Senior Lead Engineer, Code Generation MongoDB IncSenior Lead Engineer, Code GenerationCAA core difficulty in legacy code transformation is guaranteeing the equivalence of the new applications business logic, ensuring it operates smoothly and efficiently with the new MongoDB data ecosystems in a reliable and scalable manner. The Application Modernization Platform (AMP) team is tackling one of the industrys most critical challenges: leveraging Generative AI to transform rigid, legacy applications into modern, microservices-based architectures powered by MongoDB.
Director, Test Code Product & Lifecycle IQVIADirector, Test Code Product & LifecycleValencia, CaliforniaIQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. Knowledge of database administration activities including denormalization, data archival schemes, sizing, data definition language and database objects.
Analyst, Legal & Compliance (Code of Ethics) Wilshire Advisors, LLCAnalyst, Legal & Compliance (Code of Ethics)Santa Monica, CA$31–$40 / hourWilshire advises on over $1 trillion in assets for some of the world's largest and most sophisticated institutional investors and is headquartered in the United States with offices worldwide. Responsibilities: Serve as the primary point of contact for all employee compliance matters, ensuring strict adherence to regulatory requirements and Wilshire's Code of Ethics and Compliance Manual.
NewSenior BESS Safety Engineer: Codes & Permits AESSenior BESS Safety Engineer: Codes & PermitsLong Beach, CA$113,000–$141,525 / yearThe ideal candidate will possess a Bachelor's degree in a relevant field, with 5-7 years of experience in mechanical design and fire protection. AES Corporation is seeking a Senior BESS Product Safety Engineer based in Long Beach, California.
NewSenior Plans Examiner: Building Codes & Compliance BPR Consulting Group, LLCSenior Plans Examiner: Building Codes & ComplianceCovina, CAA consulting firm in California is seeking an experienced and certified Plans Examiner to check building plans and specifications for compliance with codes. The successful candidate will provide information to the public and contractors, coordinate activities with other departments, and maintain project logs.
Emergency Care - Associate Veterinarian - Long Beach , {State_Code UsvtaEmergency Care - Associate Veterinarian - Long Beach , {State_CodeLong Beach, CaliforniaAn exceptional veterinary hospital, with a dedicated team, is seeking an Associate Veterinarian to provide superior patient and client care to members of its community. This hospital is open to considering veterinarians who are experienced, as well as new graduates who are looking to begin their career in emergency medicine.
Emergency Care - Associate Veterinarian - Norwalk , {State_Code UsvtaEmergency Care - Associate Veterinarian - Norwalk , {State_CodeNorwalk, CaliforniaAn exceptional veterinary hospital, with a dedicated team, is seeking an Associate Veterinarian to provide superior patient and client care to members of its community. This hospital is open to considering veterinarians who are experienced, as well as new graduates who are looking to begin their career in emergency medicine.
NewSenior Plan-Check Engineer: CA Code Expert CSG ConsultantsSenior Plan-Check Engineer: CA Code ExpertIrvine, CA$115,000–$140,000 / yearCandidates should possess 5-10 years of experience in plan review, a Bachelor's in engineering, and a California PE license. This is a full-time position with competitive compensation between $115,000 and $140,000 USD.#J-18808-Ljbffr.
Medical Billing Manager CIBDMedical Billing ManagerOrange, CAFull timeCIBD is the regional grantee for the Western States Region for Hemophilia, the Pacific Sickle Cell Regional Collaborative (PSCRC) and Networking California for Sickle Cell Care (NCSCC) providing regional leadership, fiscal and administrative oversight, grants management, capacity building, clinical education, technical assistance, evaluation, and outreach to public and private health agencies at the local, state, and federal levels. CIBD is a part of a nationwide network of over 140 Hemophilia Treatment Centers that use multidisciplinary teams of blood disorder specialists to provide expert comprehensive diagnosis, medical care, outreach, education, outcomes monitoring, surveillance, and prevention services to people with Hemophilia, Sickle-Cell Anemia, Thalassemia, Von Willebrand Disease, Mast Cell Activation Syndrome (MCAS) and other related benign hematology conditions.
NewProfessional Billing Charge Capture UnitedHealth Group IncProfessional Billing Charge CaptureLos Angeles, CA$24–$43 / hourThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. Professional Billing Charge Capture at UnitedHealth Group ","FormTypeId":null,"UrlLanguageCode":null,"PreviewType":0,"DateCreated":"2026-03-13T13:45:39.5319907","DateUpdated":"2026-07-13T17:56:15.0506395"}, "site"); Caring.
