Jr. Quality Improvement Coder Astiva HealthJr. Quality Improvement CoderOrange, CAIn this role, the Junior QI Coder will partner with the Director to collaborate with network providers and IPA's to improve the quality of care through quality improvement activities that will include RAF, HEDIS, CMS Star Ratings and other health plan reporting. Apply official CPT/HCPCS and ICD10 coding guidelines, internal guidelines, and state specific Medicare/Medicaid coding instructions to review and analyze professionally coded services and coding queries.
Senior Specialty Physician Coder – Interventional IconmaSenior Specialty Physician Coder – InterventionalFountain Valley, CA$38.65–$41.69 / hourThis 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.
Medical Biller JOSEPH VARDAYO MD INCMedical BillerLONG BEACH, CAFull timeAs a Medical Biller, you will be working closely with clients to answer questions related to billing, processing all forms needed for insurance billing purposes, and collecting necessary documentation from clients. You will also assist other Medical Billers with follow-up inquiries to clients, communicate with physicians' offices and hospitals to obtain records, and accurately record patient information.
Payment Integrity Analyst Inland Empire Health PlanPayment Integrity AnalystRancho Cucamonga, California$80,059.20–$106,059.20 / yearFull timeKey Responsibilities: Claims Investigation : Independently investigate moderate-to-complex data mining leads, claim inventories, and audit findings for errors, including DRG (Diagnosis-Related Group) validation and billing inaccuracies to determine error sources and recommend remediation action. Collaboration : Interact with cross-functional teams (clinical, legal, IT) and external stakeholders (providers, clients) to resolve discrepancies, validate clinical appropriateness, ensure documentation adequacy, and coding alignment for claims across all lines of business.
Government Audit Recovery Specialist Apidel TechnologiesGovernment Audit Recovery SpecialistCosta Mesa, CAContractorAs 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. Experience working on government, Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Targeted Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), and other Medicaid, Medi-Cal and other regulatory audits.
Coder II Apidel TechnologiesCoder IICosta Mesa, CAContractorAs 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. Utilization Management Process, Word, Comprehensive Error Rate Testing (Cert), Office Of Inspector General (Oig), Medicaid Audits, Medi-Cal Audits Outlook, Acute Care Experience, Government Audits, Coding, Medical Necessity Criteria, CMS Billing, payment methodologies, reimbursement methodologies, privacy regulations.
Coder FT Days 8am-4:30pm AHMC HealthcareCoder FT Days 8am-4:30pmMonterey Park, CaliforniaUnder the direction of the Director of Health Information Management, Identifies and codes Newborns, Obstetrics, ER’s and outpatient records for the purpose of reimbursement, research, and compliance with Federal Regulations using the ICD-10-CM/CPT coding classification systems. Queries are formulated well; are clear, concise, and affect efficient assistance to the medical staff member for timely and accurate query response, complete documentation, and final coding.
NewAdult Education Career Technical: Medical Office Assistant/Administrative Medical Assistant (MOA/AMA) Chaffey Joint Union High School DistrictAdult Education Career Technical: Medical Office Assistant/Administrative Medical Assistant (MOA/AMA)Ontario, CA$65.75–$68 / hourDEFINITION: The MOA/AMA Teacher provides career technical instruction preparing adult learners for entry-level employment in medical office and administrative healthcare support roles. Oduro@cjuhsd.net; Title IX Coordinator: Dr. Kern Oduro, Assistant Superintendent of Student Services, 211 W. 5th Street, Ontario, CA 91762, 909-988-8511, Kern.
Biller/Collector III HireTalentBiller/Collector IIIIrwindale, CAMaintains superior understanding of CPT/HCPCS codes, ICD-10 codes, CMS 1500 form guidelines, eligibility and coverage requirements, remit and remark codes, payor/plan codes, claims management, third-party payer guidelines, state and federal regulations, claims clearinghouse workflow, and all other pertinent functions of the job. % Assists staff in identifying high-risk accounts and prioritizing resolution efforts; Ensures staff is researching high dollar accounts, high volume denials, credits, adjustments, and undistributed balances, etc. in adherence to internal policies and procedures.
