Billing and Coding Analyst - Surgical Subspecialty Clinic County of VenturaBilling and Coding Analyst - Surgical Subspecialty ClinicVentura, CA$62,964.97–$88,150.95 / yearKnowledge, Skills, and Abilities: Thorough knowledge of: common surgical specialties such as otolaryngology (ENT), plastic reconstruction, urology and neurology; surgical terminology; operative report structures related to surgery; medical reimbursement programs and complexity of payment systems; Current Procedural Terminology Codes (CPT) codes, International Classification for Diseases (ICD)-10 codes, Health Care Procedure Coding System (HCPCS) codes for payment processing of Medicare and/or Medi-Cal; Medi-Cal Provider Manual for Billing and Policy and Program and Eligibility; the Treatment Authorization Request (TAR) process; authorization requirements and processes of private health plans (such as Blue Cross/Blue Shield and Healthnet) and the Ventura County Health Care Plan. The required knowledge, skills, and abilities can typically be obtained by: Seven (7) years of hands-on working knowledge and experience performing professional medical coding and/or billing duties in a medical system comparable to the Ventura County Medical Center or an outpatient clinic providing high volume surgical specialty services similar to the Ventura County Ambulatory Care clinics.
Coding and Compliance Specialist- Hybrid ConcentraCoding and Compliance Specialist- HybridSanta Clarita, California$28.81–$33.13 / hourSchedule meetings to present audit findings and be available to meet with clinicians via Zoom as their schedules dictate, accommodating calls outside of normal working hours when the need arises. This function is critical to the overall revenue cycle in supporting charge entry, level of service selection, procedure and diagnosis coding, as well as one on one, and group, education and training to employed and contracted Clinicians.
Coding and Compliance Specialist Hybrid Concentra Inc.Coding and Compliance Specialist HybridSanta Clarita, CA$28.81–$33.13 / hourSchedule meetings to present audit findings and be available to meet with clinicians via Zoom as their schedules dictate, accommodating calls outside of normal working hours when the need arises. This function is critical to the overall revenue cycle in supporting charge entry, level of service selection, procedure and diagnosis coding, as well as one on one, and group, education and training to employed and contracted Clinicians.
NewSTEM & Coding Instructor Opportunities Concorde EducationSTEM & Coding Instructor OpportunitiesSimi Valley, Ventura County$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.
Medical Billing Specialist I/II - Behavioral Health County of VenturaMedical Billing Specialist I/II - Behavioral HealthOxnard, CA$47,840–$69,546.52 / yearLATERAL TRANSFER OPTION: If presently permanently employed in another "merit" or "civil service" public agency/entity in the same or substantively similar position as is advertised, and if appointed to that position by successful performance in a "merit" or "civil service" style examination, then appointment by "Lateral Transfer" may be possible. Current Procedural Terminology Codes (CPT) codes, International Classification for Diseases (ICD)-10 codes, Health Care Procedure Coding System (HCPCS) codes for payment processing of Medicare and/or Medi-Cal.
Billing Specialist Clinicas del Camino Real IncBilling SpecialistVentura, CAMust have knowledge of Current Procedural Terminology (CPT) and International Classification for Diseases (ICD) codes; Medi-cal , Medicare and insurance billing knowledge or experience; insurance claim forms: paper or electronic. The Billing Specialist will be responsible for the completion of all tasks to ensure accurate, compliant and timely billing of patient charges for appropriate reimbursement from all sources, such as patients and all other third party payers.
Medical Biller TMJ & Sleep Therapy CentreMedical BillerTHOUSAND OAKS, CAAs a Medical Biller, you will be working closely with patients connecting them with our offsite medical billing company, processing all forms needed for insurance billing purposes, and collecting necessary documentation from patients. The ideal candidate has excellent attention to detail, strong customer service skills, and is comfortable spending much of the day on the phone and on EHR.
Front Desk Coordinator - Part Time with Benefits RestorixHealthFront Desk Coordinator - Part Time with BenefitsWest Hills, CAResponsible for scheduling patients, precertification, insurance verification, charge entry and daily reconciliations, this position will wear many hats. When you join our team, you have the opportunity to develop your career based on your strengths and potential, including the possibility to move functionally, geographically, laterally and vertically.
Care Management - Nurse, Senior (CA Children''s Services) Blue Cross and Blue Shield AssociationCare Management - Nurse, Senior (CA Children''s Services)Woodland Hills, CAIn this role, you will: Perform complex care management/care management/care coordination 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 Medi-Cal and CCS/EIES/DDS/CSHCN/EPSDT Eligibility guidelines. Responsible in assisting and working daily inventory, providing high-quality clinical reviews, performing efficient care management and care coordination, and ensuring compliance performance metrics are met.
Coder III Henry Mayo Newhall Memorial HospitalCoder IIIValencia, CAThe Coder III is responsible for analyzing medical records for completion by Medical Staff, clinical or ancillary department; performing coding and abstracting functions; efficiently navigating the electronic medical record to find patient information required for coding; and accurately abstracting medical records for quality assessment screens. Acute hospital experience in an acute care hospital, with three years of inpatient and outpatient coding experience utilizing automated encoder.
Rheumatologist | Optum CA UnitedHealth Group IncRheumatologist | Optum CANorthridge, 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.
Claims 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.
Key Account Manager - Bone Health - Southern California (San Diego, Hawaii) Amgen IncKey Account Manager - Bone Health - Southern California (San Diego, Hawaii)CAAmgen offers a Total Rewards Plan comprising health and welfare plans for staff and eligible dependents, financial plans with opportunities to save towards retirement or other goals, work/life balance, and career development opportunities including: Comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and flexible spending accounts. The Account Manager will work internally through the matrix team, and externally with customers to develop strong relationships for Amgen to support sales performance and brand strategies at multiple touch points and levels within complex partner organizations.