Billing Specialist West Coast AmbulanceBilling SpecialistBurbank, CaliforniaYour role will involve accurately processing and managing medical billing claims, ensuring timely reimbursements, and helping to maintain our financial stability. We are looking for a full-time and if you're a dedicated Billing Specialist ready to contribute to the success of a leading healthcare provider, we want to hear from you!
Medical Billing Clerk Ultimate Staffing ServicesMedical Billing ClerkPasadena, California$23–$27 / hourThe ideal candidate will be responsible for submitting and following up on insurance claims, ensuring accurate billing, and supporting revenue cycle operations. Communicate with insurance providers, patients, and internal teams regarding billing inquiries.
Manager, Billing & Audit (KH) - USC Care Medical Group CBO - Full Time 8 Hour Days (Exempt) (Non-Union) University of Southern CaliforniaManager, Billing & Audit (KH) - USC Care Medical Group CBO - Full Time 8 Hour Days (Exempt) (Non-Union)CA$95,680–$158,230 / yearWhen 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. The organization encompasses 17 clinical departments, with approximately 1,500 physicians and 2,000 staff delivering care across more than 80 locations from Kern County to Orange County and into Las Vegas.
Medical Assistant Floater ST. JOHNS WELL CHILD AND FAMILY CENTER, INC.Medical Assistant FloaterLos Angeles, CAInterview patients, take vital signs (such as pulse rate, temperature, blood pressure, weight and height) and record information; Properly utilize Electronic Health Records system, recording all required and/or relevant information in the system; Prepare treatment rooms for examination of patients; Drape patients with covering and positions instruments and equipment; Hand instruments and materials to medical provider as directed; Clean and sterilize instruments; Operate X rays, electrocardiograph (EKG), and other equipment to administer routine diagnostic test or calls medical facility or department to schedule patients for tests; Give injections or treatments, and performs routine laboratory tests; Key data into computer to maintain office and patient records as necessary (Misys, LINK); Keep exam and treatment rooms clean, well-stocked; Set up equipment in exam rooms; Perform hearing screening, plotting growth parameters; Advise patients concerning preparation for tests; Document administration of immunizations and medications in chart; Administer immunization injections/treatments (must be done only with licensed provider on premises); Call patients to provide normal and abnormal lab results; Keep logs: lead, medications, record refrigerator temperature and zero scales daily and abnormal TB results; Calibrate lab machines as needed and urine machines monthly; Provide translation for providers or arrange for translation services; Travel between clinic sites to cover staffing shortages; Provide back-up to front desk responsibilities including receptionist duties, clerical duties such as filling out forms, answering telephones or filing; Electronic Health Record (EHR) inputting prescriptions and patients chart; Practice Management System (PMS) Registration, Scheduling and Billing; File medical charts when needed; Maintain patient flow to reduce waiting time; Perform lab proficiency testing, run in-house lab tests, prepare outside lab specimens, check lab orders and bills for accuracy; Participate in MA review of charts; Send out Medical Records when requested by other offices; Attend staff meetings; Inventory and order medical supplies and materials; Notify Clinic Manager when supplies need to be ordered or when vaccines or medications are out; Serve as advocate for Indigent Program organizing forms for providers, instructing patients, helping patients complete forms and serving as liaison with drug companies; Comply with all personal medical requirements including but not limited to: annual physical, current vaccinations (MMR, Tdap, Influenza, Hepatitis B), and TB testing (skin test or chest x-ray); Attend meetings, trainings, and other work-related events as needed; and. Clinical duties may include taking and recording vital signs and medical histories, preparing patients for examination, drawing blood, and administering medications as directed by a physician.
Medical Biller Victory Hematology And OncologyMedical BillerSherman Oaks, CaliforniaHas experience in medical billing processes including charge entry, payment posting and claim follow-up and extensive knowledge of Medicare, HMO, local IPAs, and PPO carriers. Victory Hematology and Oncology has a Medical Billing Specialist position available for a well-organized and knowledgeable Medical Billing and Coding Specialist with a Hematology and Oncology practice in Sherman Oaks, California.
