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.
Specialty Physician Coder Integrated Resources, IncSpecialty Physician CoderFountain Valley, CAThis role is 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. -Analyze and interpret medical information in the medical record and assign and sequence the correct ICD-10-CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient, and/or outpatient medical records according to established coding guidelines.
Sr. Speciality Physician Coder - Interventional Radiology 26-00157 Alura Workforce SolutionsSr. Speciality Physician Coder - Interventional Radiology 26-00157Fountain Valley, CARemote$43.75–$46.50 / hourDESCRIPTION Under the direction of the Coding Compliance Manager, the Senior Specialty Physician Coder is responsible for reviewing and accurately coding physician services to ensure compliant reimbursement and complete charge capture. This role is highly specialized in Interventional Radiology (IR) and requires a coder who can independently perform complex IR coding from day one.
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.
Claims Auditor Cohere Health Technologies LLCClaims AuditorCARemote$72,000–$82,000 / 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.
ProFee Audit Specialist- FT Datavant LLCProFee Audit Specialist- FTCARemote$35–$45 / hourWhat We're Looking For: As a Profee Auditing Specialist, you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies.
Business Office Manager Surgery PartnersBusiness Office ManagerBeverly Hills, CAGENERAL 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.
Field Reimbursement Manager, Southeast ImmunityBio IncField Reimbursement Manager, SoutheastEl Segundo, CAImmunityBio, Inc. (NASDAQ: IBRX) is a commercial-stage biotechnology company developing cell and immunotherapy products that are designed to help strengthen each patient's natural immune system, potentially enabling it to outsmart the disease and eliminate cancerous or infected cells. ImmunityBio is developing cutting-edge technology with the goal to transform the lives of patients with cancer and develop next-generation therapies and vaccines that complement, harness and amplify the immune system to defeat cancers and infectious diseases.
Certified Professional Coder AltaMedCertified Professional CoderCommerce, CA$27–$33.75 / hourAssigned codes to patient symptoms, diagnosis, operations, and treatments to process reimbursements, knowledge and expertise in reviewing and adjudicating coding services, procedures, and diagnoses on medical claims. 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.
Medical Assistant/ Medical Home Coordinator TriHealth IncMedical Assistant/ Medical Home CoordinatorCAUnderstands adult and/or pediatric preventive medicine schedules, including wellness visits, vitals, labs, immunizations, screening tools, and patient education; identifies and communicates care gaps, utilization, and chronic disease needs. Provides accurate and complete documentation of rooming information, clinical calls, orders, pending prescriptions, pharmacy updates, and workflow tasks; addresses phone and MyChart messages promptly and escalates issues as needed.
Patient Collections Specialist Your Behavioral HealthPatient Collections SpecialistTorrance, CA$21–$24At YBH, we pride ourselves on being a centralized hub teeming with resources designed to aid clients and their families in pinpointing the optimal support tailored to their distinct needs and aspirations for well-being. -Answering questions from patients, clerical staff and insurance companies, -Compiling and tracking outstanding balances owed to our providers.
Co-Founder & CEO - Healthtech - AI Clinical Documentation Compliance FutureSightCo-Founder & CEO - Healthtech - AI Clinical Documentation ComplianceLos Angeles, CA$80–$85 / hourYou’ll co-create with a proven studio team, led by John Carbrey (4x entrepreneur, $100M ARR), Krista LaRiviere (3x exited, E&Y Top Women Entrepreneur), Alan Smith (Strategyzer co-founder, $120M in products built), Prathna Ramesh (former MD of Maple Leaf Angels, $275M in follow-on capital), and Johnny Tong (0-to-1 builder, acquired by SAP and Stripe) bring a rare combination of operator exits, institutional investing, and AI product depth. The market signal is incredibly strong: Unprompted Product Pull: Every single lead described the exact product we want to build: a pre-billing, real-time, EHR-integrated flagging layer that checks documentation against payer-specific rules before claims are submitted.
Co-Founder & CEO - AI Clinical Documentation Compliance FutureSightCo-Founder & CEO - AI Clinical Documentation ComplianceLos Angeles, CA$80–$85 / hourYou’ll co-create with a proven studio team, led by John Carbrey (4x entrepreneur, $100M ARR), Krista LaRiviere (3x exited, E&Y Top Women Entrepreneur), Alan Smith (Strategyzer co-founder, $120M in products built), Prathna Ramesh (former MD of Maple Leaf Angels, $275M in follow-on capital), and Johnny Tong (0-to-1 builder, acquired by SAP and Stripe) bring a rare combination of operator exits, institutional investing, and AI product depth. The market signal is incredibly strong: Unprompted Product Pull: Every single lead described the exact product we want to build: a pre-billing, real-time, EHR-integrated flagging layer that checks documentation against payer-specific rules before claims are submitted.
