Medical Director Utilization Management Cohere Health Technologies LLCMedical Director Utilization ManagementCARemote$240,000–$250,000 / yearBy unifying pre-service authorization data with post-service claims validation, we're creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately. With an enterprise approach that streamlines payer-provider decision-making across the care continuum-including policy, prior authorization, payment accuracy, and more-the company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction.
Medical Patient Language Writing Specialist Cohere Health Technologies LLCMedical Patient Language Writing SpecialistCARemote$85,000–$92,000 / yearBy unifying pre-service authorization data with post-service claims validation, we're creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately. With an enterprise approach that streamlines payer-provider decision-making across the care continuum-including policy, prior authorization, payment accuracy, and more-the company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction.
Strategic Medical Director, Diagnostic Imaging Cohere Health Technologies LLCStrategic Medical Director, Diagnostic ImagingCARemote$285,000–$305,000 / yearProvide leadership in the creation of comprehensive research packages, investigating specific clinical areas/offerings and strategic partners of interest to strengthen the offering, then execute on cultivating any external partnerships and/or vendor relationships as necessary. Build and expand client relationships by partnering with the Growth and Client Experience teams to uncover client pain points, deliver solutions, assign clients to managers as appropriate, and support upsell opportunities (e.g., Sleep programs).
Specialist (Hospital) - Revenue Cycle Operations - Full Time 8 Hour Days (Non-Exempt) (Non-Union) University of Southern CaliforniaSpecialist (Hospital) - Revenue Cycle Operations - Full Time 8 Hour Days (Non-Exempt) (Non-Union)Alhambra, CA$25–$39.69 / hourWhen 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. Quality of Work Is attentive to detail and accuracy, is committed to excellence, looks for improvements continuously, monitors quality levels, finds root cause of quality problems, owns/acts on quality problems.
CCSB Eligibility Specialist I (50509) Western GrowersCCSB Eligibility Specialist I (50509)Irvine, CAUnder the direction of the Director, Operations, the Child Care Providers United (CCPU) Eligibility Specialist I is responsible for performing enrollment and billing functions necessary to maintain Child Care Providers United accounts on the CCPU Portal and Healthcare Common Procedure Coding System (HCPS) as assigned. Assist in reviewing and processing all manual and/or Electronic Data Interchange (EDI) enrollment transactions (adds, changes, terminations) in HCPS as received from CCPU, providers, or internal sources in accordance with Participation Agreements, Employer Policy Statements, Eligibility Guidelines and Summary Plan Descriptions.
Dental Billing Manager Children's Dental FunZoneDental Billing ManagerWest Covina, CA$25–$40 / hourRequirements •* 3+ years of dental billing experience, including 1+ years in a supervisory or management capacity•* Experience in a multi-location or DSO/MSO dental environment•* Knowledge of Medicaid/Denti-cal, dental insurance processes, CDT codes, and claims/appeals workflows•* Experience with billing/reporting tools such as Excel or practice analytics dashboards•* Experience with dental practice management software Dentrix Ascend•* Excellent organizational and analytical skills, with the ability to manage billing operations •* Strong leadership and communication skills; experience training and developing a team•* High attention to detail and a commitment to accuracy and compliance. Children's Dental FunZone is a growing pediatric dental group with locations across Southern California, dedicated to providing a fun, welcoming, and clinically excellent dental experience for kids and families.
Senior Specialty Physician Coder - Interventional Iconma LLCSenior Specialty Physician Coder - InterventionalFountain Valley, CAThis role will be responsible for reviewing and accurately coding office, hospital, and surgical procedures for reimbursement and ensuring accurate and compliant medical coding for both inpatient and outpatient services, diagnostic tests, and other medical services rendered to patients. This role will be responsible for reviewing and accurately coding office, hospital, and surgical/procedures for reimbursement and ensuring accurate and compliant medical coding for inpatient and outpatient services, diagnostic tests, and other medical services rendered to patients.
Collections Representative – Government Billing SGA Inc.Collections Representative – Government BillingLos Angeles, CA$20–$27 / hourResponsibilities : The Collections Representative – Government Billing is responsible for the accurate and timely billing of inpatient, outpatient, and laboratory claims to government and third-party payers. Software Guidance & Assistance, Inc., (SGA), is searching for a Collections Representative – Government Billing for a Contract assignment with one of our premier Healthcare clients in Los Angeles, CA.
NewSenior Manager, Clinical Data Analytics Edwards LifesciencesSenior Manager, Clinical Data AnalyticsIrvine, California$139,000–$196,000 / yearWorking knowledge of cloud-hosted data architectures (AWS preferred) and data lake concepts (ingestion, ETL/ELT, data cataloging) sufficient to partner effectively with engineering teams — not expected to build pipelines personally, but must be able to translate business/safety requirements into technical specs and validate outputs. Identify issues and collaborate with appropriate team members to bring to resolution; determine root cause; recommend and lead the implementation of corrective actions, complex process development and process improvement solutions to optimize strategic imperatives.