Medical Biller VICTORY HEMATOLOGY AND ONCOLOGY INCMedical BillerSherman Oaks, CAFull timeHas experience in medical billing processes including charge entry, payment posting and claim follow-up and extensive knowledge of Medicare, HMO, local IPAs, and PPO carriers. Victory Hematology and Oncology has a Medical Billing Specialist position available for a well-organized and knowledgeable Medical Billing and Coding Specialist with a Hematology and Oncology practice in Sherman Oaks, California.
NewExperienced Medical Biller Renew Vein and VascularExperienced Medical BillerLos Angeles, CAFull timeResponsibilities include claim submission, payment posting, denial resolution, and working closely with providers and staff to maintain efficient revenue cycle operations. The ideal candidate will have a strong background in medical billing, coding, and insurance claim management, with a proven ability to ensure timely and accurate reimbursement.
NewRemote Medical Review Nurse (LVN/LPN)- PST schedule Molina Healthcare IncRemote Medical Review Nurse (LVN/LPN)- PST scheduleCARemoteReevaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of relevant and applicable state and federal regulatory requirements and guidelines, knowledge of Molina policies and procedures, and individual judgment and experience to assess the appropriateness of services provided, length of stay, level of care, and inpatient readmissions in alignment with federal and state regulations and with health plan contracts. Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and claim submitted support correct coding to ensure appropriate reimbursement to providers.
Office Coordinator (Front Office + Billing) Modern Support ServicesOffice Coordinator (Front Office + Billing)Encino, CAThrough the use of compassionate and collaborative care - guided by integrity - we strive to support a meaningful and fulfilling life by nurturing emotional wellbeing, fostering valued relationships, identifying the core self, and promoting lifelong learning. Modern Support Services is a human services agency providing home- and community-based services to adults with Intellectual/Developmental Disabilities (I/DD) for over twenty-six (26) years.
Sleep Apnea Medical Biller Aava InternationalSleep Apnea Medical BillerIrvine, CAFull timeZapZzz is a specialized sleep apnea treatment program with a mission of improving patients’ overall health and quality of life by providing advanced, patient-centered solutions for sleep apnea. The Medical Biller will be responsible for accurately preparing, submitting, and managing insurance claims related to sleep apnea treatment and oral appliance therapy.
Medical Biller Family Health MattersMedical BillerAnaheim, CA$22–$25 / hourExperience with: o Medi -Cal PPS billing o T1015 encounter billing o Managed care wrap payments o Medicare FQHC billing o Safety -net population billing (preferred) Knowledge & Skills • Strong understanding of: o HRSA FQHC billing guidelines o PPS methodology o CPT, ICD -10, HCPCS coding o Revenue cycle management • Experience with EHR and practice management systems. • Ensure correct use of FQHC billing codes, including: o Revenue code 0521 o T1015 (FQHC encounter code) o Appropriate CPT/HCPCS codes • Verify encounters meet billable visit criteria under HRSA and Medi -Cal guidelines.
FQHC Billing Account Manager Nexus HR ServicesFQHC Billing Account ManagerSanta Fe Springs, CAThe RCM Billing Account Manager is responsible for overseeing all aspects of Revenue Cycle Management (RCM), including billing operations, coding compliance, claims submission, denial management, and reimbursement optimization for FQHC clients. Serve as a trusted advisor on FQHC billing rules, UDS reporting, wraparound payments, PPS/APM reimbursement models, sliding fee schedules, and Medicaid/Medicare billing.
NewHealth Info Coder II Avispa TechnologyHealth Info Coder IILos Angeles, CA$52.79 / hourA leading medical institution is seeking a Health Info Coder with at least two years of experience in medical coding, billing, and abstracting. Perform transactional reviews in compliance with all regulatory bodies, e.g., Centers for Medicare and Medicaid Services.
Health Info Coder II Avispa Fukuoka Co LtdHealth Info Coder IILos Angeles, CAWorksite: Leading medical institution (Los Angeles, CA 90024 - Hybrid, Must be onsite during the first month for training, then the position will be primarily remote). A leading medical institution is seeking a Health Info Coder with at least two years of experience in medical coding, billing, and abstracting.
NewRevenue Cycle Analyst Exempt Hollywood PresbyterianRevenue Cycle Analyst ExemptLos Angeles, CA$75,000–$85,000 / yearRevenue Integrity Professional (CRIP).Certified Coding Specialist (CCS).Certified Professional Coder (CPC).Certified Healthcare Financial Professional (CHFP).Required Licensure, Certification, Registration or Designation:Current Los Angeles County Fire Card (or must be obtained within 30 days of employment).Assault Response Competency (ARC) required (within 30 days of hire).Shift Revenue Cycle Analyst ExemptFull Time 80 Hrs, Los Angeles, CA, US30+ days ago Requisition ID: 2732Salary Range: $75,000.00 To $85,000.00 AnnuallyThe Revenue Integrity Analyst is responsible for supporting the hospital's revenue cycle by ensuring accurate charge capture, compliant billing practices, and optimal reimbursement.
