of illness and risk of mortality indicators.
Clinical Documentation Specialist - Coding Pyramid, IncClinical Documentation Specialist - CodingOakland, CA$45–$50 / hourFull timeKey Requirements and Technology Experience: Minimum of four (4) years of clinical nursing experience in inpatient care, clinical documentation, discharge planning, or case management. Collaborate with physicians and medical coding staff to identify and clarify additional diagnoses impacting severity of illness and risk of mortality indicators.
IT Consultant IV, Solutions - SNOMED CT, Clinical Coding, Epic, EHR, Informatics Kaiser PermanenteIT Consultant IV, Solutions - SNOMED CT, Clinical Coding, Epic, EHR, InformaticsPleasanton, CAEssential Responsibilities: Completes work assignments and supports business-specific projects by applying expertise in subject area; supporting the development of work plans to meet business priorities and deadlines; ensuring team follows all procedures and policies; coordinating and assigning resources to accomplish priorities and deadlines; collaborating cross-functionally to make effective business decisions; solving complex problems; escalating high priority issues or risks, as appropriate; and recognizing and capitalizing on improvement opportunities. Ability and/or having the capacity to learn -knowledge representation- logic to create, maintain subsets of clinical records to support reporting, business intelligence in the areas of best practice alerts, population and healthcare management, quality measurements, and health information exchanges.
Epic Resolute Application Developer (Charge Router and Coding Skills) - 6260321 Accenture PlcEpic Resolute Application Developer (Charge Router and Coding Skills) - 6260321Walnut Creek, CAIn addition to delivering innovative solutions for Accenture's clients, you will work with a highly skilled, diverse network of people across Accenture businesses who are using the latest emerging technologies to address today's biggest business challenges. Dropping orders using chart review-> creating new patient encounter -> dropping an order and signing the order/Unite charge entry ->creating new encounter.
NewSTEM & Coding Teaching Opportunities Concorde EducationSTEM & Coding Teaching OpportunitiesOakland, CA$50–$100 / hourPreferred qualifications include: • At least 60 college credits, where required by the applicable assignment or site; • Experience with coding, programming, computer science, or related technology subjects; • Experience teaching, tutoring, coaching, mentoring, or leading activities with school-age students; • Strong communication, organization, and classroom facilitation skills; • Availability to provide services for the accepted assignment schedule and communicate schedule issues as soon as reasonably practicable; and. Payment for completed services is generally made by direct deposit on the fifteenth day of the month following the month in which services were completed, unless otherwise stated in the accepted assignment terms or required by applicable law.
[2026-2027] Part-Time Coding Instructor Yu Ming Charter School[2026-2027] Part-Time Coding InstructorOakland, CA$44.40–$66.13 / hourProvide a high quality, personalized education program in upper elementary and middle school level coding Maintain a high-level of professionalism including meeting deadlines and commitments to self and the community Develop a week-long expeditionary hands-on learning experiences for upper school students. We seek teachers that are excited by the possibility of transforming the traditional model of education to be learner-centered through personalized and project based learning that cultivates both the cognitive and social emotional skills our students need to thrive in school and beyond.
DISTRICT REPRESENTATIVE I, DIVISION OF CODES AND STANDARDS (NON-PEACE OFF) State Of CaliforniaDISTRICT REPRESENTATIVE I, DIVISION OF CODES AND STANDARDS (NON-PEACE OFF)Contra Costa County, CA$6,308–$7,825Candidates who reside more than 50 miles outside of the assigned geographical area may be interviewed; however, the selected candidate must have a primary residency within 50-miles of the assigned geographic area prior to appointment (and continue to maintain residency) as a condition of employment. This funding supports the construction, acquisition, rehabilitation, and preservation of affordable rental and ownership homes, provides permanent supportive housing options as well as stable, safe shelter for those experiencing homelessness.
Code Enforcement Officer Willdan Group IncCode Enforcement OfficerOakland, CAThe qualified individuals will be responsible for Conducting field investigations regarding possible violations of a variety of City/County codes and ordinances, and related state codes including zoning, nuisance, property maintenance, housing, transportation, and animal and business license/permits, health and sanitation. Public Agency Resources (PARS), a subsidiary of Willdan Group Inc., currently has an opening for a part-time Code Enforcement Officer in the Berkeley, CA area.
