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JobsJobs in CaliforniaJobs in Folsom, CAHealthcare Jobs in Folsom, CAMedical Billing and Coding JobsCoding Jobs in Folsom, CA
66 Results for

Coding Jobs in Folsom, CA

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    Jobs

    Jobot logo
    New

    Code Enforcement Attorney Jobot

    Code Enforcement Attorney
    Sacramento, CA
    • $140,000–$220,000 / year

    Information collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. This role focuses on representing cities, counties, special districts, and public agencies in complex public safety matters and civil and criminal prosecution.

    4 days ago
    New

    Family Med Physician Needed in Sacramento Agile Occupational Medicine

    Family Med Physician Needed in Sacramento
    West Sacramento, CA
    • $250,000–$300,000 / year

    The Staff Physician works with the Center Leadership Team at assigned Center, and under the direction of the Chief Medical Officer directs the Center's medical policies and programs ensuring the delivery of affordable, efficient, responsible, and accountable occupational healthcare of the highest quality to business, industry and patients in accordance with Agile’s policies, practices and procedures. Agile Occupational Medicine is a leading occupational medicine group with a network of 42 centers dedicated to providing comprehensive healthcare services to businesses and their employees across California and Yuma, Arizona.

    1 day ago

    Supervisor, Coding (Remote) Adventist Health System

    Supervisor, Coding (Remote)
    Roseville, CA
    Remote

    Monitors and assesses performance of coding staff to assure timely, accurate coding of inpatient discharges, ambulatory surgery encounters, emergency department, clinic encounters, and diagnostic services. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God''s love by inspiring health, wholeness and hope.

    18 days ago

    Acute Coding Quality Review Auditor (Remote) Adventist Health System

    Acute Coding Quality Review Auditor (Remote)
    Roseville, CA
    Remote

    Uses performance improvement analyses to improve the accuracy, integrity and quality of patient data, ensure minimal variation in coding practices, and improve the quality of physician documentation within the body of the medical record to support code assignments which results in appropriate reimbursement and data integrity. Essential Functions: Performs regularly scheduled quality reviews and audits per departmental policies and procedures (routine, pre-bill, policy driven, targeted, and post-bill) for hospital inpatient and/or outpatient coding.

    8 days ago
    New

    Certified Medical Coding Specialist Elica Health Centers

    Certified Medical Coding Specialist
    Sacramento, CA
    • $28–$35 / hour

    Our passion extends throughout Elica, from the exceptional healthcare services we provide to our underserved patients at our Community Health Clinics and state-of-the-art mobile medicine program, Health on Wheels, to our Resource Center where we empower patients and members of the community to connect with resources to help them build healthy and full lives. Language Skills (Preferred): Bilingual or multilingual communication skills in English and Russian, Farsi, Pashto/Pushto, Hmong or Spanish are preferred to support the needs of the communities we serve, where more than 50% of patients report a primary language other than English.

    1 day ago

    Epic Resolute Application Developer (Charge Router and Coding Skills) - 6260321 Accenture Plc

    Epic Resolute Application Developer (Charge Router and Coding Skills) - 6260321
    Sacramento, CA

    In addition to delivering innovative solutions for Accenture's clients, you will work with a highly skilled, diverse network of people across Accenture businesses who are using the latest emerging technologies to address today's biggest business challenges. Dropping orders using chart review-> creating new patient encounter -> dropping an order and signing the order/Unite charge entry ->creating new encounter.

    30+ days ago
    New

    Coding Instructor Code Ninjas

    Coding Instructor
    Elk Grove, CA

    We are looking for Code Sensei (Coding Instructor) for this coming Summer Camps schedule to join our team of dynamic, energetic, forward thinking minds, working toward our common goal: providing a fun and safe learning environment for children. Parents are thrilled as their children gain confidence and new skills including coding, math, logic, and problem-solving, as they progress from white to black belt.

