SVP AI & Data ReveleerSVP AI & DataCARemote$305,000–$355,000 / yearDirect the engineering teams that extract medical codes and quality data from charts: retrospective risk extraction built on Textract OCR, Comprehend Medical, and Gemini; prospective risk extraction that runs PDF and CCDA charts through Gemini and a custom rules engine to surface candidate ICD codes; and quality and HEDIS extraction that applies large language models to chart content. The SVP, AI & Data sets technical direction and architecture, partners with engineering and product leadership on delivery, and stays close enough to the systems to make sound build decisions - while giving team leaders the autonomy to own their domains.
NewClaims Auditor MedPOINT ManagementClaims AuditorSherman Oaks, CARemoteFull timeMedPOINT Management is a leading Independent Practice Association (IPA) management company serving the greater Los Angeles area, dedicated to delivering high-quality, coordinated healthcare to patients across Southern California. Our team enjoys a collaborative work culture, opportunities for professional growth, and the satisfaction of making a meaningful impact in the healthcare industry.
Director - Clinical Research Billing (Remote - CA) Stanford Health CareDirector - Clinical Research Billing (Remote - CA)CARemote$94.35–$125.03 / hourThe Director of Clinical Research Billing will collaborate and have direct interaction with a broad set of stakeholders across the institution, including Principal Investigators, study sponsors, study teams, finance/accounting, revenue cycle, internal audit, compliance, business office leaders, and clinic operational teams. Responsible for overseeing revenue cycle post-award activities, such as research charge review, patient care billing for all clinical trials, reviewing trends in revenue capture and reimbursement, and forecasting financial impacts pertaining to clinical research activities.
Medical Billing Customer Representative UCLA Health SystemMedical Billing Customer RepresentativeLos Angeles, CA$30.79–$40.60 / hourAs a condition of employment, the final candidate who accepts an 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; or have filed an appeal of a finding of substantiated misconduct with a previous employer. We're seeking detail-oriented, self-directed professional with: REQUIRED - Two years recent professional billing collection experience as well as two years of customer service experience.
NewSIU 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.
NewSr. Coordinator, Individualized Care (Case Manager) Cardinal Health IncSr. Coordinator, Individualized Care (Case Manager)CA$21.40–$30.60 / hourDelivering an exclusive model that fully integrates direct drug distribution to site-of-care with non-commercial pharmacy services, patient access support, and financial programs, Sonexus Health, a subsidiary of Cardinal Health, helps specialty pharmaceutical manufacturers have a greater connection to the customer experience and better control of product success. These steps include patient referral intake, investigating all patient health insurance benefits, identifying & initiating prior authorization and step therapy reviews, proactively following up with various partners including the insurance payers, specialty pharmacies, and support organizations to facilitate coverage and delivery of product in a timely manner.
Strategic Client Manager CPSIStrategic Client ManagerCAThis role owns client-specific success and recovery plans, drives measurable improvements across the revenue cycle and broader solution portfolio, coordinates cross-functional execution, manages escalations and risk, supports retention and growth, and ensures clients can demonstrate value from the TruBridge partnership. Maintain a disciplined client risk management process using service, financial, operational, relationship, and contractual indicators; identify emerging risks early; quantify retention and financial exposure; establish mitigation plans with accountable owners and deadlines; and escalate unresolved risks through measurable resolution.
Internal Medicine Physician - Optum - Torrance, CA UnitedHealth Group IncInternal Medicine Physician - Optum - Torrance, CATorrance, CAClinical ›Corporate and business operations ›Customer and support services ›Early careers›Sales and account management ›Technology and data›Physicians›Advanced practice clinicians›Pharmacy›Behavioral health›Nursing›Medical coding›Clinical support›U.S. Artificial intelligence Architecture Business systems analysis Data analytics Data engineering Data science Network infrastructure Product management & development Security and risk Software engineering.
Primary Care Physician - South Bay/Torrance - Optum UnitedHealth Group IncPrimary Care Physician - South Bay/Torrance - OptumTorrance, CA$237,361–$331,688 / yearOur Value Based Care model allows our clinicians the time needed to provide quality care to patients while supporting a healthy worklife balance Our model is designed to provide the most efficient comprehensive and proven care techniques to treat the whole patient - physically mentally and socially - at each visit. Clinical ›Corporate and business operations ›Customer and support services ›Early careers›Sales and account management ›Technology and data›Physicians›Advanced practice clinicians›Pharmacy›Behavioral health›Nursing›Medical coding›Clinical support›U.S.
NewClinical Documentation Integrity Specialist II - Hybrid FT Days Torrance Memorial Medical CenterClinical Documentation Integrity Specialist II - Hybrid FT DaysTorrance, CaliforniaUses clinical/nursing/coding knowledge to concurrently review and assess the medical record within 24-48 hours of admission including but not limited to physician documentation, lab and radiology results, nursing, nutrition, physical therapy and other provider’s documentation to determine that the most accurate severity of illness and expected risk of morality is reflected in the patient’s health record. Obtains additional documentation from physician or other qualified healthcare provider for clarification when there is conflicting, incomplete or ambiguous information in the healthcare record regarding any reportable data elements dependent on health record documentation.
