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.
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.
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 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.
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.
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.
Senior Consultant - Clinical Documentation Specialist Deloitte Touche Tohmatsu LtdSenior Consultant - Clinical Documentation SpecialistLos Angeles, CA$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.
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.
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.
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.
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.
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.
Senior Specialty Physician Coder - Interventional Integrated Resources, IncSenior Specialty Physician Coder - InterventionalFountain Valley, CARemoteThis 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. Under the direction of the Coding Compliance Manager, the Specialty Physician Coder plays a key role in reviewing and analyzing specialty coding and billing for charge processing.
Charge Capture Specialist Career StrategiesCharge Capture SpecialistLos Angeles, CaliforniaWe encourage candidates who meet these qualifications to apply for this exciting opportunity to contribute to our dedicated team in the healthcare field. Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification (preferred).
Revenue Integrity Specialist II Cedars-Sinai Medical CenterRevenue Integrity Specialist IILos Angeles, CAThe Specialist: Performs accurate and timely coding charge posting (CPT, ICD-10, HCPCS, modifiers) Maintains familiarity with such issues as CMS coding regulations, Medicare rules, visits and procedures on the same day, consultation vs. The Revenue Integrity Spec II, of Compliance and Revenue Integrity, is responsible for fact-finding, organization, and presentation of information in a manner that facilitates patient account management, revenue recognition and process improvement efforts.
Revenue Cycle Specialist III (Gastroenterology) Cedars-Sinai Medical CenterRevenue Cycle Specialist III (Gastroenterology)Los Angeles, CAPrimary duties include: Develops and maintains excellent working relationships with Cedars-Sinai Clinical Departments, external clients, and patients, performing duties that include identifying, analyzing, resolving, and responding to our client's inquiries, concerns, and issues, and following up on accounts to ensure resolution. The Revenue Cycle Specialist III works under general supervision and following established practices, policies, and guidelines of Revenue Cycle Management supporting Hospital, Professional Fee billing and collections.
Revenue Cycle Specialist III (Emergency) Cedars-Sinai Medical CenterRevenue Cycle Specialist III (Emergency)Torrance, CAPrimary duties include: • Develops and maintains excellent working relationships with Cedars-Sinai Clinical Departments, external clients, and patients, performing duties that include identifying, analyzing, resolving, and responding to our client's inquiries, concerns, and issues, and following up on accounts to ensure resolution. Duties include but are not limited to, reviewing and submitting claims to payors, performing account follow-up activities, updating information on patient account, reviewing and processing credits, posting payments, and account reconciliations.
Payment Selections Manager Cohere Health Technologies LLCPayment Selections ManagerCARemote$110,000–$122,000 / yearBacked by leading investors such as Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners, Cohere Health drives more transparent, streamlined healthcare processes, helping patients receive faster, more appropriate care and higher-quality outcomes. By 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.
Medical Claims Examiner Ultimate Staffing ServicesMedical Claims ExaminerPasadena, California$26–$29 / hourWe are seeking an experienced Medical Claims Examiner to review, analyze, and adjudicate medical claims for accuracy, compliance, and medical necessity. Identify coding discrepancies, overpayments, and potential fraud or abuse.
Director, Field Reimbursement HistoSonics IncDirector, Field ReimbursementCARemote5+ years of field reimbursement management experience, including experience with hospital medical device capital equipment, Category III CPT codes, revenue cycle management, physician payment, Medicare and private payer payment models, hospital billing, and coding systems (including chargemaster, payer contracting, and revenue cycle management). In addition to its current liver tumor indication, HistoSonics is pursuing future indications across multiple applications including kidney, pancreas, prostate, neuro, women's health, and other significant underserved human health areas, to realize the broader potential histotripsy across multiple disease states and medical specialties.
Sr. Specialty Physician Coder - Cardiology, CTS, Peds Cardiology & IR MemorialCare Health SystemSr. Specialty Physician Coder - Cardiology, CTS, Peds Cardiology & IRFountain Valley, CA$35.46–$51.46 / 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. MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups - consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties.