    3 days ago

    Urgent Care - Partner Veterinarian - Sacramento , {State_Code Usvta

    Urgent Care - Partner Veterinarian - Sacramento , {State_Code
    Sacramento, California

    An exceptional veterinary hospital, with a dedicated team, is seeking an experienced Partner Veterinarian to provide leadership, superior patient and client care, and financial ownership in the hospital. The ideal leader for this hospital is a veterinarian who is prepared to manage a team of doctors and medical staff and successfully oversee the clinical direction of the practice while building equity.

    10 days ago

    Billing Medical Coder One Community Health

    Billing Medical Coder
    Sacramento, CA

    The Billing Medical Coder is responsible for the day-to-day coding and billing operations for all services billable under grants, federal, state, and county programs including Medicare, Medi-Cal, managed care and private insurances. Ensures that all diagnosis ICD10 codes and procedure CPT, HCPCS codes are identified, sequenced, and coded in an accurate and ethical manner for optimized reimbursement.

    30+ days ago

    Sr. Certified Coder, Cardiac/IVR Specialty Adventist Health System

    Sr. Certified Coder, Cardiac/IVR Specialty
    Roseville, CA

    Job Requirements: Education and Work Experience: High School Education/GED or equivalent: Required Two years experience if certified interventional radiology cardiovascular coder (CIRCC); otherwise, ten years experience: Required Experience in an acute care setting: Preferred Experience in cardiac and IVR coding: Required. Licenses/Certifications: Certified Coding Specialist (CCS): Required Certified Interventional Radiology Cardiovascular Coder (CIRCC) or earn certification within one year of hire: Required CIRCC-AAPC: Required.

    30+ days ago

    Sr. Cancer Center Specialty Certified Coder Adventist Health System

    Sr. Cancer Center Specialty Certified Coder
    Roseville, CA

    Job Requirements: Education and Work Experience: • High School Education/GED or equivalent: Required • Experience with RadOnc and MedOnc coding: Required • Experience in an acute care setting: Preferred • Experience with Varian, Aria, Mosaiq and Cerner Oncology programs: Preferred. Reviews and resolves medical necessity edits that may apply for any outpatient surgical encounters, applying hospital and professional modifiers to CPT codes and processes any errors associated with the revenue cycle process.

    30+ days ago

    Hospital Billing Coordinator Deloitte Touche Tohmatsu Ltd

    Hospital Billing Coordinator
    CA
    • $50,000–$60,000 / year

    Our purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.

    30+ days ago

    Revenue Cycle Manager Salma Health

    Revenue Cycle Manager
    Sacramento, California

    In addition to traditional revenue cycle management responsibilities, this position requires hands-on expertise in mental health billing as well as experience working on third-party insurance verification, prior authorization, and revenue cycle management tools and systems. We are the brain health company of the future, integrating care delivery, technology innovation, and research breakthroughs to better understand brain biology and diagnose, treat, and ultimately cure brain disorders across all stages of life.

    30+ days ago
    New

    Professional Fee Coder II (Remote) Stanford Health Care

    Professional Fee Coder II (Remote)
    Sacramento, CA
    Remote
    • $52.37–$58.98 / hour

    Works closely with departments to optimize reimbursement, ensure charge capture, reduce late charges and provide feedback to providers. The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training.

    2 days ago

    Hospital Billing Operator Deloitte Touche Tohmatsu Ltd

    Hospital Billing Operator
    CA
    • $70,000–$90,000 / year

    Our purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.

    25 days ago

    Medical Office Manager LuxeMdspa.com

    Medical Office Manager
    folsom, CA

    Join us as a Medical Office Manager, where you will play a pivotal role in ensuring smooth operations in our state-of-the-art facility in Folsom, CA. Our Clinic has been a leader in providing high quality medical care for the past 18 years.

    30+ days ago
    United Surgical Partners International Inc (USPI) logo

    Front Desk / Medical Records United Surgical Partners International Inc (USPI)

    Front Desk / Medical Records
    Citrus Heights, CA
    • $25–$27
    • Full time

    Must have a high school diploma or equivalent with two years of work experience in medical office, hospital or clinic office administration with experience in patient services, scheduling, billing, coding or related fields. Must demonstrate the desire and ability to work productively within a Team concept while utilizing exceptional interpersonal and communication skills to independently interact with physicians, patients, family members and all levels of staff.