DRG Clinical Validation Lead Elevance HealthDRG Clinical Validation LeadCosta Mesa, CA$89,520–$161,136 / 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. How you will make an impact: Conducts pre-certification, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
DRG Coder Astrana Health, Inc.DRG CoderCA, CaliforniaRemote$28–$32 / hourIn an Independent Practice Association (IPA) and Management Services Organization (MSO) environment, the DRG Coder partners with utilization management, care management, finance, and provider network teams to support accurate payment, risk adjustment, quality reporting, and medical expense analysis. The DRG Coder is responsible for reviewing inpatient medical records and accurately assigning diagnosis and procedure codes using ICD-10-CM and ICD-10-PCS to determine the appropriate Diagnosis-Related Group (DRG) assignment.
Optometric Technician (Pre-Testing and Front Office) Santa Fe Springs OptometryOptometric Technician (Pre-Testing and Front Office)Santa Fe Springs, CAFull timeWork-up patients prior to seeing doctor Includes autorefraction, lensometry, retinal photos (Optos), intraocualar pressure assessment (using iCare), visual acuities, case history, medical history and recording all above tests in patient's electronic medical record (average 10 patients per day). When not working directly with patients, your role will be to assist the front office with answering phones and emails to communicate with our patients, as well as assist with medical billing and processing orders for glasses and contact lenses.
Health Claims Examiner Ultimate Staffing ServicesHealth Claims ExaminerPasadena, California$23–$27 / hourCommunicate professionally with members and providers to address inquiries, follow up on pended claims, and complete necessary corrections or adjustments. Strong working knowledge of medical terminology, billing practices, and coding systems, including CPT, ICD-9/ICD-10, HCPCS, DRG, and revenue codes.
Healthcare Claims Examiner Ultimate Staffing ServicesHealthcare Claims ExaminerEl Monte, California$25–$28 / hourResearch and resolve claim discrepancies, including making payment corrections, recovering overpayments, and reprocessing claims as needed. Evaluate claims for potential fraud, waste, abuse, Workers' Compensation, hospital-acquired conditions, and third-party liability; escalate issues appropriately.
Medical Billing / Frontdesk Kohan International FoundationMedical Billing / FrontdeskCULVER CITY, CAMedical Biller/Office Administrator (Full-Time, In-Person) We are a non-profit group therapy practice seeking a skilled and dedicated Medical Biller/Office Administrator to join our team immediately! Fluency in Tagalog/Filipino is A MUST to effectively serve our diverse clientele and team but not required.
Medical Collections Specialist Marquee StaffingMedical Collections SpecialistNewport Beach, CAWe are seeking an experienced Medical Collections Specialist to process and follow up on physician claims from various payer types (HMO, PPO, Medi-Cal, Medicare, etc.) to ensure timely payment for services rendered. Duties: Review and analyze medical documentation and patient records for accurate and timely billing entry; assign or reassign appropriate medical codes (ICD-10, CPT, HCPC) for diagnoses, procedures, and services rendered.
NewMedi-Cal Billing Specialist Pyramid Consulting, IncMedi-Cal Billing SpecialistPomona, CA$21–$24 / hourBy applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Must have skills: 1-3 years of experience in hospital accounts receivable, medical billing, or healthcare collections .
Manager, Administrative Operations - Patient Accounting - Full Time 8 Hour Days (Exempt) (Non-Union) University of Southern CaliforniaManager, Administrative Operations - Patient Accounting - Full Time 8 Hour Days (Exempt) (Non-Union)Los Angeles, CA$99,507–$164,559 / 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. It will also include oversight and tasks associated with vendor management, more specifically, controlling costs, reducing vendor related risks, facilitates all communications between the PFS Business Office and the vendors and ensures service delivery by creating vendor expectations.
Senior Payment Integrity Program Development Specialist Inland Empire Health PlanSenior Payment Integrity Program Development SpecialistRancho Cucamonga, California$80,059.20–$106,059.20 / yearFull timeReporting to the Manager of Payment Integrity Program Development, the Senior Payment Integrity Program Development Specialist services as a subject matter expert driving the research, analysis, and development of Payment Integrity initiatives that strengthen payment accuracy, reduce overpayments, and ensure regulatory and contractual compliance. This Senior Payment Integrity Program Development Specialist also assesses existing pre and post payment audit programs to enhance fraud, waste, and abuse (FWA) detection, while guiding cost avoidance improvements across Payment Integrity operations.
HIM Specialty ROCC Coder - Health Information - FT Days University of California, IrvineHIM Specialty ROCC Coder - Health Information - FT DaysIrvine, CaliforniaFull timeAs Orange County’s only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region’s only American College of Surgeons-verified Level I adult and Level II pediatric trauma center , American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. *Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional 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; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.