Coding Compliance Auditor - Coding Services - Full Time 8 Hour Days (Non-Exempt) (Non-Union) University of Southern CaliforniaCoding Compliance Auditor - Coding Services - Full Time 8 Hour Days (Non-Exempt) (Non-Union)Los Angeles, CA$33–$54.02 / hourIn accordance with current federal coding compliance regulations and guidelines, the Coding Compliance Auditor performs 2nd level review of previously coded accounts to ensure appropriate CPT, ICD-10-CM, and HCPCS assignments - and accuracy and completeness of all ICD-10-CM, CPT, and HCPCS codes assigned by professional revenue coders and providers. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.
Home Health Quality Assuranc / Coding Specialist Green Meadows Home Health Care IncHome Health Quality Assuranc / Coding SpecialistSanta Ana, CAFull timeThe Home Health Quality Assurance (QA) / Coding Specialist is responsible for reviewing clinical documentation to ensure compliance with Medicare Conditions of Participation (CoPs), state and federal regulations, and agency policies. This position performs ICD-10 coding, OASIS review, chart audits, and quality assurance activities to support accurate reimbursement, regulatory compliance, and high-quality patient care.
DRG Coding Auditor - MS-DRG and APR-DRG Elevance Health IncDRG Coding Auditor - MS-DRG and APR-DRGCosta Mesa, CA$92,880–$160,218 / yearRequires at least one of the following certifications: RHIA certification as a Registered Health Information Administrator, RHIT certification as a Registered Health Information Technician, CCS as a Cert Coding Specialist, CIC as a Certified Inpatient Coder, or Certified Clinical Documentation Specialist (CCDS). Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred.
DRG Coding Auditor - Ms-Drg And Apr-Drg Elevance HealthDRG Coding Auditor - Ms-Drg And Apr-DrgCosta Mesa, CA$92,880–$160,218 / yearRequires at least one of the following certifications: RHIA certification as a Registered Health Information Administrator, RHIT certification as a Registered Health Information Technician, CCS as a Cert Coding Specialist, CIC as a Certified Inpatient Coder, or Certified Clinical Documentation Specialist (CCDS). Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred.
Risk Adjustment Documentation & Coding Educator (CRC Required) Privia Health Group, IncRisk Adjustment Documentation & Coding Educator (CRC Required)CA$70,000–$85,000 / yearThe Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers. Ensure all audited charts meet CMS documentation requirements (e.g., MEAT criteria: Monitor, Evaluate, Assess, Treat) and ensuring data integrity, regulatory compliance, and optimal risk score accuracy through rigorous medical record auditing.
Coding Compliance Audit & Education Specialist Privia Health Group, IncCoding Compliance Audit & Education SpecialistCA$70,000–$80,000 / yearThe Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers. Technical Requirements (for remote workers only, not applicable for onsite/in office work): In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed.
Risk Adjustment Coding Specialist II - Orange County Astrana Health, Inc.Risk Adjustment Coding Specialist II - Orange CountyOrange, California$70,000–$85,000 / yearPerform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines. Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements.
Coding Auditor & Educator Welbe Health LLCCoding Auditor & EducatorCA$70,304–$89,535.30 / yearAt the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Oversee audits and participate in provider education programs to ensure compliance with CMS risk adjustments diagnosis coding guidelines.
Investigator, Special Investigative Unit Coding (Remote) Molina Healthcare IncInvestigator, Special Investigative Unit Coding (Remote)CARemoteWorking knowledge of local, state and federal laws and regulations pertaining to health insurance, investigations and legal processes (commercial insurance, Medicare, Medicare Advantage, Medicare Part D, Medicaid, Tricare, Pharmacy, etc.). In some states, 5 years of experience working in a fraud, waste and abuse (FWA)/special investigations unit (SIU)/fraud investigations role may be required (dependent on state/contractual requirements).
Profee Coding Consultant - PRN Datavant LLCProfee Coding Consultant - PRNCA$20–$28 / 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. Collaborating closely with key stakeholders such as clients and healthcare leaders, you'll meet and exceed customer expectations through identifying and proposing solutions, and being a responsible and reliable teammate.
Revenue Integrity & Coding Supervisor AltaMed Health Services CorpRevenue Integrity & Coding SupervisorCommerce, CA$70,903.04–$88,628.80 / yearLeveraging a strong background in Health Information Management or Healthcare Administration, the supervisor optimizes Epic's native revenue cycle modules, ensures Charge Description Master (CDM) accuracy, and secures optimal, compliant clean claim rates. The Revenue Integrity & Coding Supervisor (Epic & FQHC) leads the day-to-day operations of the healthcare revenue cycle and medical coding teams to eliminate revenue leakage and maintain compliance.