    30+ days ago

    Biller I Health & Life Organisation Inc

    Biller I
    Sacramento, CA

    Process and send claims for CHDP, Medi-Cal, CPSP, HMO (Manage care), Medicare, Liberty, Healthnet, Access Dental and other funding sources. The Biller is to fix all errors such as missing CPT, CDT and ICD-9 codes, ICD-10, HCPCS and be in compliance with FQHC Billing.

    8 days ago
    Sutter Health logo
    New

    Compliance Analyst III - Delegation Oversight Sutter Health

    Compliance Analyst III - Delegation Oversight
    Sacramento, CA
    • $104,332.80–$156,499.20 / year

    Familiar with healthcare industry, including current trends, cultural concerns, and local/state/federal regulations, such as the CA Knox-Keene Act, California Insurance Code, Office of Inspector General (OIG) Work Plan, Affordable Care Act (ACA), and HIPAA regulations, in addition to federal and state reimbursement program requirements (e.g., Medicare and Medi-Cal). Key responsibilities include preparing and organizing audit documentation, supporting audit execution and follow-up activities, maintaining oversight trackers and dashboards, analyzing performance and compliance data, and identifying potential risks or gaps.

    3 days ago
    Sutter Health logo
    New

    Compliance Analyst III – Delegation Oversight Sutter Health

    Compliance Analyst III – Delegation Oversight
    Sacramento, California

    Familiar with healthcare industry, including current trends, cultural concerns, and local/state/federal regulations, such as the CA Knox-Keene Act, California Insurance Code, Office of Inspector General (OIG) Work Plan, Affordable Care Act (ACA), and HIPAA regulations, in addition to federal and state reimbursement program requirements (e.g., Medicare and Medi-Cal). Key responsibilities include preparing and organizing audit documentation, supporting audit execution and follow-up activities, maintaining oversight trackers and dashboards, analyzing performance and compliance data, and identifying potential risks or gaps.

    4 days ago
    New

    Sr. Certified Coder, Acute SDS-OBSV (Remote) Adventist Health

    Sr. Certified Coder, Acute SDS-OBSV (Remote)
    Roseville, CA
    Remote

    Job RequirementsEducation and Work Experience:High School Education/GED or equivalent: RequiredAssociate's/Technical Degree or equivalent combination of education/related experience: PreferredWorking knowledge of hospital Cerner EMR (electronic medical record): RequiredThree years' coding and health care experience: RequiredLicenses/CertificationsAHIMA Certified Coding Specialist (CCS): RequiredEssential FunctionsAbstracts and assigns ICD-10-CM diagnosis codes and CPT procedure codes from the SDS and OBV patient record to ensure accurate APC assignment and to provide information required for reimbursement and statistical data submissions. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.#J-18808-Ljbffr.

    2 days ago

    Primary Care Physician Assistant WellSpace Health Inc

    Primary Care Physician Assistant
    Sacramento, CA
    • $162,800–$211,640 / year

    As the region's largest Community Health System, WellSpace utilizes a Confluence Model to integrate an internal network of healthcare modalities, including Federally Qualified Health Centers (FQHC), Certified Community Behavioral Health Center (CCBHC), Drug Medi-Cal and Specialty Mental Health programs, California's second largest 988 Suicide and Crisis Lifeline Center, an independent Risk Bearing Organization (WellSpace Nexus), and more into a seamless confluence of care. Current Drug Enforcement Administration Registration Current BLS certifications Commitment to a community health philosophy Ability to communicate effectively and work with individuals from a wide variety of ethnic and socio-economic backgrounds and sensitivity to their health problems Able to communicate effectively both verbally and in writing Excellent interpersonal skills and customer service Basic computer knowledge and experience with electronic medical records Must be willing to successfully complete the credentialing process.