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.
Senior Revenue Integrity Specialist - Clinical Rev Integrity - Full Time 8 Hour Days (Exempt) (Non-Union) University of Southern CaliforniaSenior Revenue Integrity Specialist - Clinical Rev Integrity - Full Time 8 Hour Days (Exempt) (Non-Union)Los Angeles, CA$99,507–$164,559 / yearThe 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.
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, CARemote$99,507–$130,000 / yearThe 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.
Medical Coder II Integrated Resources, IncMedical Coder IIDallast, TXRemoteAssists in coordinating CMS Data Validation activities, including record selection, tracking and submission, in conjunction with the Coding Manager of the RAMP Department • Maintains professional and technical knowledge by attending educational workshops reviewing professional publications establishing personal networks participating in professional societies. Coordinate with Clinical Informatics on system errors and suggest improvements to ensure effective and efficient processes are followed Documents results/findings from chart reviews and provides feedback to management, providers, and office staff.
Manager, Medical Economics - REMOTE Molina Healthcare IncManager, Medical Economics - REMOTELong Beach, CARemoteDemonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRGs), Ambulatory Patient Groups (APGs), Ambulatory Payment Classifications (APCs), and other payment mechanisms. Analytical work experience within the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.).
Senior Analyst, Medical Economics - REMOTE Molina Healthcare IncSenior Analyst, Medical Economics - REMOTELong Beach, CARemoteDemonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms. Provides support and ownership for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities and improve financial performance.
Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG) Elevance Health IncDiagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG)CA$82,232–$155,808 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would provide an equivalent background.
Senior Director of Payment Integrity Delta Dental of California Inc.Senior Director of Payment IntegrityCerritos, CAThis leader oversees end-to-end payment integrity capabilities, including pre-payment accuracy, post-payment audit and recovery, clinical and coding review, reimbursement and payment policy, fraud, waste and abuse support, provider billing trend analysis, and payment integrity analytics. Provide end-to-end strategic oversight of Payment integrity programs, including pre-payment prevention, post-payment recovery, clinical review, data mining, coding validation, reimbursement policy, provider education, analytics-driven monitoring, and continuous program optimization.
Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment (Hybrid) University of CaliforniaClinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment (Hybrid)Los Angeles, CA$95,400–$208,300 / yearAs the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and documentation, working closely with physicians, IPA coders, and risk adjustment teams associated with the health plan. As a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.
NewDental Office Manager/ Treatment Coordinator Empower Dental GroupDental Office Manager/ Treatment CoordinatorPasadena, California$80,000–$100,000 / yearPay Range DOE: $80,000-$100,000 Annually + $30,000 + performance bonus program; high performers can earn an additional $30K–$50K per year Required Qualifications High School Diploma or equivalent required. As 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.
NewCertified Professional Coder I AltaMed Health Services CorpCertified Professional Coder ICommerce, CA$27–$33.75 / hourThe Certified Coder I is responsible for reviewing medical documentation and assigning accurate ICD-10-CM, CPT, HCPCS, and applicable modifier codes to support compliant billing, reimbursement, quality reporting, and regulatory requirements. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.
NewCollector, Management Services Organization/Centralized Billing Office - CBO - Full Time 8 Hour Days (Non-Exempt) (Non-Union) University of Southern CaliforniaCollector, Management Services Organization/Centralized Billing Office - CBO - Full Time 8 Hour Days (Non-Exempt) (Non-Union)Pasadena, California$26–$41.28 / hourResponsible for ensuring timely filing and guidelines are met; provided quality control checks on paper and electronic claims; process tracers, denial and related correspondence; initiate appeals; compose and submit appeal letters specific challengeable denial issues consistent with the most update American Medical Association Current Procedural Terminology. System Folder Notes / Account Documentation Documents claim bill date, billed amounts, billing address, billing attachments, invoice number, expected payment, contractual amount, received payments, actual transplant date(s), type of transplant, pre and post periods for transplant days, and all pertinent billing data relevant to billing the claim.
