Manager, RCM Client Success Modernizing Medicine IncManager, RCM Client SuccessCAGenerous Paid Time Off and Paid Parental Leave programs, Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs, Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed, Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning, Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles, Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters. Job Description Summary: ModMed is hiring a Manager, RCM Client Success to oversee team members, including Enterprise Client Advisors, Client Advisors, and Leads, who support assigned RCM Specialties and ensure that exceptional service delivery, client satisfaction, and adherence to revenue cycle management objectives are met across assigned verticals.
Sr Fraud, Waste and Abuse Investigator (Investigator Sr) CalOptimaSr Fraud, Waste and Abuse Investigator (Investigator Sr)Orange, CA$72,096–$115,353 / yearWe are hoping you will join us as a Sr Fraud, Waste and Abuse Investigator (Investigator Sr) and help shape the future of healthcare where you'll be an integral part of our OOC - Fraud & Waste team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet.
CHIEF, REVENUE MANAGEMENT, HEALTH SERVICES/CORRECTIONAL HEALTH Los Angeles CountyCHIEF, REVENUE MANAGEMENT, HEALTH SERVICES/CORRECTIONAL HEALTHLos Angeles, CA$141,907.20–$220,694.40 / yearVeteran's Credit: Pursuant to the County Charter and County policy, in all open competitive examinations (i.e., examinations open to everyone), the County of Los Angeles will add a credit of 10 percent of the total credits specified for such examination to the final passing score of an honorably discharged veteran, as well as the spouse of a deceased or disabled veteran, who served in the Armed Forces of the United States under specific conditions. Option 1: Three years of experience in directing one or more of the following complex health care fiscal operations: budgetary projections or reporting; revenue programs; patient, general, or cost accounting; cost reporting; revenue enhancement strategy development; revenue cycle operations; or other major finance-related areas.
Medical Review Nurse II - SNF/MDS Auditor MachinifyMedical Review Nurse II - SNF/MDS AuditorCA$85,000–$100,000 / yearMust be able to independently work within Microsoft Office products including Word, Excel, PPT, to Include creating/saving documents in folders, setting up and utilizing spreadsheets, copying and pasting data from one document to another. Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country.
Patient Navigator HealogicsPatient NavigatorCorona, CaliforniaLearn more about this role here: Healogics is the largest provider of advanced wound care services in the United States, treating more than 300,000 chronic wound patients annually across over 600 sites. All Healogics employees must perform their job responsibilities according to all Healogics policies, Hospital policies, as well as to accrediting organizations, federal and state regulation, and to the Centers for Medicare and Medicaid Services (CMS) guidelines, as applicable.
Medical Billing / Frontdesk Kohan International FoundationMedical Billing / FrontdeskCULVER CITY, CAMedical Biller/Office Administrator (Full-Time, In-Person) We are a non-profit group therapy practice seeking a skilled and dedicated Medical Biller/Office Administrator to join our team immediately! Fluency in Tagalog/Filipino is A MUST to effectively serve our diverse clientele and team but not required.
Patient Care Coordinator Upperline Health IncPatient Care CoordinatorCAUpperline Health providers coordinate patients' care among a team of physician specialists, nurse practitioners, care navigators, nutritionists, social workers, and pharmacists for integrated treatment that addresses patients' immediate and long-term health needs. The Patient Care Coordinator will be responsible for medical front desk receptionist duties including greeting patients in a friendly manner, and ensuring patients are accurately checked in and prepared for their appointments in a timely manner.
Account Follow-Up Representative I Harris Computer SystemsAccount Follow-Up Representative ILos Angeles, CARemote$18–$26 / hourTimely follow-up on hospital patient accounts that are outstanding for insurance payment, including but not limited to the following processes: verify claim payment status, rebill to patient's insurance, proration to correct financial class and notation of patient accounts with steps taken for resolution. As a wholly owned subsidiary of Constellation Software Inc. ("CSI", symbol CSU on the TSX), Harris has become the cornerstone for CSI's investment in utility, local government, school districts, public safety, and healthcare software verticals.
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.
Patient Navigator PRN Healogics IncPatient Navigator PRNCorona, CARequired Education, Experience and Credentials: High School Diploma or General Education Development (GED); Associate's degree preferred Minimum of Two (2) or more years office administration experience, preferably in a medical setting; Prior medical coding experience preferred Preferred Knowledge, Skills and Abilities: Proficient in Microsoft Office (Word, Excel, Outlook) Good customer, interpersonal and communication skills, both orally and in writing Organization and time-management skills Ability to type 60 words per minute (wpm) Basic math skills Attention to details Ability to maintain confidentiality Ability to work in fast paced environment and to work on multiple projects at the same time Ability to work with others and in a team environment Physical Demands: Being in a stationary position for extended periods of time (4 hours or more) Viewing computer screen for extended periods of time (4 hours or more) Keying frequently on a computer for 4 hours or more Reading Communicating Detecting sounds by ear Close, distance and peripheral vision Lifting/moving items up to 75 pounds with equipment assistance Repetitive motions Bending/stooping Writing Work Environment: * Patient care environment The hourly rate for this position generally ranges between $19.69-$24.20 Learn more about this role here: Healogics is the largest provider of advanced wound care services in the United States, treating more than 300,000 chronic wound patients annually across over 600 sites.