Medical Billing Supervisor Solano County CailforniaMedical Billing SupervisorFairfield, CA$83,155.86–$101,076.47 / yearThe Medical Billing Supervisor plans, organizes and supervises the medical insurance billing functions and accounting/clerical staff for the Department of Health and Social Services' Medical Billing Unit; assists in developing, implementing and maintaining the department-specific patient accounting and billing systems; serves as the electronic health record billing liaison between the County and the State; and resolves technical billing problems in coordination with the claim management system and clearing house provider. Possession of one (1) of a valid and current certification is required, such as a: Certified Coding Associate (CCA), Certified Coding Specialist (CCS), Certified Documentation Expert-Outpatient (CDEO), Certified Professional Coder (CPC), or related certification from a recognized accredited college, university, or professional association (e.g., American Academy of Professional Coders (AAPC) or American Medical Billing Association (AMBA)).
CalAIM Medical Billing Specialist FRIENDS OUTSIDECalAIM Medical Billing SpecialistStockton, CAVerify member eligibility with assigned MCPs prior to billing and throughout service enrollment periods Monitor and maintain ECM and Community Supports authorizations, referrals, and service approvals Ensure services billed are authorized, medically appropriate, and documented in accordance with DHCS and MCP requirements Track authorization expiration dates and coordinate reauthorization needs with program staff. Coordinate with care managers, housing support staff, supervisors, and external partners to obtain necessary documentation and service information Communicate with MCP representatives regarding claims, authorizations, billing inquiries, and service requirements Assist staff in resolving documentation deficiencies impacting billing or reimbursement Participate in interdisciplinary meetings as needed to support program operations and billing integrity.
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)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.
Adult Education Career Technical Education Medical/Business Office Teacher (Monday - Thursday 10:30 am -12:30 pm) 8-10 hours per week Liberty Union High School DistrictAdult Education Career Technical Education Medical/Business Office Teacher (Monday - Thursday 10:30 am -12:30 pm) 8-10 hours per weekBrentwood, CASITE: Liberty Adult Education Center Courses may include: Customer Relations, Business Math, Business English, Medical Terminology, and related Medical Front Office, Medical Law & Ethics, Electronic Health Records, Medical Coding & Billing. • Strong knowledge of subject areas such as customer relations, basic business mathematics, professional writing, medical terminology, and administrative healthcare procedures.
Biller/Account Receivable Kerae MedicalBiller/Account ReceivableWalnut Creek, California$23–$25Responsibilities: Submitting and tracking claims for DME services, ensuring proper coding using HCPCS and ICD-10 codes. Posting charges, payments, and explanations of benefits (EOBs) to patient accounts and Private Facility Accounts.
Professional Surgical Coder II (Onsite, Hybrid, Remote) NorthBay Medical CenterProfessional Surgical Coder II (Onsite, Hybrid, Remote)Fairfield, CARemote$42.24–$51.34 / hourWe are expanding access to care across our communities through two acute-care hospitals, including a Level II Trauma Center and a Level III NICU maternity unit, along with a cancer center, urgent care locations, and a growing network of primary and specialty care clinics. At NorthBay, the Professional Surgical Coder will play a crucial role in accurately translating medical procedures and diagnoses into ICD 10, CPT and HCPCS codes in an accurate and timely manner for professional surgery charges in the outpatient and inpatient settings.
Medical Office Coordinator - Wound Care - Jovive Wound Care - Walnut Creek CEP America LLCMedical Office Coordinator - Wound Care - Jovive Wound Care - Walnut CreekWalnut Creek, CA$24.99–$31.24 / hourPartner with Clinic Manager to identify and implement policy, process, and workflow improvements and changes to increase office efficiency and address areas of deficiency in patient experience concerns, production, and quality of care. Applie knowledge of ICD-10 (International Classification of Diseases, 10th revision) and CPT (Current Procedural Terminology) coding of procedures and enters documentation into medical record as directed by the licensed care provider.
