Collector, Management Services Organization/Centralized Billing Office - CBO - Full Time 8 Hour Days (Non-Exempt) (Non-Union) University of Southern CaliforniaCollector, Management Services Organization/Centralized Billing Office - CBO - Full Time 8 Hour Days (Non-Exempt) (Non-Union)Pasadena, CaliforniaResponsible for ensuring timely filing and guidelines are met; provided quality control checks on paper and electronic claims; process tracers, denial and related correspondence; initiate appeals; compose and submit appeal letters specific challengeable denial issues consistent with the most update American Medical Association Current Procedural Terminology. System Folder Notes / Account Documentation Documents claim bill date, billed amounts, billing address, billing attachments, invoice number, expected payment, contractual amount, received payments, actual transplant date(s), type of transplant, pre and post periods for transplant days, and all pertinent billing data relevant to billing the claim.
Senior Consultant - Clinical Documentation Specialist Deloitte Touche Tohmatsu LtdSenior Consultant - Clinical Documentation SpecialistLos Angeles, CA$110,700–$218,300 / yearOther skills include the ability to analyze, act and design action plans upon monthly and quarterly reports related to individual providers, facilities, MS-DRGs, APR, PSIs, severity of illness and risk of mortality, capture rates, quality metrics and can effectively prioritize their work activities. Clinical Payments Optimization: Assisting clients by validating that payments for clinical healthcare services comply with regulatory, clinical based evidence and contractual requirements while also determining that payments are appropriate for the type and level of care provided.
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.
Sr. Medical Claims Processor Ultimate Staffing ServicesSr. Medical Claims ProcessorPasadena, California$24–$29 / hourEnsure accuracy of claim details, including patient information, coding (ICD-10, CPT, HCPCS), and billing data prior to submission. Investigate and resolve denied, rejected, or pending claims by working with providers, payers, and internal departments.
NewCertified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)CA$43,888–$93,574 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. Uses department resources regularly and follows workflows with minimal assistance or intervention to perform daily work to meet metrics.
Manager, Payment Integrity Enablement Inland Empire Health PlanManager, Payment Integrity EnablementRancho Cucamonga, California$104,041.60–$137,841.60 / yearFull timeReporting to the Director of Payment Integrity, the Manager, Payment Integrity Enablement provides strategic and operational leadership over enterprise-wide payment accuracy education, provider billing guidance, and compliance‑aligned intervention programs. Stakeholder Communication & Engagement Strategy : Serve as the operational driver for Payment Integrity Enablement interventions, ensuring programs scale effectively, are audit-ready, and deliver measurable reductions in inaccurate or wasteful spend.
NewHCC Coder NORTHEAST COMMUNITY CLINIC, INCHCC CoderAlhambra, CAThe HCC Coder will collaborate with the Billing Manager and Medical Director in providing expertise in the use and application of current coding classifications including but not limited to ICD-10-CM, CPT, E&M and record documentation to ensure compliance in the collection of outpatient diagnoses and services. Extensive knowledge of ICD-10-CM outpatient diagnosis coding guidelines (with knowledge and demonstrated understanding of CMS HCC Risk Adjustment coding and data validation requirements is preferred) Ability to work as a team player and work independently.
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.
NewHCC Coder Northeast Community ClinicsHCC CoderAlhambra, CAThe HCC Coder will collaborate with the Billing Manager and Medical Director in providing expertise in the use and application of current coding classifications including but not limited to ICD-10-CM, CPT, E&M and record documentation to ensure compliance in the collection of outpatient diagnoses and services. Attend weekly meetings and present HCC Risk Adjustment Coding Department feedback, including data analysis, summary details; provide work flows and worksheets as necessary.
Field Reimbursement Manager-South Central Harrow, Inc.Field Reimbursement Manager-South CentralLos Angeles, CAThis individual will provide non-promotional, compliant education on coverage, coding, billing, and claims processes - giving customers the confidence and technical know-how to appropriately access and be reimbursed for Harrow brands. The ideal candidate is a proactive problem-solver who thrives in the field, builds strong relationships with practice staff, and brings sharp analytical skills to identify and resolve access barriers at the account level.
Charge Capture Specialist Career StrategiesCharge Capture SpecialistLos Angeles, CaliforniaWe encourage candidates who meet these qualifications to apply for this exciting opportunity to contribute to our dedicated team in the healthcare field. Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification (preferred).