    30+ days ago

    Clinical Documentation Integrity Specialist (Roseville) Adventist Health System

    Clinical Documentation Integrity Specialist (Roseville)
    Roseville, CA

    Working under the direction of quality leader, this role reviews patient records, recommends provider queries using established templates, and helps ensure documentation supports appropriate coding. Job Requirements: Education and Work Experience: Associate''s/Technical Degree in Nursing, Health Information Management, or related clinical field or equivalent combination of education/related experience: Required.

    30+ days ago

    Billing Follow Up Associate Adventist Health System

    Billing Follow Up Associate
    Roseville, CA

    Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God''s love by inspiring health, wholeness and hope. Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities.

    30+ days ago
    CorVel Corp logo

    Bill Review Analyst I CorVel Corp

    Bill Review Analyst I
    Folsom, CA
    • $13.38–$23.42 / hour

    Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. ABOUT CORVEL: CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries.

    30+ days ago

    Sr. Certified Coder, Acute SDS-OBSV (Remote) Adventist Health System

    Sr. Certified Coder, Acute SDS-OBSV (Remote)
    Roseville, CA
    Remote

    Essential Functions: Abstracts and assigns ICD-10-CM diagnosis codes and CPT procedure codes from the SDS and OBV patient record to ensure accurate APC assignment and to provide information required for reimbursement and statistical data submissions. Attends meetings and training pertaining to coder education, audit reviews, staff meetings, outpatient coder roundtable meetings, and SDC to OBV charges.

    22 days ago
    New

    Sr. Certified Coder, Acute Inpatient (Remote) Adventist Health System

    Sr. Certified Coder, Acute Inpatient (Remote)
    Roseville, CA
    Remote

    Essential Functions: Abstracts and assigns ICD-10-CM diagnosis codes and PCS codes from the inpatient patient record to ensure accurate MS-DRG and APR-DRG assignment and to provide information required for reimbursement and statistical data submissions. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God''s love by inspiring health, wholeness and hope.

    1 day ago

    Billing Specialist - Dental Image Specialty Partners

    Billing Specialist - Dental
    West Sacramento, CA

    Propelled by our core values of Integrity, Efficiency, Teamwork, and Going Above and Beyond, we are committed to excellence in every facet of our work: providing the best experience for our patients and cultivating a workplace where everybody thrives together. Image Specialty Partner (ISP) is a doctor-led dental partnership organization where we believe that a healthy, beautiful smile is more than just an aesthetic feature – it is a catalyst for confidence and self-esteem.

    11 days ago

    Billing and Accounts Receivable Manager Deloitte Touche Tohmatsu Ltd

    Billing and Accounts Receivable Manager
    CA
    Remote
    • $140,000–$160,000 / year

    As an Epic Billing and Accounts Receivable Manager you will help deliver back-end revenue cycle management (RCM) services, including billing and claims submission, A/R follow-up, denials management, payment posting, and credits and refunds, for health care provider client. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.

    30+ days ago
    Blue Cross and Blue Shield Association logo

    Care Management - Nurse, Senior (CA Children''s Services) Blue Cross and Blue Shield Association

    Care Management - Nurse, Senior (CA Children''s Services)
    El Dorado Hills, CA

    In 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.

    23 days ago

    2026-27 AY Lecturer Pool - Doctor of Audiology Program CSU Careers

    2026-27 AY Lecturer Pool - Doctor of Audiology Program
    Sacramento, California

    As the regional hub of higher education, Sacramento State is dedicated to learning and student success ; teaching, research, scholarship and creative activity ; justice, diversity, equity and inclusion ; resource development and sustainability ; dedicated community engagement , and wellness and safety . Hires from the pool of applicants are made when there are instructional needs to fill coursework offered by an academic department based on changing enrollment patterns, changes to tenure-track faculty assignments, and other factors that cannot be addressed with our existing faculty.

    30+ days ago

    2026-27 AY Lecturer Pool - Doctor of Audiology Program Sacramento State

    2026-27 AY Lecturer Pool - Doctor of Audiology Program
    Sacramento, California

    As the regional hub of higher education, Sacramento State is dedicated to learning and student success ; teaching, research, scholarship and creative activity ; justice, diversity, equity and inclusion ; resource development and sustainability ; dedicated community engagement , and wellness and safety . Hires from the pool of applicants are made when there are instructional needs to fill coursework offered by an academic department based on changing enrollment patterns, changes to tenure-track faculty assignments, and other factors that cannot be addressed with our existing faculty.