Senior Medical Billing Specialist – Multi-Specialty (PM&R Focus) Health Atlast West LaSenior Medical Billing Specialist – Multi-Specialty (PM&R Focus)Los Angeles, California$20–$28 / hourCompensation: $22.00 - $30.00 per hour After seeing many patients placed on multiple medications by numerous providers without much coordination, HEALTH ATLAST founders Stephanie and Wayne Higashi, both doctors of chiropractic, found a need to create a multi-disciplinary approach to healing where doctors work together as one to optimize a patient's health. Role Summary (Read Carefully) We are hiring a seasoned Medical Billing Specialist with direct, hands-on experience billing PM&R-based services in an outpatient, multi-provider environment.
Senior Medical Billing Specialist – Multi-Specialty (PM&R Focus) HEALTH ATLAST WEST LASenior Medical Billing Specialist – Multi-Specialty (PM&R Focus)Los Angeles, CA$20–$28 / hourFull timeWe are hiring a seasoned Medical Billing Specialist with direct, hands-on experience billing PM&R-based services in an outpatient, multi-provider environment. Health Atlast is a high-volume, integrated, multi-disciplinary healthcare organization in West Los Angeles.
NewGovernment Audit Recovery Specialist Integrated Resources, 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), Cliented Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), Quality Improvement Organizations (QIO) and other Medicaid, MediCal regulatory auditing body for pre and post payment audits. Experience working on government, Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Cliented Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), and other Medicaid, MediCal and other regulatory audits.
NewGovernment Audit Recovery Specialist TalentBurst, Inc.Government Audit Recovery SpecialistCosta Mesa, CA$1,000 / weekAs 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.
NewRevenue Cycle Specialist III (Emergency) Cedars-SinaiRevenue Cycle Specialist III (Emergency)Torrance, CAPrimary duties include:Develops and maintains excellent working relationships with Cedars-Sinai Clinical Departments, external clients, and patients, performing duties that include identifying, analyzing, resolving, and responding to our client's inquiries, concerns, and issues, and following up on accounts to ensure resolution. Duties include but are not limited to, reviewing and submitting claims to payors, performing account follow-up activities, updating information on patient account, reviewing and processing credits, posting payments, and account reconciliations.
Revenue Cycle Specialist II (Physician Billing) Cedars-Sinai Medical CenterRevenue Cycle Specialist II (Physician Billing)Los Angeles, CAUnder general supervision and following established practices, policies, and guidelines, provides Commercial and Government billing and collections support to Insurance Follow up and Accounts Receivable, performing duties which may include reviewing and submitting multi-specialty claims to third party payors, performing account follow-up activities, updating patient registration on accounts, etc. Cedars-Sinai was awarded the National Research Corporation's Consumer Choice Award 19 times for providing the highest-quality medical care in Los Angeles.
Medical Records Coordinator Wu PediatricsMedical Records CoordinatorTemple City, CARemoteFull timeWu Pediatrics is a trusted pediatric practice serving the Temple City, CA community with a commitment to providing compassionate, high-quality healthcare for children of all ages. In this essential role, you'll be the backbone of our patient information management, ensuring accurate and timely records that support the exceptional care our young patients deserve.
Charge Capture Specialist Exempt Hollywood Presbyterian Medical CenterCharge Capture Specialist ExemptLos Angeles, CAReviews, analyzes and coordinates charge capture activities, including, but not limited to charge reconciliation, charge posting, evaluation/resolution of billing edits, department outreach and AD HOC reporting. Utilize coding systems (CPT, ICD-10, HCPCS, NRVs/Revenue Codes) to assign appropriate codes for services rendered.
Senior Robotics C++ Engineer — Controls Platform Horizon Surgical SystemsSenior Robotics C++ Engineer — Controls PlatformLos Angeles, CaliforniaIn your role as a Robotics C++ Software Engineer at Horizon Surgical Systems, you will contribute to the architecture and design of a cutting-edge surgical robotics system, implementing and verifying mission-critical software modules. Microsurgery in general and Ophthalmology are subfields of surgery for which the surgical outcomes can be significantly improved by robotic systems to allow superior dexterity, precision, accuracy, and visualization beyond the human surgeon’s own capabilities.
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.
NewRevenue Integrity Specialist II Cedars-SinaiRevenue Integrity Specialist IILos Angeles, CAThis role serves as the single point of contact for all charging work queue issues and charge tickets, performs recurring data compilations from varied sources to inform the management team of work queue trends and late charge analysis, and may coordinate or monitor special projects related to identified late charge and revenue gaps. Cedars‑Sinai has earned recognition for excellence, including 19 National Research Corporation Consumer Choice Awards, an Advisory Board Company Workplace of the Year award, and ranking among U.S. News & World Report's Best Hospitals.