Practice Operations and Revenue Cycle Manager Widger TalentPractice Operations and Revenue Cycle ManagerLos Angeles, CaliforniaDirect experience managing the full administrative Spravato workflow in an outpatient clinic, including REMS, benefit verification, prior authorization, specialty pharmacy or buy and bill processes, scheduling, treatment readiness, documentation controls, and claim readiness. This is a visible operating role for someone who can move comfortably between a patient tracker, a payer or pharmacy escalation, a staff coaching conversation, a billing report, and a sensitive patient concern without losing control of priorities.
Specialty Physician Coder 26-00243 Alura Workforce SolutionsSpecialty Physician Coder 26-00243Fountain Valley, CARemote$43.75–$46 / hourWe're looking for an experienced Specialty Physician Coder to join a growing Coding Compliance team, remote, with real variety in your day-to-day work. If this sounds like the kind of role where your specialty experience actually gets used, not just your general coding skills, let's talk.
Medical Auditor - Remote YO AI LabsMedical Auditor - RemoteLos Angeles, CARemoteWe are seeking experienced Medical Auditors to contribute their specialized expertise to an innovative healthcare AI project. This opportunity is ideal for professionals with strong experience in outpatient professional fee coding, auditing, and academic medical center environments.
Medical Claims Examiner Ultimate Staffing ServicesMedical Claims ExaminerPasadena, California$26–$29 / hourWe are seeking an experienced Medical Claims Examiner to review, analyze, and adjudicate medical claims for accuracy, compliance, and medical necessity. Identify coding discrepancies, overpayments, and potential fraud or abuse.
Revenue Cycle Specialist III (Gastroenterology) Cedars-Sinai Medical CenterRevenue Cycle Specialist III (Gastroenterology)Los Angeles, CAPrimary duties include: Develops and maintains excellent working relationships with Cedars-Sinai Clinical Departments, external clients, and patients, performing duties that include identifying, analyzing, resolving, and responding to our client's inquiries, concerns, and issues, and following up on accounts to ensure resolution. The Revenue Cycle Specialist III works under general supervision and following established practices, policies, and guidelines of Revenue Cycle Management supporting Hospital, Professional Fee billing and collections.
Medical Accounts Receivable Representative (Level Two) California Medical Business ServicesMedical Accounts Receivable Representative (Level Two)Arcadia, CaliforniaPhysical: Primary functions require sufficient physical ability and mobility to work in an office setting; to stand or sit for prolonged periods of time; to occasionally stoop, bend, kneel, crouch, reach, and twist; to lift, carry, push, and/or pull light to moderate amounts of weight; to operate office equipment requiring repetitive hand movement and fine coordination including use of a computer keyboard; to travel to other locations using various modes of private and commercial transportation; and to verbally communicate to exchange information. Huntington-Hill Imaging Center (managed by California Medical Business Services, LLC) is dedicated to improving medical practices through the use of innovative technologies, strategic partnerships, and years of industry experience.
Dental Office Manager Empower Dental GroupDental Office ManagerRancho Cucamonga, CaliforniaAs 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. Founded by Dr. Gyokchyan, Dr. Arkelakyan, and Dr. Khachatryan, Empower Dental brings together experience, innovation, and compassion to deliver exceptional, patient-centered care.
Senior Analyst, Medical Economics - Senior Analyst, Medical Economics (Trend Analytics, SQL, Power BI, Medicaid) - REMOTE Molina Healthcare IncSenior Analyst, Medical Economics - Senior Analyst, Medical Economics (Trend Analytics, SQL, Power BI, Medicaid) - REMOTECARemoteDemonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms. Provides senior-level analytical support for Medical Economics initiatives through the extraction, analysis, and synthesis of complex healthcare data to identify risks, opportunities, and drivers of medical cost and utilization trends.
Revenue Integrity Program Manager (Remote) Stanford Health CareRevenue Integrity Program Manager (Remote)CARemote$66.52–$88.14 / hourThrough a combination of data analytics, and process improvement techniques, this role will support the accurate capture of charges, identify meaningful opportunities to improve, and work closely with physician leadership and partnering with Compliance to provide education and training. Performance Review: Provides ongoing reporting of revenue performance to a variety of audiences including Chairs, Faculty, DFA's, Division and Clinic Chiefs, Executive Director, Mid-Revenue Cycle, the Director of Revenue Integrity and others as appropriate.