Director, Patient Financial Services, Hospital Billing NorthBay Medical CenterDirector, Patient Financial Services, Hospital BillingFairfield, CA$185,000–$200,000 / yeart NorthBay Health, the Director of Patient Financial Services Hospital Billing (HB) will be responsible building and leading a highly effective centralized billing, follow-up, and collections department for NorthBay Health hospitals, ambulatory surgery centers, collaborate closely with and contributed to the success of other areas of the NorthBay Revenue Cycle, including but not limited to, front-end and middle revenue cycle operations, ambulatory revenue cycle operations, as well as collaborating with non-Revenue Cycle areas of NorthBay to contribute to the overall operational, financial, quality, and safety achievements and excellence of NorthBay Health. We are expanding access to care across our communities through two acute-care hospitals, including a Level II Trauma Center and a Level III NICU maternity unit, along with a cancer center, urgent care locations, and a growing network of primary and specialty care clinics.
NewCoder Outpatient Speciality Sutter HealthCoder Outpatient SpecialityBerkeley, CA$47.58–$66.60 / hourTotal compensation considers multiple factors, including, but not limited to a candidate's experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Job Description: Accurately assigns ICD-10 diagnosis and CPT procedure codes for outpatient specialty services in the hospital or office setting.
NewClinic Assistant Rogers Memorial HospitalClinic AssistantWalnut Creek, CA$25.69–$34.52 / hourThis location is operated under a collective bargaining agreement which will determine placement in the wage scale - all new hires will be paid at a rate on the scale and placed at that step of the scale, while all internal hires'' wages will align to their years of service. The Clinic Assistant performs receptionist and billing responsibilities related to clinic operations; coordinates patient information, maintains confidentiality of patient files, and coordinates billing functions with central offices.
NewDirector, Patient Financial Services, Hospital Billing Northbay HealthcareDirector, Patient Financial Services, Hospital BillingFairfield, California$185,000–$200,000 / yearFull timeDirector Of Patient Financial Services Hospital BillingAt NorthBay Health, the Director of Patient Financial Services Hospital Billing will be responsible for building and leading a highly effective centralized billing, follow-up, and collections department for NorthBay Health hospitals, ambulatory surgery centers, and collaborate closely with and contribute to the success of other areas of the NorthBay Revenue Cycle, including but not limited to, front-end and middle revenue cycle operations, ambulatory revenue cycle operations, as well as collaborating with non-Revenue Cycle areas of NorthBay to contribute to the overall operational, financial, quality, and safety achievements and excellence of NorthBay Health. We are expanding access to care across our communities through two acute-care hospitals, including a Level II Trauma Center and a Level III NICU maternity unit, along with a cancer center, urgent care locations, and a growing network of primary and specialty care clinics.
NewRevenue Cycle Informaticist (Onsite, Hybrid,Remote) Northbay HealthcareRevenue Cycle Informaticist (Onsite, Hybrid,Remote)Fairfield, CaliforniaRemote$33–$41 / hourFull timeExperience5+ years demonstrated experience in health system revenue cycle management from any area of revenue cycle, including front-end (patient access, registration, practice management), middle revenue cycle (HIM, coding, revenue integrity), or back-end (hospital billing, physician billing, or cash management).3+ years demonstrated experience supporting Epic revenue cycle reporting and analytics, including requirements gathering, build/configuration support, validation, deployment, and ongoing maintenance of reports and dashboards. Establish and manage a structured intake and prioritization process for reporting/dashboard support requests (requirements gathering, documentation, testing/validation, deployment, and ongoing maintenance).Partner with revenue cycle, finance, and operational leaders to identify improvement opportunities and support adoption of data-driven workflows; translate analytic insights into operational actions and change management support.
DRG Clinical Validation Lead Elevance Health IncDRG Clinical Validation LeadWalnut Creek, CA$89,520–$161,136 / 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. How you will make an impact: Conducts pre-certification, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
Professional Fee Coder - Analyst II (part-time / per diem) UCSF Medical CenterProfessional Fee Coder - Analyst II (part-time / per diem)Emeryville, CAProfessional Fee Coder - Analyst II, under the direction of their Revenue Manager and Associate Director, will provide support in areas of revenue operations related to coding, auditing, and training for their designated areas. Detail-oriented, with demonstrated organizational skills and the ability to manage time efficiently, prioritize tasks, set schedules, and complete projects in a timely and cost-effective manner.
