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.
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.
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.
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.
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.
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.
Office Manager/Supervisor Skyline UrologyOffice Manager/SupervisorTarzana, CaliforniaThe Office Manager/Supervisor leads goals and objectives that will provide the efficient operation of the Physician/s practice by overseeing daily operations and staff. Oversees and approves medical office supply inventory, ensures that mail is opened and processed, and offices are opened and closed according to procedures.
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 .
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.
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, California$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.
Revenue Cycle Supervisor Orthopaedic Institute for ChildrenRevenue Cycle SupervisorLos Angeles, California$113,000–$149,000Position Summary: The Revenue Cycle Supervisor is responsible for overseeing daily operations across key revenue cycle functions, including billing, collections, charge capture, and denial management for an orthopedic outpatient environment. Physical Requirements: Intermittent (25-35% of the time) walking, standing, bending, sitting and verbally communicating with patients and other OIC healthcare team members.
NewForward Deployed Engineer, Data Studio Revenue Cycle - Innovation_Delivery_Transformation DeloitteForward Deployed Engineer, Data Studio Revenue Cycle - Innovation_Delivery_TransformationLos Angeles, CA$105,400–$207,800 / yearWorking knowledge of the retrieval and knowledge layer behind agentic systems - RAG pipelines, embeddings and vector stores, and increasingly knowledge graphs - including how to ground use cases in large volumes of unstructured healthcare data (e.g., clinical notes, payer policies, contracts) alongside structured sources. Partner with Health Care consulting teams and Converge for Healthcare's account and product teams during the sales cycle - running technical discovery, demonstrations, and use-case fit assessments - such as denial prevention, prior authorization automation, or AR follow-up - that qualify client needs and shape a credible path to production value.
Clinical Documentation Integrity Specialist- Onsite, Los Angeles UnitedHealth Group Inc.Clinical Documentation Integrity Specialist- Onsite, Los AngelesLos Angeles, CA$72,800–$130,000 / yearPrimary Responsibilities: Provides expert level review of inpatient clinical records within 24-48 hours of admit; identifies gaps in clinical documentation that need clarification for accurate code assignment to ensure the documentation accurately reflects the severity of the condition and acuity of care provided. The Clinical Document Integrity Specialist - (CDIS) is responsible for providing CDI program oversight and day to day CDI implementation of processes related to the concurrent review of the clinical documentation in the inpatient medical record of Optum 360 clients' patients.
Medical Office Supervisor Argus Medical Management, LLCMedical Office SupervisorNewport Beach, CA$22–$26 / hourFull timeNewport Children's Medical Group provides expert, compassionate pediatric care for children of all ages, from newborns to adolescents, at its locations in Newport Beach, Irvine, Costa Mesa, and Laguna Beach. Job Type: Full-Time, Direct HireHours: Mon-Fri, 8-hour shiftsPay: $22-26 per hourPosition Summary:To ensure all aspects of the medical office are managed effectively to comply with physician/company policies and procedure and state/federal regulations.
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.
Medical Billing Specialist American Family Care Ladera RanchMedical Billing SpecialistLadera Ranch, California$18–$23 / hourmagazine as one of the fastest-growing companies in the U.S., AFC's stated mission is to provide the best healthcare possible, in a kind and caring environment, while respecting the rights of all patients, in an economical manner, at times and locations convenient to the patient. Today, with more than 250 clinics and 800 in-network physicians caring for over 6 million patients a year, AFC is the nation's leading provider of urgent care, accessible primary care, and occupational medicine.
Senior Payment Integrity Analyst Inland Empire Health PlanSenior Payment Integrity AnalystRancho Cucamonga, California$91,249.60–$120,910.40 / yearFull timeReporting to the Manager, Payment Integrity Operations, the Senior Payment Integrity Analyst provides lead level analyst support to a team of Payment Integrity Analysts on daily operations of vendor(s) and internal programs for Payment Integrity. Data Analysis & Reporting : Develop and refine complex audit data mining techniques to detect irregularities, billing trends, and potential Fraud, Waste, and Abuse (FWA) and translate insights into actionable remediation strategies.
NewClinical Data AMS Sr. Consultant DeloitteClinical Data AMS Sr. ConsultantLos Angeles, CA$120,200–$140,000 / yearThis role owns the health, stability, and compliance posture of a suite of clinical and regulatory R&D platforms - including Axway Secure Transport (ST), eClinical Elluminate, Eclipse (medical coding), and EAST - across the full engagement lifecycle: implementation, configuration, validation, and steady-state managed services. The team operates at the intersection of IT infrastructure, clinical operations, and quality/regulatory compliance, partnering closely with global business and technology stakeholders to support end-to-end clinical trial data lifecycles from data capture and coding through statistical analysis and submission-ready outputs.
Account Advisor I - Call Center Blue Cross and Blue Shield AssociationAccount Advisor I - Call CenterLos Angeles, CARemotePursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner. Reviews and researches billing and healthcare claim inquiries from members and providers, to ensure proper benefits and/or payments are applied correctly; researches multiple computer systems/applications to verify data/information accuracy.