Senior Director, Strategic Analytics Tendo Systems IncSenior Director, Strategic AnalyticsCARemote$2,024–$2,025This person will combine deep clinical informatics expertise with hands-on Databricks engineering and AI/ML skill to build algorithms that do two things simultaneously: (1) close documentation and coding gaps that affect risk adjustment, mortality index, and quality attribution, and (2) identify gaps and variation in the actual clinical processes of care that drive the metrics used by national hospital ranking and rating programs (e.g., CMS Star Ratings, U.S. News & World Report, Leapfrog, Vizient, Healthgrades, IBM Watson Health/Chartis 100 Top Hospitals). Maintain expert-level, current knowledge of major hospital ranking, rating, and benchmarking methodologies, including but not limited to: CMS Hospital Compare/Star Ratings, CMS Value-Based Purchasing and Hospital-Acquired Condition programs, U.S. News & World Report Best Hospitals methodology, Leapfrog Hospital Safety Grade, Vizient quality and safety benchmarking, Healthgrades, and payer-specific quality programs.
Coder City of HopeCoderCAThis role abstracts and codes relevant data elements for a certain type of professional fee service area (i.e., Evaluation & Management, major and minor surgical procedure, radiologic service, pathologic service, ancillary service, radiation oncology, and/or infusion charges) for multi-specialty physicians. City of Hope's growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix.
Clinical Documentation Integrity Specialist University of CaliforniaClinical Documentation Integrity SpecialistLos Angeles, CARemote$100,161.36–$218,718 / yearThis role involves daily review of high-acuity patient records to identify potential and active payer denials, assess clinical validity, and to support denial prevention, analysis, and appeals across inpatient and outpatient settings; continuously communicating with department staff; educating physicians, residents, and mid-levels; and assisting with appropriate documentation strategies. You will prepare and submit high quality appeal letters supported by clinical evidence, regulatory guidelines, and payor-specific medical necessity criteria, while identifying denial trends and root causes and provide feedback to the CDI and Clinical teams.
Senior Physician Assistant - Radiology UCSF Medical CenterSenior Physician Assistant - RadiologyCAKey responsibilities for this role include (but not limited to) the following: Billable inpatient evaluation and management (E&M) services including evaluation of new adult and pediatric inpatient consults, daily rounding on established IR patients, assistance with admission and discharge for primary IR patients and with care coordination for all IR patients across all UCSF campuses. UCSF APPs are expected to demonstrate accountability for their own clinical practice, participate in patient and staff education, serve as resources for APPs, APP students/fellows, physician residents/fellows, nurses and other staff, exhibit leadership skills, and engage in the mentoring of newly hired APPs.
Case Manager West Coast Alnylam Pharmaceuticals IncCase Manager West CoastCARemote$85,500–$115,600 / yearThanks to the commitment of every employee globally, Alnylam is proud to have been recognized as one of Fast Company's 2021 Best Workplaces for Innovators, a Science Magazine Top Employer three years in a row (2019-2021), a Boston Globe Top Places to Work seven years in a row (2015-2021), a Great Place to Work in Asia, Japan, Brazil, the U.K., Germany, Spain, Netherlands, Italy, France and Switzerland, Seramount's 100 Best Companies (formerly Working Mother 100 Best Companies) and Best Companies for Dads, Bloomberg's Gender Equality Index two years in a row (2021-2022), among others. Fosters collaborative relationships with all internal and external customers including but not limited to Patient Education Liaisons, medical, sales, field reimbursement, corporate accounts, patient advocacy, insurance company case managers, specialty pharmacies, home health agencies, and office coordinators.
NewClaims Development Specialist Xifin IncClaims Development SpecialistWestlake Village, CA$20–$24 / hourThe Claims Development Specialist is responsible for specific geographic locations, ensuring accurate conversion of files, demographic posting, charge posting and clean up, and review of all outstanding data is completed daily. Our innovative technologies help diagnostic providers, laboratories, and healthcare systems manage complexity, drive better outcomes, and stay focused on what matters most: patient care.
Inpatient Audit Specialist- PRN Datavant LLCInpatient Audit Specialist- PRNCARemote$35–$45 / hourWhat You Will Do: Performs Inpatient Facility coding audits according to scope of work, for the purpose of Onboarding, Focused, Service Level Agreements or Other Types of reviews, using appropriate assignment of codes and other coding-related elements using MS DRG or APR DRGs. What We're Looking For: As an Inpatient Auditing Specialist, you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, and coding workflow operations reviews.
Medical Biller United Surgical Partners InternationalMedical BillerTorrance, CARequirements KNOWLEDGE, SKILLS, QUALIFICATION and EDUCATIONAL AND /OR EXPERIENCE REQUIREMENTS: High school diploma or equivalent. United Surgical Partners International is a publicly traded company that specializes in the development and operation of Ambulatory Surgical Facilities in the U.S. and the UK.
NewSr. Manager, Engineering Cohere Health Technologies LLCSr. Manager, EngineeringCARemote$185,000–$225,000 / yearOpportunity Overview: We are seeking a Senior Engineering Manager to lead our Review Engineering team - roughly 20+ engineers across three squads in the US and India - building the workflows and capabilities that let clinical operations staff deliver care at scale, efficiently and with high quality. Leading through dedicated technical leads on each squad, you''ll own the reliability and technical direction of Review''s systems while partnering closely with Product, Design, Security, Clinical Operations, and peer engineering teams on shared platforms.
Director of Revenue Cycle Continuous Improvement University of CaliforniaDirector of Revenue Cycle Continuous ImprovementLos Angeles, CA$116,300–$264,600 / yearAs the Director of Revenue Cycle Continuous Improvement, you will oversee a portfolio of cross-functional initiatives focused on reducing preventable denials, addressing revenue leakage, improving clean claim performance, and accelerating the adoption of automation and leading practices. Demonstrated leadership, critical-thinking, problem-solving, and communication skills with the ability to build collaborative teams, establish operational and financial targets, and convey complex revenue cycle information clearly.