Professional Fee Coding Educator Community Health Systems IncProfessional Fee Coding EducatorCAConducts training sessions, seminars, and educational meetings for CHS-affiliated providers and staff, including the PPS Physician Coding and Documentation Seminar. The Physician Education Specialist provides training and education to CHS-affiliated providers and staff on accurate coding and documentation to ensure compliance with federal, state, and local laws.
Outpatient Coding Consultant - Remote Datavant LLCOutpatient Coding Consultant - RemoteCARemoteGuided 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. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health.
Profee Coding Consultant - Full Time Datavant LLCProfee Coding Consultant - Full TimeCA$20–$28 / 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. Collaborating closely with key stakeholders such as clients and healthcare leaders, you'll meet and exceed customer expectations through identifying and proposing solutions, and being a responsible and reliable teammate.
NewSr Mgr, Compliance, Medical Coding Kaiser PermanenteSr Mgr, Compliance, Medical CodingPasadena, CAManages designated units by translating business plans into tactical action items; communicating goals and objectives; ensuring all policies and procedures are followed; overseeing the completion of work assignments; assuming responsibility for decision making; aligning team efforts; building accountability for and measuring progress in achieving results; incorporating resources, costs, and forecasts into unit plans; removing obstacles that impact performance; guiding performance and developing contingency plans accordingly; partnering with key stakeholders and business leaders to ensure products and/or services meet requirements and expectations while aligning with departmental strategies; and influencing units to operate in alignment with business objectives. Essential Responsibilities: Pursues professional growth and provides developmental opportunities for others by soliciting and acting on performance feedback; building collaborative, cross-functional relationships; hiring, training, and developing talent for growth opportunities; delegating tasks and decisions; fostering open dialogue amongst departments; strategically evaluating talent for succession planning; setting performance management guidelines and expectations across units; and working closely with employees to set goals and provide open feedback and coaching to drive performance improvement.
NewCompliance Consultant V, Medical Coding Kaiser PermanenteCompliance Consultant V, Medical CodingPasadena, CAManages projects or compliance components of larger cross-functional projects by identifying and managing stakeholder contacts; assembling teams based on project needs and team member strengths; developing, analyzing, and managing project plans; negotiating and managing project schedules and resource forecasts; and managing project financials and deliverables. Job Summary: In addition to the responsibilities listed below, the position is responsible for serving as a compliance subject matter expert related to functions within all settings of care, maintaining compliance with national coding policies and procedures, assisting with coding questions and related topics, and auditing and monitoring the quality of coding assignments across all lines of business.
NewCompliance Consultant IV, Medical Coding Kaiser PermanenteCompliance Consultant IV, Medical CodingPasadena, CACompletes work assignments and supports business-specific projects by applying expertise in subject area; supporting the development of work plans to meet business priorities and deadlines; ensuring team follows all procedures and policies; coordinating resources to accomplish priorities and deadlines; collaborating cross-functionally to make effective business decisions; solving complex problems; escalating high priority issues or risks as appropriate; and recognizing and capitalizing on improvement opportunities. Assists with and supports the management of projects or compliance components of larger cross-functional projects by coordinating stakeholder contacts; recommending team resources based on project needs and team member strengths; assisting in the development, analysis, and management of project plans; and coordinating project schedules and resource forecasts.
Payer Coding Ops Hourly Datavant LLCPayer Coding Ops HourlyCA$25–$26 / 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. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health.
Senior Coding Auditor Montefiore Medical CenterSenior Coding AuditorLos Angeles, CA$76,632.04–$95,790.05 / yearThe Senior Coding Auditor reviews and audits current and retro accounts, and reports audit outcomes regarding charge errors, percentage of savings or losses for the facility, data processing errors, the performance of the hospital charging system as well as documentation and justification within the medical record and itemized bill. The Senior Coding Auditor performs detailed audits of medical cases to ensure accuracy of assigned codes, charges, availability of documented medical records, medical accounts and compares the cases with the itemized bill and overall procedures.
Home Health Quality Assuranc / Coding Specialist CbHome Health Quality Assuranc / Coding SpecialistSanta Ana, CaliforniaThe Home Health Quality Assurance (QA) / Coding Specialist is responsible for reviewing clinical documentation to ensure compliance with Medicare Conditions of Participation (CoPs), state and federal regulations, and agency policies. This position performs ICD-10 coding, OASIS review, chart audits, and quality assurance activities to support accurate reimbursement, regulatory compliance, and high-quality patient care.