Medical Assistant The Coos, Lower Umpqua and Siuslaw IndiansMedical AssistantCAThis role involves assisting physicians and other healthcare professionals with patient examinations, preparing patients for procedures, handling medical records, and performing routine office tasks. Must be able to walk, bend, reach, talk, hear, use hands to handle, feel or operate objects, tools, or controls, and reach with hands and arms.
Quality Analyst - Outpatient, Healthcare ExlService Holdings IncQuality Analyst - Outpatient, HealthcareCARemote$85,000–$92,000 / yearEXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world's leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others.
Business Office Manager La Peer Surgery CenterBusiness Office ManagerBeverly Hills, CAFull timeGENERAL SUMMARY OF DUTIES: The Business Office Manager (BOM) assists the Facility Director and Clinical Manager in running the Center in an efficient, cost-effective and patient-centered manner. Be able to communicate effectively with upper management, center staff, physicians and their staffs, patients, their families, marketing, insurance and sales representatives.
Senior Medical Assistant- Santa Ana CA UnitedHealth Group IncSenior Medical Assistant- Santa Ana CASanta Ana, CAAdministrative Duties Responsible for routine and basic front and back-office duties to include answering phones scheduling and confirming appointments preparing schedules data entry including referral contracts post appointment information prefill document retrieval filing performing data entry and assisting in the examination process of patients under the direction of a physician or other licensed provider. Direct individual patient care activities and coordination including interviewing patients measuring vital signs and records information on patients charts drawing and collecting blood samples from patients preparing specimens for laboratory analysis complete lab requisitions and conducting a variety of diagnostic tests.
Senior Specialty Physician Coder Interventional ICONMA, LLCSenior 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.
CHIEF, REVENUE MANAGEMENT, HEALTH SERVICES/CORRECTIONAL HEALTH Los Angeles CountyCHIEF, REVENUE MANAGEMENT, HEALTH SERVICES/CORRECTIONAL HEALTHLos Angeles, CA$141,907.20–$220,694.40 / yearVeteran'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. Option 1: Three years of experience in directing one or more of the following complex health care fiscal operations: budgetary projections or reporting; revenue programs; patient, general, or cost accounting; cost reporting; revenue enhancement strategy development; revenue cycle operations; or other major finance-related areas.
Outpatient Trainer ExlService Holdings IncOutpatient TrainerCARemote$85,000–$90,000 / yearMinimum 5 years coding experience: Professional or hospital coding with thorough understanding of ICD-10 Coding; HCPCS/CPT coding systems; Medicare Outpatient Prospective Payment System (OPPS), and Ambulatory Payment Classification (APC). EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates.
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.
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.
Senior Robotics C++ Engineer - Controls Platform Horizon Surgical Systems IncSenior Robotics C++ Engineer - Controls PlatformLos Angeles, CAIn your role as a Robotics C++ Software Engineer at Horizon Surgical Systems, you will contribute to the architecture and design of a cutting-edge surgical robotics system, implementing and verifying mission-critical software modules. Responsibilities: Software Implementation: Designing, implementing, and maintaining a controls software platform that provides real-time-safe data transfer and observability mechanisms.
Accountant K2 Space CorpAccountantLos Angeles, CA$80,000–$110,000 / yearBacked by $450M from leading investors including Altimeter Capital, Redpoint Ventures, T. Rowe Price, Lightspeed Venture Partners, Alpine Space Ventures, and others - with an additional $500M in signed contracts across commercial and US government customers - we're mass-producing the highest-power satellite platforms ever built for missions from LEO to deep space. Engineered to survive the harshest radiation environments and to fully capitalize on today's and tomorrow's massive rockets, K2 satellites deliver unmatched capability at constellation scale and across multiple orbits.
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.
Clinical Policy Clinical Coder RN II L.A. Care Health PlanClinical Policy Clinical Coder RN IILos Angeles, CAThe Clinical Policy Clinical Coder RN II is responsible for analyzing, interpreting, and operationalizing medical and utilization management policies to ensure accurate coding, appropriate authorization requirements, compliant claims processing, and effective utilization oversight. Participate in and lead specialty and cross-functional workgroups and committees focused on healthcare services clinical policies, utilization management processes, strategic initiatives, policy governance, operational alignment, and continuous improvement efforts.
DRG Clinical Validation Lead Elevance Health IncDRG 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.