Specialty Physician Coder ICONMA, LLCSpecialty Physician CoderFountain Valley, CA$38.65–$41.69 / hourAnalyze and interpret medical information in the medical record and assign and sequence the correct ICD10CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient, and/or outpatient medical records according to established coding guidelines. Participate in developing, implementing, and reviewing programs for coding compliance monitoring, benchmark comparisons, organizational policies and procedures, and physician clinical documentation improvement programs.
Specialty Physician Coder IconmaSpecialty Physician CoderFountain Valley, CA$38.65–$41.69 / hourAnalyze and interpret medical information in the medical record and assign and sequence the correct ICD10CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient, and/or outpatient medical records according to established coding guidelines. Participate in developing, implementing, and reviewing programs for coding compliance monitoring, benchmark comparisons, organizational policies and procedures, and physician clinical documentation improvement programs.
SENIOR APPLICATION DEVELOPER (DATA & ANALYTICS) Los Angeles CountySENIOR APPLICATION DEVELOPER (DATA & ANALYTICS)Los Angeles, CA$99,735.36–$134,407.68 / yearBachelors degree* from an accredited college or university in Computer Science, Information Systems, or Data Science AND three (3) years of enterprise-level, full-time, paid experience, obtained within the last three (3) years, in a data and analytics unit, designing, developing, troubleshooting, and optimizing complex Transact-SQL and PL/SQL (Procedural Language/Structured Query Language) code, including stored procedures, queries, and database performance tuning. Veteran'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.
Senior Consultant - Clinical Documentation Specialist Deloitte Touche Tohmatsu LtdSenior Consultant - Clinical Documentation SpecialistCA$110,700–$218,300 / yearOther skills include the ability to analyze, act and design action plans upon monthly and quarterly reports related to individual providers, facilities, MS-DRGs, APR, PSIs, severity of illness and risk of mortality, capture rates, quality metrics and can effectively prioritize their work activities. Clinical Payments Optimization: Assisting clients by validating that payments for clinical healthcare services comply with regulatory, clinical based evidence and contractual requirements while also determining that payments are appropriate for the type and level of care provided.
Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment Hybrid UCLA Health SystemClinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment HybridLos Angeles, CA$95,400–$208,300 / yearAs the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and documentation, working closely with physicians, IPA coders, and risk adjustment teams associated with the health plan. As a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.
Diagnosis Related Group Clinical Validation Auditor-Rn (Cdi, Ms-Drg, Ap-Drg And Apr-Drg) Elevance HealthDiagnosis Related Group Clinical Validation Auditor-Rn (Cdi, Ms-Drg, Ap-Drg And Apr-Drg)Costa Mesa, CA$86,560–$155,808 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would provide an equivalent background.
Certified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)CA$43,888–$93,574 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. Uses department resources regularly and follows workflows with minimal assistance or intervention to perform daily work to meet metrics.
NewSenior Consultant - Clinical Documentation Specialist DeloitteSenior Consultant - Clinical Documentation SpecialistLos Angeles, CAFull timeOther skills include the ability to analyze, act and design action plans upon monthly and quarterly reports related to individual providers, facilities, MS-DRGs, APR, PSIs, severity of illness and risk of mortality, capture rates, quality metrics and can effectively prioritize their work activities. Clinical Payments Optimization: Assisting clients by validating that payments for clinical healthcare services comply with regulatory, clinical based evidence and contractual requirements while also determining that payments are appropriate for the type and level of care provided.
NewPayment 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.
Sr. Medical Claims Processor Ultimate Staffing ServicesSr. Medical Claims ProcessorPasadena, California$24–$29 / hourEnsure accuracy of claim details, including patient information, coding (ICD-10, CPT, HCPCS), and billing data prior to submission. Investigate and resolve denied, rejected, or pending claims by working with providers, payers, and internal departments.
NewCertified Professional Coder I AltaMedCertified Professional Coder ICommerce, CA$27–$33.75 / hourThe Certified Coder I is responsible for reviewing medical documentation and assigning accurate ICD-10-CM, CPT, HCPCS, and applicable modifier codes to support compliant billing, reimbursement, quality reporting, and regulatory requirements. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.
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.
Clinical Documentation Specialist City of HopeClinical Documentation SpecialistCACity of Hope's growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. As an essential member of the Coding and Data Quality team, the Clinical Documentation Specialist is responsible for improving the quality, accuracy, and completeness of clinical documentation to accurately reflect patient severity of illness and risk of mortality.