Senior Revenue Integrity Specialist - Clinical Rev Integrity - Full Time 8 Hour Days (REMOTE) (Exempt) (Non-Union) University of Southern CaliforniaSenior Revenue Integrity Specialist - Clinical Rev Integrity - Full Time 8 Hour Days (REMOTE) (Exempt) (Non-Union)Alhambra, CaliforniaRemoteThe Senior RI Specialist also coordinates with Keck Medical Center of USC Administration, IS, Compliance, Clinical Informatics and Integration personnel on technology projects impacting charge entry, charge dictionaries, and charge, and provides data derived from multiple entities of Keck Medical Center of USC for the management and support of critical decisions and functions related the Chargemaster, CDM Maintenance, and the improvement of charge capture. As a subject matter expert in the area of compliance and pricing of services, the Senior RI Specialist responds to inquiries regarding Chargemaster issues and is responsible for supervising meetings for projects associated with educating and communicating to clinical revenue generating departmental staff regarding the CDM Maintenance process, coding updates, compliance issues, and charge capture improvement.
HCC 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.
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.
Medical Coder - Remote YO AI LabsMedical Coder - RemoteLos Angeles, CARemoteWe are seeking experienced Medical Coders to contribute their healthcare coding expertise to an innovative project focused on improving next-generation AI systems. In this role, you will review and annotate medical records, evaluate coding accuracy, and provide expert feedback to support the development of high-quality medical datasets.
Advisor, Managed Care, Revenue Cycle Management System Administration Cardinal Health IncAdvisor, Managed Care, Revenue Cycle Management System AdministrationCA$80,900–$92,400 / yearManaged Care oversees the interactions that take place between payer and provider(s) to ensure optimal reimbursement including managed care contracting, enrollment, credentialing, and any other activity as it relates to payer interaction. Continuously evaluate revenue cycle system performance and business processes, utilizing analytics and stakeholder feedback to identify opportunities for workflow optimization, operational efficiencies, enhanced data integrity, and improved financial outcomes.
Medical Collections Specialist Marquee StaffingMedical Collections SpecialistNewport Beach, CAWe are seeking an experienced Medical Collections Specialist to process and follow up on physician claims from various payer types (HMO, PPO, Medi-Cal, Medicare, etc.) to ensure timely payment for services rendered. Duties: Review and analyze medical documentation and patient records for accurate and timely billing entry; assign or reassign appropriate medical codes (ICD-10, CPT, HCPC) for diagnoses, procedures, and services rendered.
NewSr. Denials & Appeals Specialist Baylor Miraca Genetics Laboratories LLCSr. Denials & Appeals SpecialistCAAny resumes submitted to Baylor Genetics in the absence of an Agreement executed by Baylor Genetics authorized signatory will be considered the property of Baylor Genetics, and Baylor Genetics will not be obligated to pay any associated recruitment fees. While we occasionally partner with select recruitment agencies for specialized roles, we do not accept unsolicited resumes from recruiters or agencies without a written agreement executed by the authorized signatory for Baylor Genetics ("Agreement").
Insurance Verification Specialist - Biller DME - Remote J & B Medical Supply Co IncInsurance Verification Specialist - Biller DME - RemoteCARemote$17–$19 / hourSetting and completing all aspects of an account for incontinence, diabetes, Insulin pump, CGM, urological, ostomy, wound care, blood pressure monitors, and enteral supplies for J&B Medical members. Required Education and Experience: 2+ years of experience in a Medical Billing role requiring patient insurance verification and account setup.
NewMedical Assistant (MA) Wellness Visit PIH HealthMedical Assistant (MA) Wellness VisitCerritos, CA$23–$33.12Full timeThe fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The WVMA reviews preventive care needs and quality care gaps using approved protocols, obtain and documented patient-reported medications and medical histories, documents findings in the electronic health record (EHR), and prepares patients for the second portion of the visit, which is completed in person by a Nurse Practitioner.
Inpatient Medical Coder PRN - Up to $1k Sign-on Bonus Datavant LLCInpatient Medical Coder PRN - Up to $1k Sign-on BonusCARemote$32–$42 / hourGuided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. What Helps You Stand Out: Associate or Bachelor''s degree from an AHIMA-certified HIM or Nursing Program, or completion of a certificate program from AHIMA/AAPC with a preference for CCS.