Market Analysis Bachelor's Intern Kaiser PermanenteMarket Analysis Bachelor's InternWalnut Creek, CARevenue Cycle team members are required to build strong collaboration with clinical, operational, and financial partners to deliver a seamless revenue cycle that supports organizational sustainability and patient trust. Internship Projects: The intern role will partner directly with the Market Executive to perform an analysis of collections, charges, and various other Key Performance Indicators at the Market and Service Area level.
Revenue Cycle Informaticist NorthBay Medical CenterRevenue Cycle InformaticistFairfield, CA$33–$41 / hourThe Revenue Cycle Informaticist partners closely with Patient Financial Services, Revenue Cycle leadership, and enabling teams (e.g., IT/analytics) to intake and prioritize reporting needs, translate data into actionable insights, and drive sustainable operational change in support of staffing, volume, and performance decisions. Serve as a key Epic reporting and analytics resource for revenue cycle, leveraging Epic tools as applicable (e.g., Reporting Workbench, dashboards, and enterprise data sources) and partnering with IT/analytics teams for advanced data sets as needed.
NewED Professional Fee Coder (Hybrid, Remote) Northbay HealthcareED Professional Fee Coder (Hybrid, Remote)Fairfield, CaliforniaRemote$42.24–$51.34 / hourFull timeThis person is a dedicated, knowledgeable individual with a strong understanding of medical terminology, coding guidelines, regulations, and proficiency in utilizing an EHR/encoder system who can also effectively communicate with providers via email, query, phone call or in person to educate or discuss coding requirements. Candidates must be available schedule 7am -5pm PST.At NorthBay Health, the ED Professional Coder II will play a crucial role in accurately translating medical procedures and diagnoses into ICD 10, CPT and HCPCS codes in an accurate and timely manner.
NewProfessional Surgical Coder II (Onsite, Hybrid, Remote) Northbay HealthcareProfessional Surgical Coder II (Onsite, Hybrid, Remote)Fairfield, CaliforniaRemote$42.24–$51.34 / hourFull timeComprehensive knowledge and application of profee surgical guidelines including appropriate coding of assistants and co-surgeonsDemonstrated knowledge of anatomy and physiology, medical terminology, disease process, reimbursement methodologies (DRGs, HCCs, APCs), and the conventions, rules and guidelines for current coding classification (ICD10-CM, CPT and HCPCS).Demonstrated understanding of the clinical content of a health record. College coursework a plusLicensure: Certified Professional Coder (CPC), Certified Coding Specialist (CCS),or Certified Coding Specialist – Physician (CCS-P)Experience:Five or more years of experience in professional fee coding required including surgical coding in both inpatient and outpatient settings.
Medical Coder MedHQ, LLCMedical CoderTracy, CARemoteFull timeWe are seeking a meticulous and detail-oriented Medical Coder specializing in professional services, experience coding General and Orthopedic surgery with emphasis on spine and sports medicine. About Us: MedHQ, LLC, is a fast-growing, leading provider of consulting and technology-enabled expert services for outpatient healthcare.
Clinical Program Manager International Rescue CommitteeClinical Program ManagerOakland, CaliforniaThis is an opportunity to implement and operationalize ACBHD’s established EI model — activating clinical operations, standing up Medi-Cal billing infrastructure, and building IRC’s capacity to deliver high-quality early intervention behavioral health services in Alameda County. Job Overview: The International Rescue Committee (IRC) is launching a new Early Intervention (EI) Specialty Mental Health Services (SMHS) program in partnership with Alameda County Behavioral Health Department (ACBHD), funded under the Behavioral Health Services Act (BHSA).
NewInpatient Coder Kaiser PermanenteInpatient CoderOakland, CAAll work must be performed in accordance with the rules, regulations and coding conventions of ICD-CM Official Guidelines for Coding and Reporting, Coding Clinic published by the American Hospital Association, the ICD-CM, ICD-PCS, CPT and HCPCS code book, CPT Assistant, NCCI Edits, CMS, OSHPD and Kaiser Permanentes organizational and institutional coding guidelines. The Inpatient Coder is expected to code and abstract Observation (OBS), Hospital Ambulatory Surgery (HAS), Emergency Department (ED), and complex Hospital Outpatient Visit (CHOY) services when needed.