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.
Coder II - Full Time - Days - 8hr QVH Emanate Health Medical CenterCoder II - Full Time - Days - 8hr QVHWest Covina, CA$33.95–$48.55 / hourMinimum Education Requirement: High School Diploma or equivalent work experience required; college degree preferred with coursework in Medical Terminology/Anatomy & Physiology and Computer experience. Job Summary Assigns and sequence diagnostic/procedural codes to in-patient and outpatient medical records for billing, reimbursement and data retrieval by following established coding guidelines.
Outpatient Coder - Per Diem UCLA Health SystemOutpatient Coder - Per DiemLos Angeles, CA$47.60–$62.78 / hourb'nn n n n n n n n n n n n nn n n n n n n n n n n n n n n n n n Outpatient Coder - Per Diem - - 31249 - UCLA Healthn n nnnn nn n n n nn n n n n Skip to content nn n n n n n UCLA Health Home Page n n nn nnn n nn n Main menu. Press enter or space keys to expands and escape key to collapse nn n n n n n n Search jobs n n nn n n n...
Insurance Collections Specialist Your Behavioral HealthInsurance Collections SpecialistTorrance, CA$21–$24At YBH, we pride ourselves on being a centralized hub teeming with resources designed to aid clients and their families in pinpointing the optimal support tailored to their distinct needs and aspirations for well-being. Answering questions from patients, clerical staff and insurance companies, Compiling and tracking outstanding balances owed to our providers.
Cardiologist, Outpatient Welcome Health Cares, PCCardiologist, OutpatientLos Angeles, California$400,000–$600,000 / yearThe role will be primarily based at our Bell clinic, with the opportunity to support additional clinic locations across Los Angeles, Orange, and Riverside Counties as the practice grows. Built on the principles of geriatric medicine and backed by SCAN Group, Welcome Health delivers care that meets patients where they are, including in home, in clinic, and virtual visits.
CDI Specialist - Health Information Rady Children's HospitalCDI Specialist - Health InformationCA$39.51–$54.33 / hourJOB SUMMARY: This position uses clinical knowledge and knowledge of coded data for documentation requirements to improve overall patient quality, capture severity, acuity and risk of mortality. Compensation decisions consider a variety of factors including experience, education, licensure, unique skillsets, organizational need, and internal equity.
Diagnosis-Related Group (DRG) Auditor III, Healthcare -Remote US ExlService Holdings IncDiagnosis-Related Group (DRG) Auditor III, Healthcare -Remote USCARemote$75,000–$95,000 / yearEXL 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. 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.
Cardiologist, Outpatient Welcome HealthCardiologist, OutpatientLos Angeles, CaliforniaThe role will be primarily based at our Bell clinic, with the opportunity to support additional clinic locations across Los Angeles, Orange, and Riverside Counties as the practice grows. Built on the principles of geriatric medicine and backed by SCAN Group, Welcome Health delivers care that meets patients where they are, including in home, in clinic, and virtual visits.
NewPatient Account Rep Senior MemorialCare Health SystemPatient Account Rep SeniorFountain Valley, CA$25.22–$36.57 / hourThis position must be able to utilize and understand many complex and varying State and Federal statutes and regulations, guidelines, and systems, and perform the account follow-up function with all Medicare government agencies to obtain maximum and correct reimbursement of accounts receivables. Medicare Patient Account Representative, Senior is responsible for all Medicare insurance collections of accounts to ensure that PFS is capturing all revenues as timely and efficiently as possible.
Senior AI Automation Engineer Alignment Healthcare IncSenior AI Automation EngineerCA$172,364–$258,547 / yearAI/ML Engineering: Expert-level Python proficiency with deep command of ML frameworks including PyTorch, TensorFlow, scikit-learn, and Hugging Face Transformers; advanced experience designing LLM-based systems including RAG pipelines, vector databases, and multi-agent orchestration frameworks (LangChain, LangGraph, AutoGen, CrewAI). Cloud AI Platforms & MLOps: Expert-level experience with AWS SageMaker, Azure AI / Document Intelligence, Google Cloud Vertex AI, or Databricks; mastery of containerization (Docker, Kubernetes), CI/CD pipelines, and MLOps tooling (MLflow, Kubeflow, or equivalent) at an architecture and governance level.
Drug Safety Analyst BelcanDrug Safety AnalystLos Angeles, CA$42–$45.70 / hourAbility to effectively prioritize and manage multiple tasks to ensure successful completion targeted deadlines-Proficient in Windows 7 and MS Office (Excel, PowerPoint, Visio, Word)- Familiarity with validation of computer systems and/or GMP environments is essential.- Work as Signal Analyst during signal management activities including extractions of signal detection reports ensuring document filing and archivingEnsure quality and compliance with the legal requirements for pharmacovigilance tasks and responsibilities:1.
