NewCLINICAL DOCUMENTATION SPECIALIST 4 HX - Clinical Doc Integrity - FT Days Remote University of California, IrvineCLINICAL DOCUMENTATION SPECIALIST 4 HX - Clinical Doc Integrity - FT Days RemoteIrvine, CaliforniaRemoteFull timeAs Orange County’s only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region’s only American College of Surgeons-verified Level I adult and Level II pediatric trauma center , American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. *Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional 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; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.
NewCLINICAL DOCUMENTATION SPECIALIST 4 HX - Clinical Doc Integrity - FT Days REMOTE University of California, IrvineCLINICAL DOCUMENTATION SPECIALIST 4 HX - Clinical Doc Integrity - FT Days REMOTEIrvine, CaliforniaRemoteFull timeAs Orange County’s only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region’s only American College of Surgeons-verified Level I adult and Level II pediatric trauma center , American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. *Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional 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; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.
Vermont Rural Healthcare IT and HIM Leadership Opportunities Rural Staffing ServicesVermont Rural Healthcare IT and HIM Leadership OpportunitiesVermont, VermontRural Staffing Services® partners with rural hospitals, clinics, community health centers, long-term care organizations, and healthcare systems throughout Vermont to identify experienced information technology and health information leaders who understand the unique needs of rural healthcare. These opportunities may include leadership within Critical Access Hospitals, Rural Health Clinics, Federally Qualified Health Centers, community hospitals, long-term care organizations, and integrated rural healthcare systems.
Xcelys Medical Claims Examiner (Remote) NTT DATAXcelys Medical Claims Examiner (Remote)Ontario, CARemoteAs part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.
Financial Clearance Specialist III - PreArrival - Full Time 8 Hour Rotating (Non-Exempt) (Non-Union) University of Southern CaliforniaFinancial Clearance Specialist III - PreArrival - Full Time 8 Hour Rotating (Non-Exempt) (Non-Union)Los Angeles, CaliforniaWhen 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. As a leading academic medical center, hundreds of clinical trials are currently taking place at Keck Hospital and its affiliated research institutions, giving patients access to novel and promising therapies that are generally not available elsewhere.
Financial Clearance Specialist III - Prearrival - Full Time 8 Hour Rotating (Non-Exempt) (Non-Union) University of Southern CaliforniaFinancial Clearance Specialist III - Prearrival - Full Time 8 Hour Rotating (Non-Exempt) (Non-Union)Los Angeles, CA$26–$41.28 / hourWhen 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. As a leading academic medical center, hundreds of clinical trials are currently taking place at Keck Hospital and its affiliated research institutions, giving patients access to novel and promising therapies that are generally not available elsewhere.
Facility Outpatient Surgical and Claims Edit Auditor (Remote) Cedars-Sinai Medical CenterFacility Outpatient Surgical and Claims Edit Auditor (Remote)Los Angeles, CARemoteMaintains appropriate open communication with internal and external partners and peer departments such as Coding Operations, Clinical Documentation Integrity (CDI), Payor Revenue Management (PRM), and Compliance Revenue Integrity (CRI). Auditors evaluate compliance with all coding guidelines including but not limited to: Internal Coding policies/procedures/handbook, American Hospital Association (AHA) and American Medical Association (AMA) coding references, local, State, and Federal Coding Guidelines.
Facility Inpatient Surgical and Claims Edit Auditor Cedars-Sinai Medical CenterFacility Inpatient Surgical and Claims Edit AuditorLos Angeles, CARemoteMaintains appropriate open communication with internal and external partners and peer departments such as Coding Operations, Clinical Documentation Integrity (CDI), Payor Revenue Management (PRM), and Compliance Revenue Integrity (CRI). Auditors evaluate compliance with all coding guidelines including but not limited to: Internal Coding policies/procedures/handbook, American Hospital Association (AHA) and American Medical Association (AMA) coding references, local, State, and Federal Coding Guidelines.
NewClient Service Representative Vicar Operating dba VCAClient Service RepresentativeOntario, California$18–$20 / hourAs a CSR, you must be a self-starter with a strong attention to detail, ability to work in fast-paced environment, be able to handle difficult cases and clients, and have outstanding communication skills. SUMMARY: As part of the Client Service Representative Team, you will help set the tone for the practice as we build and maintain each customer's trust and confidence in our abilities.
Implementation Auditor (50487) Western Growers AssociationImplementation Auditor (50487)Irvine, CAUsing close and comprehensive analyses, verify new and existing plans loaded on the Company's claim management system against the appropriate Summary Plan Description to determine the accuracy of present and future claims payments. This position will ensure that all new and existing health (medical/dental) insurance plans underwritten by the Western Growers Assurance Trust (WGAT) and those of Pinnacle, Inc. (PCMI) are in compliance with the respective employers' summary plan descriptions.