Clinical Documentation Integrity (CDI) Specialist Pyramid Consulting, IncClinical Documentation Integrity (CDI) SpecialistCalifornia, CARemote$45–$50 / hourBy applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Identify opportunities to improve documentation related to severity of illness (SOI), risk of mortality (ROM), quality indicators, and reimbursement.
Operations Supervisor (Dental) Community Medical CentersOperations Supervisor (Dental)Vacaville, CAAs one of the region's largest healthcare providers, our growing network of neighborhood health centers serves over 100,000 patients in San Joaquin and Solano counties. KNOWLEDGE, SKILLS, AND ABILITIES: Knowledge of ambulatory care, CPT/ICD- 10 coding procedures and be familiar with Medi-Cal, Medicare, and commercial insurance billing procedures.
Appeals & Grievance RN Wollborg Michelson RecruitingAppeals & Grievance RNOakland, CAUtilize National Coverage Determination (NCD), Local Coverage Determination (LCD), Milliman Care Guidelines, and other nationally recognized clinical guidelines such as NCCN and ACOG. This role is responsible for concurrent review of medical records and documentation, determining appropriate outcomes, and ensuring members have quality access to provider care.
Utilization Management Nurse RN 5 Wollborg Michelson RecruitingUtilization Management Nurse RN 5Oakland, CAProvides referrals to Case Management, Disease Management, Appeals and Grievance, and Quality departments as needed. Supports post-service and prior authorization review processes and collaborates with clinical leadership to ensure appropriate care determinations.
NewAppeals and Grievances - RN, Consultant (MediCare) Blue Cross and Blue Shield AssociationAppeals and Grievances - RN, Consultant (MediCare)Oakland, CAIn this role, you will: Perform retrospective utilization reviews and first level determination approvals for members using BSC evidenced based guidelines, policies and nationally recognized clinal criteria across lines of business or for a specific line of business such as Medicare and Med-Cal, including dual-eligibility products. In this role you will be leading a team of nurses who will be responsible for performing first level appeal reviews for members utilizing the National Coverage Determination (NCD) guidelines, Local Coverage Determination (LCD) Guidelines, and nationally recognized sources such as MCG, NCCN, and ACOG.
Medical Biller MedHQ, LLCMedical BillerTracy, CAFull timeIn this role, you will be responsible for charge entry and processing, patient registration, managing patient aging reports, and handling patient inquiries via phone. About Us: MedHQ, LLC, is a fast-growing, leading provider of consulting and technology-enabled expert services for outpatient healthcare.
Patient Services Rep United Surgical Partners InternationalPatient Services RepSAN RAMON, CA$24–$29 / hourA diverse workforce, combined with an inclusive culture, makes USPI stronger and better able to meet the needs of our diverse patient and physician population. The Successful candidate will possess outstanding multi-tasking abilities, communication and teamwork as well as the ability to keep up in a fast-paced working environment.
Business Development Executive (MedInsight) Milliman IncBusiness Development Executive (MedInsight)Walnut Creek, CARemote$120,635–$199,065 / yearMedInsight is a subsidiary of Milliman; a global, employee-owned consultancy providing actuarial consulting, retirement funding and healthcare financing, enterprise risk management and regulatory compliance, data analytics and business transformation as well as a range of other consulting and technology solutions. Primary Responsibilities: Develop deep expertise in MedInsight's risk adjustment software and analytics, and in the surrounding market (CMS-HCC models, RADV, quality programs, value-based care, and the competitive landscape) to engage prospects as a credible advisor.
Billing Manager PIEDMONT ACCESS TO HEALTH SERVICES INCBilling ManagerDanville, CAPosted On: Tuesday 24th March 2026 Category: Management Department: Billing Shift: Week Days Location: Danville Administration, 549 Main Street Job Type: 40 Hours per Week Education: Other Diploma/Certificate Duration: Permanent. The billing manager will work with providers to make sure all documents are coded appropriately for billing and charts are locked within the 72-hour window stated in the policy.