NewCoder Auditor Medical Records Prime Healthcare Services IncCoder Auditor Medical RecordsSherman Oaks, CA$28–$43.40 / hourCoder Auditor finalizes the coding and abstracting of the medical record upon ensuring the assignment of International Classifications of Diseases, Ninth Revision (ICD-9-CM) or Tenth revision (ICD-10/PCS), Current Procedural Terminology (CPT), and Health Care Procedure Coding System (HCPCS), are accurate and supported by the clinical documentation of the respective medial record. The Coder Auditor reviews and analyzes documentation present in the medical record for both inpatient and outpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software.
Sr. Certified Coder, Acute SDS-OBSV Adventist Health SystemSr. Certified Coder, Acute SDS-OBSVCAEssential Functions: Abstracts and assigns ICD-10-CM diagnosis codes and CPT procedure codes from the SDS and OBV patient record to ensure accurate APC assignment and to provide information required for reimbursement and statistical data submissions. Job Requirements: Education and Work Experience: High School Education/GED or equivalent: Required Associates/Technical Degree or equivalent combination of education/related experience: Preferred.
Sr. Certified Coder, Acute Inpatient (Remote, Part-time) Adventist Health SystemSr. Certified Coder, Acute Inpatient (Remote, Part-time)CARemoteEssential Functions: Abstracts and assigns ICD-10-CM diagnosis codes and PCS codes from the inpatient patient record to ensure accurate MS-DRG and APR-DRG assignment and to provide information required for reimbursement and statistical data submissions. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God''s love by inspiring health, wholeness and hope.
Physician Billing Specialist MemorialCare Health SystemPhysician Billing SpecialistFountain Valley, CA$22.50–$31.57 / hourWe are committed to increasing access to patient-centric, affordable, and high-quality healthcare; your personal contributions are integral to MemorialCare''s recognition as a market leader and innovator in value-based and other care models. 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.
E/M Multi-Specialty Coder - Coder II (Remote) Cedars-Sinai Medical CenterE/M Multi-Specialty Coder - Coder II (Remote)Los Angeles, CARemoteWe are Seeking: • Minimum of 3 years of coding experience within a multi-specialty medical group or multi-specialty physician practice (i.e., Cardiothoracic Surgery, Neurosurgery, General Surgery, Orthopedics, Obstetrics/Gynecology) preferred. Cedars-Sinai was awarded the National Research Corporation's Consumer Choice Award 19 times for providing the highest-quality medical care in Los Angeles.
Coder II - Surgical (Remote) Cedars-Sinai Medical CenterCoder II - Surgical (Remote)Los Angeles, CARemoteAccurately assigns all applicable modifiers for all patients to assure optimal reimbursement and the highest quality data possible Duties of this Coder II include: Performs accurate and timely coding (CPT, ICD-10, HCPCS, modifiers). Experience we are Seeking: Minimum of 3 years of surgical coding experience within a multi-specialty medical group or multi-specialty physician practice (i.e., Orthopedics, Cardiothoracic Surgery, Neurosurgery, General Surgery, Obstetrics/Gynecology, Gastroenterology).
Emergency Department ChargerCoder UCLA Health SystemEmergency Department ChargerCoderLos Angeles, CA$40.04–$52.83 / hourAs 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. You will assign ICD-10-CM and CPT/HCPCS codes for emergency department patients while ensuring accurate charge assignments using ASAP software within EPIC (CareConnect).
Claims Edit Coder Cedars-Sinai Medical CenterClaims Edit CoderLos Angeles, CAWhat you will be doing in this role: The Claims Edit Coder (Coder II) operated under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team. Communicates with physicians, providers, and external departments regarding documentation clarity, specificity, ensure the completeness of documentation required for code assignment within area(s) of assignment or specialty.
RCM Training Consultant 2 Modernizing Medicine IncRCM Training Consultant 2CAGenerous Paid Time Off and Paid Parental Leave programs, Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs, Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed, Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning, Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles, Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters. ModMed is seeking an RCM Training Consultant who will be responsible for developing and delivering comprehensive training programs for Revenue Cycle Management (RCM) solutions, ensuring clients and internal teams are proficient in utilizing our software to optimize their financial operations.
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.