    30+ days ago
    PricewaterhouseCoopers LLP logo

    Applied AI Health Data System Engineer-Senior Manager PricewaterhouseCoopers LLP

    Applied AI Health Data System Engineer-Senior Manager
    CA
    • $124,000–$280,000 / year

    Managing development teams in building healthcare AI and GenAI solutions, including analytical modeling, prompt engineering, Python-based development, testing, communication of results to clinical and operational stakeholders, front-end and back-end integration, and iterative use case development with health system clients; Documenting and analyzing healthcare business processes - across clinical operations, and population health programs - to identify AI and GenAI opportunities, gather requirements, define initial hypotheses, and develop solution approaches tailored to health system workflows; Collaborating with health system client teams - including clinical informatics, population health, and IT leaders - to understand their business and clinical problems and select the appropriate models, LLMs, and approaches for AI/GenAI use cases; Designing and solutioning AI/GenAI architectures for health system clients, including RAG-based clinical knowledge retrieval systems, agentic AI workflows for care management and revenue cycle automation, and custom LLM application builds with appropriate PHI safeguards; Managing teams to process healthcare unstructured and structured data - including clinical notes, discharge summaries, claims records, EHR data, and ADT feeds - for use as LLM context, including embedding of large clinical text corpora, generative SQL query development, and building connectors to EHR back-end databases; Managing daily operations of a global healthcare data science team on client engagements, reviewing developed models, providing feedback, and assisting in analysis of clinical and operational outcomes; Directing data engineers and other data scientists to deliver efficient, HIPAA-compliant solutions that meet health system client requirements for clinical, financial, and operational AI use cases; Leading and contributing to development of proof of concepts, pilots, and production use cases for health system clients - spanning clinical decision support, prior authorization automation, patient risk scoring, workforce optimization, and throughput modeling - while working in cross-functional teams; Facilitating and conducting executive-level presentations to health system leadership showcasing GenAI and ML solution capabilities, use case development progress, model performance, and recommended next steps; Structuring, writing, communicating, and facilitating client presentations that translate complex AI and ML concepts into clear clinical and business value narratives for health system audiences; and, Managing associates and senior associates through coaching, providing feedback, and guiding work performance, with an emphasis on developing healthcare domain knowledge alongside technical AI and ML capabilities. You will architect and build production-grade RAG pipelines, MCP connections, agentic AI workflows, and MLOps frameworks, managing daily operations across global delivery teams while engaging health system leaders at the executive level to ensure measurable clinical and operational impact.

    30+ days ago

    2026-27 AY Lecturer Pool - Doctor of Audiology Program California State University

    2026-27 AY Lecturer Pool - Doctor of Audiology Program
    Sacramento, CA
    • $5,507–$6,677

    APPLICANT INSTRUCTIONS: New applicants are required to submit: Cover letter that includes: Diversity and inclusion statement that describes how your past experiences, current interests and activities, and/or future goals promote work, classroom, and clinical environments that value inclusion. As the regional hub of higher education, Sacramento State is dedicated to learning and student success; teaching, research, scholarship and creative activity; justice, diversity, equity and inclusion; resource development and sustainability; dedicated community engagement, and wellness and safety.

    30+ days ago

    Associate Medical Director, Pediatrics Elica Health Centers

    Associate Medical Director, Pediatrics
    Sacramento, CA

    Our passion extends throughout Elica, from the exceptional healthcare services we provide to our underserved patients at our Community Health Clinics and state-of-the-art mobile medicine program: Health on Wheels, to our Resource Center where we empower patients and members of the community to connect with resources to help them build healthy and full lives. degree from an U.S. accredited medical school, school of osteopathy medicine, or FMG with ECFMG or Fifth pathway certification, with completion of a U.S. accredited residency program in Pediatrics, OR • Completion of an accredited Nurse Practitioner or Physician Assistant program.