OB/GYN Hospitalist – Central Valley, CA | Near Sacramento & Bay Area - 1789550 Necnic GroupOB/GYN Hospitalist – Central Valley, CA | Near Sacramento & Bay Area - 1789550Stockton, CaliforniaDiverse, affordable metro with access to outdoor recreation, dining, and cultural amenities. Join an established OB/GYN hospitalist program with a 2-physician, in-house 24/7 model .
Senior Collection Representative UCSF Medical CenterSenior Collection RepresentativeEmeryville, CAThe University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. A Biller/Collector is responsible for reviewing, correcting, and completing billings to ensure complete and accurate billing of Medicare, Medi-cal, Managed Medicare/Medi-cal, and/or Other Government payers.
Senior Collections Representative UCSF Medical CenterSenior Collections RepresentativeEmeryville, CAThe University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. Excellent of hospital billing and collections, including skillset for billing and collections of packaged claims, stop losses, per diems, carve outs and other contract terms and conditions and CPT, ICD, DRG, and HCPC codes.
Utilization Management Nurse, Senior- Medicare Concurrent Review Blue Cross and Blue Shield AssociationUtilization Management Nurse, Senior- Medicare Concurrent ReviewOakland, CARequires a current California RN License Requires at least 5 years of prior relevant experience Requires strong communication and computer navigation skills Desires strong teamwork and collaboration skills Requires independent motivation and strong work ethic Requires strong critical thinking skills Hybrid Virtual Work This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need. Your Work In this role, you will: Perform prospective, concurrent and retrospective utilization reviews and first level determination approvals for members using BSC and CMS evidenced based guidelines, policies and nationally recognized clinal criteria for BSC Medicare line of business.
Utilization Management Nurse, Senior Blue Cross and Blue Shield AssociationUtilization Management Nurse, SeniorOakland, CAThe Utilization Management team independently manages complex utilization and retrospective clinical reviews across multiple lines of business, assessing medical necessity, coding accuracy, treatment plans, discharge planning, and compliance requirements while supporting clinical consistency, process improvement, quality, timeliness, and appropriate escalation of high-risk cases. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
Claims Adjuster Lee Hecht HarrisonClaims AdjusterPleasanton, CA$33–$35 / hourIn addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable. To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy .
Clerk Experienced Level Contra Costa CountyCAClerk Experienced LevelContra Costa County, CA$53,085.88–$65,865.82 / yearAll eligible Current Contra Costa County employees that are full-time, part-time or permanent-intermittent employees in the classification specified (and level of deep class if applicable) who meet the Minimum Qualifications, have been in their current position for six (6) months or more and are not on probation status may bid as per the Local 2700 MOU. Employees who are in positions which do not require typing, or classifications which require typing at a lower speed, may be required to demonstrate their ability to type 40 words per minute before appointment, transfer or reassignment into positions requiring typing.
NewCancer Data Coordinator/Tumor Registrar (On-Site) Northbay HealthcareCancer Data Coordinator/Tumor Registrar (On-Site)Vacaville, California$36.37–$47.87 / hourFull timeHe/she actively participates in Cancer Committee, contributing to its identification, planning and implementation of cancer-related services and programs, quality improvement initiatives, and other elements of cancer programs approved by the American College of Surgeons' Commission on Cancer (ACoS). Organizing cancer detection/screening initiatives w/Cancer Liaison PhysicianAssisting with oncology fundraising initiativesSupporting all other Cancer Committee activities, particularly those required of programs approved by the American College of Surgeons (ACoS) and other accrediting bodies.
Medical Biller & Revenue Cycle Manager Celebrations Speech GroupMedical Biller & Revenue Cycle ManagerBrentwood, CaliforniaCelebrations Speech Group is seeking an experienced Medical Biller & Revenue Cycle Manager to support accurate billing, timely claims submission, AR follow-up, credentialing visibility, payer compliance, and revenue cycle reporting across our clinic, home, and school-based services. In this role, you will review and submit claims, monitor accounts receivable, assist with denial resolution, track documentation and timesheet issues that impact billing, support credentialing and payer enrollment tracking, and prepare regular revenue cycle updates for leadership.