Claims Review Nurse NeueHealthClaims Review NurseLos Angeles, CABy uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid. Evaluate and process claims and post-service authorization requests for medical procedures, medications, and services based on clinical guidelines such as: Medicare criteria, Medicaid/Medi-Cal criteria, MCG, or Health Plan specific guidelines.
Payment Specialist I El Proyecto del Barrio IncPayment Specialist ICAEmployees driving personal vehicles for El Proyecto business must provide El Proyecto proof of a valid driving license, and auto liability insurance. To receive mileage reimbursement, the employee must log their mileage and submit the mileage expense report to their Appropriate Administrator.
Jr. Quality Improvement Coder Astiva Health, Inc.Jr. Quality Improvement CoderOrange, CAIn this role, the Junior QI Coder will partner with the Director to collaborate with network providers and IPA's to improve the quality of care through quality improvement activities that will include RAF, HEDIS, CMS Star Ratings and other health plan reporting. Apply official CPT/HCPCS and ICD10 coding guidelines, internal guidelines, and state specific Medicare/Medicaid coding instructions to review and analyze professionally coded services and coding queries.
Patient Care Coordinator Upperline HealthPatient Care CoordinatorOrange City, CaliforniaUpperline Health providers coordinate patients’ care among a team of physician specialists, nurse practitioners, care navigators, nutritionists, social workers, and pharmacists for integrated treatment that addresses patients’ immediate and long-term health needs. The Patient Care Coordinator will be responsible for medical front desk receptionist duties including greeting patients in a friendly manner, and ensuring patients are accurately checked in and prepared for their appointments in a timely manner.
Dental Office Manager Empower Dental GroupDental Office ManagerRancho Cucamonga, CAFull timeAs 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. Collaborate with dentists, hygienists, assistants, and front office staff for coordinated patient care.
Biller/Collector III HireTalentBiller/Collector IIIIrwindale, CAMaintains superior understanding of CPT/HCPCS codes, ICD-10 codes, CMS 1500 form guidelines, eligibility and coverage requirements, remit and remark codes, payor/plan codes, claims management, third-party payer guidelines, state and federal regulations, claims clearinghouse workflow, and all other pertinent functions of the job. % Assists staff in identifying high-risk accounts and prioritizing resolution efforts; Ensures staff is researching high dollar accounts, high volume denials, credits, adjustments, and undistributed balances, etc. in adherence to internal policies and procedures.
Payment Processing Specialist Skilled Wound CarePayment Processing SpecialistLos Angeles, CA$21–$26 / hourThe processor handles a variety of payment methods including credit cards, debit cards, checks, and electronic payments, while maintaining the highest level of patient confidentiality. The Medical Billing Payment Processor is responsible for accurately collecting, processing, and reconciling patient payments prior to and at the time of service.
NewLead, Clinical Validation Reviewer (RN) Molina Healthcare IncLead, Clinical Validation Reviewer (RN)CARequires a minimum of 3 years of experience in payment integrity medical claim review, including DRG validation, itemized bill review, clinical validation, or coding/reimbursement-focused claim review, and experience working with ICD-10, MS-DRG, AP-DRG and APR-DRG, CPT, HCPCS, revenue codes, and related coding, billing, and reimbursement guidelines; or any combination of education and experience which would provide an equivalent background. Performs advanced focused clinical reviews of claims to verify that coded diagnoses, procedures, revenue codes, billed charges, and corresponding reimbursement methodologies accurately reflect the patient's documented clinical condition, services rendered, and applicable coding, billing, payer policy, and regulatory requirements.
Senior Medical Billing Specialist – Multi-Specialty (PM&R Focus) HEALTH ATLAST WEST LASenior Medical Billing Specialist – Multi-Specialty (PM&R Focus)Los Angeles, CA$20–$28 / hourFull timeWe are hiring a seasoned Medical Billing Specialist with direct, hands-on experience billing PM&R-based services in an outpatient, multi-provider environment. Health Atlast is a high-volume, integrated, multi-disciplinary healthcare organization in West Los Angeles.
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.