Revenue Cycle Management Advantage Healthcare ServicesRevenue Cycle ManagementHuntington Beach, CAYou will also assist in developing training programs for staff, identifying opportunities for automation and workflow improvement, and partnering with clinical and operations leaders to resolve complex payer or billing issues affecting patient access to care. Success in this role will be demonstrated by measurable improvements in prior authorization turnaround time, first-pass claim acceptance rates, denial reduction, and staff productivity – along with a well-trained, engaged team capable of scaling with the organization’s growth.
Senior Financial Healthcare Analyst - Healthcare Reporting (Hybrid) Cedars-Sinai Medical CenterSenior Financial Healthcare Analyst - Healthcare Reporting (Hybrid)Los Angeles, CAResponsibilities include, but are not limited to, accessing data through a variety of databases and the creation of accurate, meaningful and relevant reports for diverse audiences; assisting with the administration and implementation financial initiatives; assisting in the interpretation of policies/procedures/practices. Reviews, analyzes, and reports on healthcare contracts (e.g., physician agreements, payer contracts) to assess financial performance, revenue generation, and profitability.
Director, Field Reimbursement HistoSonics IncDirector, Field ReimbursementCARemote5+ years of field reimbursement management experience, including experience with hospital medical device capital equipment, Category III CPT codes, revenue cycle management, physician payment, Medicare and private payer payment models, hospital billing, and coding systems (including chargemaster, payer contracting, and revenue cycle management). In addition to its current liver tumor indication, HistoSonics is pursuing future indications across multiple applications including kidney, pancreas, prostate, neuro, women's health, and other significant underserved human health areas, to realize the broader potential histotripsy across multiple disease states and medical specialties.
Government Audit Recovery Specialist IMCS Group IncGovernment Audit Recovery SpecialistCosta Mesa, CAAs an essential role and focal point of all government audit activity, the Government Recovery Specialist is responsible for responding to correspondence from Government Agencies related to Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Targeted Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), Quality Improvement Organizations (QIO) and other Medicaid, Medi-Cal regulatory auditing body for pre and post payment audits. As an essential role and focal point of all government audit activity, the Government Recovery Specialist is responsible for responding to correspondence from Government Agencies related to Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Targeted Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), Quality Improvement Organizations (QIO) and other Medicaid, Medi-Cal regulatory auditing body for pre and post payment audits.
Revenue Cycle Specialist II (Physician Billing) Cedars-Sinai Medical CenterRevenue Cycle Specialist II (Physician Billing)Los Angeles, CAUnder general supervision and following established practices, policies, and guidelines, provides Commercial and Government billing and collections support to Insurance Follow up and Accounts Receivable, performing duties which may include reviewing and submitting multi-specialty claims to third party payors, performing account follow-up activities, updating patient registration on accounts, etc. Cedars-Sinai was awarded the National Research Corporation's Consumer Choice Award 19 times for providing the highest-quality medical care in Los Angeles.
Licensed Practical Nurse/Medical Home Coordiantor TriHealth IncLicensed Practical Nurse/Medical Home CoordiantorCAJob Overview: This position provides both direct and indirect patient care in a primary care office and works with care delivery providers to identify gaps in care, contacts patients to schedule required care, and provides referral follow up. Documents all aspects of care accurately, including clinical calls, rooming questions, procedures, orders, prescriptions, pharmacy coordination, and workflow tasks; manages MyChart and patient messages in a timely manner.
Medical Assistant - Women''s Center TriHealth IncMedical Assistant - Women''s CenterCAProvides accurate/complete documentation of clinical calls and patient rooming info as well as order entry, pending prescriptions, noting current pharmacy, and enter edit workflows to result orders. Job Overview: This position provides both direct patient care in a primary care office and works with care delivery providers to identify gaps in care, contacts patients to schedule required care, and provides referral follow up.
Revenue Cycle Supervisor Orthopaedic Institute for ChildrenRevenue Cycle SupervisorLos Angeles, California$113,000–$149,000Position Summary: The Revenue Cycle Supervisor is responsible for overseeing daily operations across key revenue cycle functions, including billing, collections, charge capture, and denial management for an orthopedic outpatient environment. Physical Requirements: Intermittent (25-35% of the time) walking, standing, bending, sitting and verbally communicating with patients and other OIC healthcare team members.
Account Advisor I - Call Center Blue Cross and Blue Shield AssociationAccount Advisor I - Call CenterLos Angeles, CARemotePursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner. Reviews and researches billing and healthcare claim inquiries from members and providers, to ensure proper benefits and/or payments are applied correctly; researches multiple computer systems/applications to verify data/information accuracy.
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.