    30+ days ago
    Vertex Pharmaceuticals Inc logo

    Field Reimbursement Manager - Kidney (Northern California - San Francisco, San Jose, Sacramento) Vertex Pharmaceuticals Inc

    Field Reimbursement Manager - Kidney (Northern California - San Francisco, San Jose, Sacramento)
    Sacramento, CA
    • $136,000–$204,000 / year

    Key Duties and Responsibilities: Compliantly establish strong connections with key nephrology office personnel, including members of the care team and administrative staff responsible for prior authorizations and patient access to specialty medications, to support patient access to prescribed medications. At Vertex, our Total Rewards offerings also include inclusive market-leading benefits to meet our employees wherever they are in their career, financial, family and wellbeing journey while providing flexibility and resources to support their growth and aspirations.

    30+ days ago
    New

    Billing Follow Up Associate-Roseville-CA-18579-Pay Negotiable Talented Medical Solutions

    Billing Follow Up Associate-Roseville-CA-18579-Pay Negotiable
    Roseville, CA
    • $37–$42

    We are seeking a detail-oriented Medical Billing Specialist to process medical claims, manage billing and collections, and ensure accurate reimbursement from insurance companies, government agencies, and third-party payers. The ideal candidate will review claims, resolve payment issues, maintain billing records, and collaborate with internal departments to support efficient revenue cycle operations.

    4 days ago

    Sr. Patient Account Associate Adventist Health System

    Sr. Patient Account Associate
    Roseville, CA

    Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God''s love by inspiring health, wholeness and hope. Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities.

    30+ days ago

    Business Office Coordinator (Temporary) Shingle Springs Band of Miwok Indians

    Business Office Coordinator (Temporary)
    CA

    When two (2) or more Native American candidates have comparable qualifications, the following order of preference shall apply: (1) Members of Shingle Springs Band of Miwok Indians; (2) Spouses or domestic partners (certified through Tribal Court) of members of Shingle Springs Band of Miwok Indians; (3) Parents of children of the Shingle Springs Band of Miwok Indians; (4) All other documented Native Americans; (5) All other applicants in accordance with Title 25, U.S. Code, Section 472 and 473. Under the general guidance of the Shingle Springs Tribal Health Program Executive Director and the direct supervision of the Health Systems Administrator, the incumbent shall be responsible for transmitting all business office correspondence between the clinic and the billing company, assisting with credentialing and processing patient payments.

    11 days ago
    Sutter Health logo

    Clinical Trial Coverage Analyst Sutter Health

    Clinical Trial Coverage Analyst
    Sacramento, CA
    • $94,848–$142,272 / year

    Supporting Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) billing determinations of clinical trial items and services and applying all applicable local coverage decisions, national and local coverage determinations, and third-party payer rules for clinical trial coverage analyses. Determining and documenting billing support for clinical items by reviewing the protocol, investigator brochures, sponsor budget, sponsor proposed contract, and consent template, the evidence of medical necessity justifications, and appropriate payers of protocol-specific services and federally required research-related claims modifications for service payment by insurance.

    30+ days ago
    Blue Cross and Blue Shield Association logo

    Utilization Management Nurse, Senior- Medicare Concurrent Review Blue Cross and Blue Shield Association

    Utilization Management Nurse, Senior- Medicare Concurrent Review
    Rancho Cordova, CA

    Requires 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.

    30+ days ago
    Blue Cross and Blue Shield Association logo

    Business Analyst, Consultant Blue Cross and Blue Shield Association

    Business Analyst, Consultant
    Rancho Cordova, CA

    In 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.

    30+ days ago
    Blue Cross and Blue Shield Association logo
    New

    Utilization Management Nurse, Senior Blue Cross and Blue Shield Association

    Utilization Management Nurse, Senior
    Rancho Cordova, CA

    The 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.