Plan Coder (50456) Western Growers AssociationPlan Coder (50456)Irvine, CAThis position will ensure that all new and existing health (medical/dental/pharmacy) insurance plans underwritten by Western Growers Assurance Trust (WGAT) and those of Pinnacle Claims Management, Inc. (PCMI) are in compliance with the respective employers' summary plan descriptions. Do everything possible to help members succeed by being curious and striving to understand what others are trying to achieve, planning, and executing work helpfully and collaboratively.
NewDecision Scientist - Clinical Informatics (Clinical Data Standards) CVS Health CorpDecision Scientist - Clinical Informatics (Clinical Data Standards)CA$64,890–$158,620 / yearA&BC leverages advanced analytics, clinical informatics, and hypothesis-driven approaches to transform data into actionable, customer-centric insights that drive growth, improve health outcomes, and expand access to healthcare across all CVS Health businesses. Collaborate with data engineering teams to inform data pipeline development, ensuring clinical data is ingested, transformed, and stored in ways that support downstream analytics needs.
RAC Manager Prime Healthcare Management IncRAC ManagerOntario, California$71,760–$94,619.20 / yearFull timeExtensive knowledge of nursing care, clinical measurement tools, and clinical outcomes; ability to establish cooperative working relationship with diverse groups and individuals, the medical staff, and other healthcare disciplines; program and database development a plus. Working with the Supervisor(s), a RAC manager functions as a subject matter expert (SME) for the appeals process and takes an active role in managing the process and coordinating with the RAC team, Corporate Utilization Review and Clinical appeals team.
Clinical Documentation Specialist 4 HX - Clinical Doc Integrity - P/T Days Remote University of California, IrvineClinical Documentation Specialist 4 HX - Clinical Doc Integrity - P/T Days RemoteIrvine, CaliforniaRemotePart timeAs Orange County’s only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region’s only American College of Surgeons-verified Level I adult and Level II pediatric trauma center , American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. *Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional 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; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.
Advanced Practice Provider (App), Nurse Practitioner (Np) Or Physician Assistant (Pa) COPE Health SolutionsAdvanced Practice Provider (App), Nurse Practitioner (Np) Or Physician Assistant (Pa)Los Angeles, CA$150,000–$200,000 / yearComprehensive AWV & Gap Closure: Perform Medicare Annual Wellness Visits in the home, completing detailed cognitive screenings, fall risk assessments, and personalized prevention plans while closing active quality care gaps and appropriately capturing HCC codes as part of documentation. This role executes in-home Annual Wellness Visits (AWVs), manages complex clinical transitions of care (TOC) immediately following hospital discharge, and provides long-term stabilization for high-acuity patients enrolled in Complex Care Management (CCM) and is proficient at HCC coding and medical disease documentation.
NewTrauma Program Coordinator - Trauma Service - F/T - Days University of California, IrvineTrauma Program Coordinator - Trauma Service - F/T - DaysOrange, CaliforniaFull timeAs Orange County’s only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region’s only American College of Surgeons-verified Level I adult and Level II pediatric trauma center , American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. *Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional 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; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.
Quality Analyst Home Health, Lead Assistant Manager ExlService Holdings IncQuality Analyst Home Health, Lead Assistant ManagerCA$60,100–$98,700 / yearContinuous Improvement/Education actively participates with team to ensure alignment and sustained results; attends training (assigned or self-initiated) to improve performance or capitalize on new overpayment trends; keeps up with CMS, OIG, and other publications related to our business. EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates.
Financial Clearance Specialist III - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union) University of Southern CaliforniaFinancial Clearance Specialist III - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)Los Angeles, CaliforniaWhen 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. If you are a current USC employee, please apply to this USC job posting in Workday by copying and pasting this link into your browser: https://wd5.myworkday.com/usc/d/inst/1$9925/9925$140078.htmld
Financial Clearance Specialist IV - Admitting - Full Time 8 Hour Variable Shift (Non Union) University of Southern CaliforniaFinancial Clearance Specialist IV - Admitting - Full Time 8 Hour Variable Shift (Non Union)Glendale, CaliforniaWhen 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. Minimum (3) years of experience in a hospital, health plan or Physician office environment with extensive knowledge of contracted and non-contracted payers, division of financial responsibility, including the ability to articulate benefit negotiations as required when adjudicating a letter of agreement with a non-contracted payer.
Financial Clearance Specialist III - Prearrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union) University of Southern CaliforniaFinancial Clearance Specialist III - Prearrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)Los Angeles, CA$22–$34.18 / hourWhen 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. Preferred Qualifications: Required Licenses/Certifications: Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date.