Financial Clearance Specialist III - Prearrival - Full Time 8 Hour Rotating (Non-Exempt) (Non-Union) University of Southern CaliforniaFinancial Clearance Specialist III - Prearrival - Full Time 8 Hour Rotating (Non-Exempt) (Non-Union)Los Angeles, CA$26–$41.28 / hourWhen 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. As a leading academic medical center, hundreds of clinical trials are currently taking place at Keck Hospital and its affiliated research institutions, giving patients access to novel and promising therapies that are generally not available elsewhere.
Financial Clearance Specialist III - PreArrival - Full Time 8 Hour Rotating (Non-Exempt) (Non-Union) University of Southern CaliforniaFinancial Clearance Specialist III - PreArrival - Full Time 8 Hour Rotating (Non-Exempt) (Non-Union)Los Angeles, CA$26–$41.28 / hourWhen 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. As a leading academic medical center, hundreds of clinical trials are currently taking place at Keck Hospital and its affiliated research institutions, giving patients access to novel and promising therapies that are generally not available elsewhere.
Sr. Marketing, Manager - RECELL Avita Medical Limited (Registered office)Sr. Marketing, Manager - RECELLIrvine, CA$165,000–$180,000 / yearKey responsibilities include developing the annual brand plan, overseeing the creation of compelling brand assets, designing sales enablement tools, executing demand generation campaigns, supporting field events, and gathering and sharing actionable commercial insights. This role will also support long-term planning by identifying emerging market trends, understanding the evolving needs of customers and the sales team, and translating those insights into impactful marketing strategies.
NewRN, Clinical Documentation Integrity Specialist myPlace HealthRN, Clinical Documentation Integrity SpecialistLos Angeles, California$71,700–$105,000 / yearOperating within the PACE model, the CDI Specialist conducts clinically supported chart reviews, identifies documentation opportunities, and collaborates with physicians, nurse practitioners, and care teams to support compliant CMS-HCC capture and sustainable documentation improvement. This clinically credentialed role partners with providers, interdisciplinary care teams, and risk adjustment stakeholders to ensure documentation reflects each participant’s clinical complexity, disease burden, severity of illness, and care needs.
NewPatient Authorization and Referral Representative - Gastroenterology Providence Health & ServicesPatient Authorization and Referral Representative - GastroenterologyCalifornia, CARequsition ID: 456736 Company: Providence Jobs Job Category: Patient Access Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Day Career Track: Admin Support Department: 7520 GASTROENTEROLOGY CA DOYLE PARK 303 Address: CA Santa Rosa 500 Doyle Park Dr Work Location: St Joseph Heritage-Pediatrics-Doyle Park Workplace Type: On-site Pay Range: $26.25 - $40.14 The Referral Coordinator prepares clinical data for physician/IPP/CBO approval and obtains authorizations; acts as liaison between patient, medical assistant, physician, IPP, CMS Department and Central Business Office.
Utilization Management Assistant - Utilization Management Providence Health & ServicesUtilization Management Assistant - Utilization ManagementMission Hills, CA$24–$31.52 / hourTogether, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. Providence Clinical Network (PCN) is a service line within Providence serving patients across seven states with quality, compassionate, coordinated care.
Financial Clearance Specialist III - Prearrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union) University of Southern CaliforniaFinancial Clearance Specialist III - Prearrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)Los Angeles, CA$22–$34.18 / hourWhen 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. Preferred Qualifications: Required Licenses/Certifications: Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date.
Financial Clearance Specialist IV - Admitting - Full Time 8 Hour Variable Shift (Non Union) University of Southern CaliforniaFinancial Clearance Specialist IV - Admitting - Full Time 8 Hour Variable Shift (Non Union)Glendale, CA$26–$34 / hourMinimum Experience/Knowledge: Minimum (3) years of experience in a hospital, health plan or Physician office environment with extensive knowledge of contracted and non-contracted payers, division of financial responsibility, including the ability to articulate benefit negotiations as required when adjudicating a letter of agreement with a non-contracted payer. 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.
Financial Clearance Specialist III - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union) University of Southern CaliforniaFinancial Clearance Specialist III - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)Los Angeles, California$22–$34.18 / hourWhen 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. If you are a current USC employee, please apply to this USC job posting in Workday by copying and pasting this link into your browser: https://wd5.myworkday.com/usc/d/inst/1$9925/9925$140078.htmld
Outpatient UM Coordinator ADPOutpatient UM CoordinatorSherman Oaks, California$21–$23 / hourAbout Us: MedPOINT Management is a leading Independent Practice Association (IPA) management company based in Sherman Oaks, CA, providing comprehensive administrative and managed care services to physician networks across Southern California. About the Role: MedPOINT Management is looking for a dedicated Outpatient Utilization Management Coordinator to join our team in Sherman Oaks, CA.
Full-Time Cath PCI Clinical Data Abstractor Hourly Non-Exempt Carta Healthcare Inc.Full-Time Cath PCI Clinical Data Abstractor Hourly Non-ExemptCARemotePaid Holidays: "Full-time hourly employees receive six paid holidays per year: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, and Christmas Day, paid at their regular hourly rate. Carta Healthcare is dedicated to building a diverse and inclusive company because we serve health systems across the country; we've seen how our product and impact are strengthened the more we reflect that diversity.