    4 days ago
    Sutter Health logo

    Physician Advisor - Utilization Management Sutter Health

    Physician Advisor - Utilization Management
    Sacramento, CA
    • $118,320.80–$189,321.60 / year

    JOB ACCOUNTABILITIES: Support Central Care Management Operations: Provides PA support and clinical oversight to all programs managed through Care Management Operations: Clinical Denials and Appeals, Recovery Audit Contractor (RAC), Medicare Two Midnight Rule review, Concurrent denials review and processing, Peer to Peer discussion with payers, and Inpatient authorization clinical escalations. The PA will develop expertise on matters regarding physician practice patterns, over- and under-utilization of resources, medical necessity, documentation best practices, level of care progression, denial management and compliance with governmental regulations and conditions of participation and commercial insurance contracts.

    29 days ago

    Orthotic Fitter Pacific Medical Inc.

    Orthotic Fitter
    Roseville, CA
    • Full time

    Vacation Benefit: At completion of 3-month introductory period, vacation accrual up to an annual max of 40 hours in the first 23 months, at 24 months, accrual up to an annual max of 80 hours with a rollover balance. Pacific Medical, Inc. was established in 1986 and is a leading distributor for durable medical equipment prosthetics/orthotics, and surgical instruments servicing the seven western states.

    19 days ago

    LVN - SNF Quality & Clinical Operations Community Health Centers of America

    LVN - SNF Quality & Clinical Operations
    Fair Oaks, CA

    Perform delegated clinical services within the LVN scope of practice as assigned, which may include reading tuberculosis (TB) skin tests, performing bone density scans, obtaining basic clinical measurements, or assisting with other preventive health and quality initiatives. The LVN acts as a liaison between CHCA providers, facility staff, and internal departments to identify and resolve clinical and operational issues, ensure accurate and complete documentation, support quality improvement initiatives, and facilitate coordination of care.

    12 days ago

    Optometrist (Heritage Valley Eye Care) - Santa Paula, CA VSP Vision

    Optometrist (Heritage Valley Eye Care) - Santa Paula, CA
    Rancho Cordova, California

    In addition, residents and visitors can explore the area’s most iconic attractions, including the California Oil Museum, the Santa Paula Theater Center, the Floating Granite Ball, and the Aviation Museum of Santa Paula. Committed to preserving vision for life, Heritage Valley Eye Care utilizes cutting-edge technology to manage conditions such as glaucoma, cataracts and macular degeneration, and hypertension and diabetes with greater precision.

    30+ days ago

    Optometrist (Nostalgic Eye Care) - Philadelphia, PA VSP Vision

    Optometrist (Nostalgic Eye Care) - Philadelphia, PA
    Rancho Cordova, California

    Established in 2017, Nostalgic Eye Care provides comprehensive, patient-focused vision care to the community, utilizing advanced technology to deliver the highest quality treatment and management of ocular conditions. As a regular part of doing business, VSP Vision (“VSP”) collects many different types of personal information, including protected health information, about our audiences, including members, doctors, clients, brokers, business partners, and employees.

    30+ days ago

    Part-Time Optometrist (Laguna Eyes Optometry) - Laguna Beach, CA VSP Vision

    Part-Time Optometrist (Laguna Eyes Optometry) - Laguna Beach, CA
    Rancho Cordova, California

    Ensuring individualized and personalized care to every patient, you’ll do a complete eye health evaluation which will include diagnosing disease, promoting premium eyewear products based on the patients needs, completing the documentation and properly coding your charts, and ensuring specialty contact lenses are order to your specification. Laguna Eyes Optometry has state-of-the-art technology that includes Optovue Solix OCT, Myopia Master, Medmont Pro topographer, Optos Daytona and many others, which provides a thorough comprehensive evaluation for our patients.

    30+ days ago
    New

    Remote Outpatient Coder - ED/Injections & CPT/E/M Expert Datavant

    Remote Outpatient Coder - ED/Injections & CPT/E/M Expert
    Sacramento, CA
    Remote

    Datavant is looking for experienced outpatient coders to join their team fully remotely. Successful candidates will possess high attention to detail and medical terminology knowledge.

    2 days ago
    12

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