Business Analyst, Consultant Blue Cross and Blue Shield AssociationBusiness Analyst, ConsultantWoodland Hills, CAIn this role, you will play a critical role in ensuring payment and medical policy logic is accurately translated into system configuration, directly impacting claims accuracy, regulatory compliance, and cost of healthcare outcomes, while influencing cross-functional decision-making through expert analysis and identification of improvement opportunities. This role is responsible for analyzing data, defining business requirements, and driving operational improvements related to payment policy, medical policy, and coding related processes, while also contributing to the development of annual operating plans, budgets, forecasts, and cost/benefit analyses for new initiatives.
Utilization Management Nurse, Senior- Medicare Concurrent Review Blue Cross and Blue Shield AssociationUtilization Management Nurse, Senior- Medicare Concurrent ReviewWoodland Hills, 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.
NewUtilization Management Nurse, Senior Blue Cross and Blue Shield AssociationUtilization Management Nurse, SeniorWoodland Hills, 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.
Home Health Registered Nurse (RN) - Conejo Valley CVHCareHome Health Registered Nurse (RN) - Conejo ValleySimi Valley, CAPart timeWe provide an entire internal operational support team for our clinicians to handle the tasks of pre-populating the medication reconciliation, tracking down DME orders, getting MD signatures, coding, lab follow-up, etc., truly allowing you to function independently, with the flexibility to make your own schedule and plan patient visits around other commitments if needed. Locations: Area #45 covers the following cities: Agoura Hills, Calabasas, Moorpark, Newbury Park, Oak Park, Simi Valley, Thousand Oaks and Westlake Village.
AI-Native Software Engineer Elevance Health IncAI-Native Software EngineerCA$112,640–$176,640 / yearMinimum Requirements: Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 3 years experience on one platform, multi database, multi language or multi business application; or any combination of education and experience, which would provide an equivalent background. Experience building or integrating AI agents, tool/function calling, RAG, memory, model routing, evaluations, guardrails, observability, and secure API/tool access strongly preferred.
Medical Assistant/ Insurance verifier , authorization specialist Apex Practice Management GroupMedical Assistant/ Insurance verifier , authorization specialistNorthridge, CAThe ideal candidate will be responsible for obtaining insurance authorizations and check eligibility for medical procedures and services, ensuring timely approvals to facilitate patient care. - Communicate with healthcare providers, insurance companies, and patients to gather necessary information.
Center Medical Director (Nurse Practitioner or Physician Assistant) Carbon Health Medical Group IncCenter Medical Director (Nurse Practitioner or Physician Assistant)Woodland Hills, CA$79.12–$90.98 / hourCollaborate: Shares information with others so there are no surprises; facilitates effective collaboration among clinic medical directors, clinic managers, and external partners • Drive Outcomes: Eliminates obstacles that affect organizational performance • Influence and Inform: Negotiates skillfully in tough situations; facilitates management of differences by addressing them openly and encouraging mutually beneficial resolutions • Demonstrate Accountability: Acts with a clear sense of ownership with exceptional organization and time management skills; establishes clear responsibilities and processes for delivering, monitoring and measuring results • Manage through Ambiguity: Coaches others in finding solutions and accomplishing goals despite incomplete information • Develop Self & Others: Provide real-time coaching to others, mentors key talent and takes significant action for effectiveness in current and future job. Active NP or PA license and board certified; FM, IM or Med/Peds Minimum 2 years of experience in ER, urgent care or similar setting Ability to consult and treat patients of all ages 1+ year leading others in a healthcare setting Understanding of financial statements, P&L management and HR business processes Active listener that uses soft skills to build and maintain trusting relationships at all levels of the organization Excellent communication and interpersonal, time management, planning, organizational, analytical, problem-solving, and critical thinking skills.
Cloud Product Cybersecurity Engineer Medtronic MiniMed IncCloud Product Cybersecurity EngineerCAThis role partners with R&D, software engineering, regulatory affairs, quality assurance, and enterprise security teams to ensure products are designed and maintained with strong security controls and comply with applicable FDA cybersecurity guidance, ISO 27001, NIST, and other cybersecurity frameworks. If you are applying to perform work for MiniMed in any position which will involve performing at least two (2) hours of work on average each week within the unincorporated areas of Los Angeles County, you can find here a list of all material job duties of the specific job position which MiniMed reasonably believes that criminal history may have a direct, adverse and negative relationship potentially resulting in the withdrawal of a conditional offer of employment.
Nurse Practitioner (Per Diem) ComplexCare SolutionsNurse Practitioner (Per Diem)Oxnard, California$2,400–$10,000 / yearPer diemAbility to practice autonomously in a remote clinical environment, including independently conducting patient assessments, formulating evidence-based treatment plans, managing complex chronic conditions, and making soundclinical decisions without direct on-site supervision. Pay Range: $2,400.00 - $10,000.00 per month (Potential income) Earnings will vary based on completed assessments, state of residence, and business needs as there is no guarantee of visits or minimum income.
NewCloud Product Cybersecurity Engineer USA-Medtronic MiniMed 1017Cloud Product Cybersecurity EngineerNorthridge, CaliforniaThis role partners with R&D, software engineering, regulatory affairs, quality assurance, and enterprise security teams to ensure products are designed and maintained with strong security controls and comply with applicable FDA cybersecurity guidance, ISO 27001, NIST, and other cybersecurity frameworks. If you are applying to perform work for MiniMed in any position which will involve performing at least two (2) hours of work on average each week within the unincorporated areas of Los Angeles County, you can find here a list of all material job duties of the specific job position which MiniMed reasonably believes that criminal history may have a direct, adverse and negative relationship potentially resulting in the withdrawal of a conditional offer of employment.