Neurosurgery medical assistant UC HealthNeurosurgery medical assistantCAMembers of UC Health include: UC Medical Center, West Chester Hospital, University of Cincinnati Physicians and UC Health Ambulatory Services (with more than 900 board-certified clinicians and surgeons), Lindner Center of HOPE and several specialized institutes including: UC Gardner Neuroscience Institute and the University of Cincinnati Cancer Center. Administrative Duties: Using computer applications Answering telephones Greeting patients Updating and filing patient medical records Coding and filling out insurance forms Scheduling appointments Arranging for hospital admissions and laboratory services Handling correspondence, billing, and bookkeeping.
NewMedical Billing Negotiator 26-00226 Alura Workforce SolutionsMedical Billing Negotiator 26-00226Simi Valley, CACandidates must have minimum 1 year of experience in bill negotiations or California workers' compensation claims IEA certificate or California Certificate of Self Insurance a plus. Knowledge of California Labor Code statutes, Rules and Regulations, case law, and California workers' compensation fee schedules a plus.
NewClinical Documentation Integrity Specialist (HYBRID, Glendale) Adventist HealthClinical Documentation Integrity Specialist (HYBRID, Glendale)Glendale, CAJob Summary: Reviews, evaluates and assesses medical records of patients, looks for specificity of an illness, the accuracy of the clinician's documentation, coding requirements and documentation of important medical details to ensure the overall quality and completeness of clinical documentation of the patient medical record and ensure it is in compliance with government and other regulations. Essential Functions: Evaluates and assesses medical records of patients, looks for specificity of an illness, the accuracy of the clinician's documentation, coding requirements and documentation of important medical details to ensure the overall quality and completeness of clinical documentation of the patient medical record.
NewUtilization Management Policy Initiatives Registered Nurse Macpower Digital Assets Edge Private LimitedUtilization Management Policy Initiatives Registered NurseLos Angeles, CARemote$102,183–$132,838 / yearThis role ensures that the day to day functions of Utilization Management initiatives comply with regulatory and accreditation requirements such as those stated in contracts, CalAIM Population Health Management (PHM) Policy Guide, National Committee on Quality Assurance (NCQA) Department of Health Care Services (DHCS) All Plan Letters (APLs), and Centers for Medicare and Medicaid Services (CMS) Model of Care (MOC) through sound clinical policy maintenance. Non-negotiable requirements of this position: Direct past experience with Health Care / Medical Policy work specifically within a Managed Care Plans environment; experience with the ongoing development of the Medical Policy review process including clinical and utilization data analysis; Assisted in developing training documents and presentations for new and/or revised Medical Policies to internal stakeholders.
Director, Revenue Cycle (Exempt) Monterey Park Hospital AHMC Healthcare IncDirector, Revenue Cycle (Exempt) Monterey Park HospitalMonterey Park, CAThe Director, Revenue assures effective coordination of work processes and communication with Patient Financial Services, Admitting/Registration, Central Business Office, Health Information Management, clinical departments, Provider Medical Groups, Case Management, Denials Management, and IT. Overview Monterey Park Hospital, a 101-acute care facility in the San Gabriel Valley of Los Angeles County, is seeking a Full-Time Director of Revenue Cycle for our Managed Care Department.
Medical Director, Utilization Management L.A. Care Health PlanMedical Director, Utilization ManagementLos Angeles, CAThis position plays a critical role in the mitigation of Fraud, Waste and Abuse (FWA) and requires proactive analysis of service level utilization data to identify trends, outliers and emerging risk areas and recommend corrective action to minimize utilization variation, prevent improper payments and ensure financial stewardship. Job Summary The Medical Director, Utilization Management provides clinical oversight of authorization decision making and processing, pre and post payment claims review activities, payment integrity clinical validation and program integrity functions.
Nurse Practitioner Family Medicine, Administrative Provider Solutions & DevelopmentNurse Practitioner Family Medicine, AdministrativeAnaheim, CA$183,822–$217,790 / yearIn addition, conducting telehealth visits once a week, a key success factor of this position is educating providers to improve the completeness, accuracy, and reliability of clinical documentation and HCC coding to accurately reflect the patient's true clinical picture. Famous for being the home of Disneyland Resort and the Los Angeles Angels baseball team, the city offers an escape from the bustle of city life, with multiple nature reserves, including Oak Canyon, Weir Canyon and the Anaheim Wetlands.
Emergency Department Charger/Coder University of CaliforniaEmergency Department Charger/CoderLos Angeles, CARemote$40.04–$52.83 / hourAs 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. You will assign ICD-10-CM and CPT/HCPCS codes for emergency department patients while ensuring accurate charge assignments using ASAP software within EPIC (CareConnect).
Clinical Documentation Integrity Specialist University of CaliforniaClinical Documentation Integrity SpecialistLos Angeles, CARemote$100,161.36–$218,718 / yearThis role involves daily review of high-acuity patient records to identify potential and active payer denials, assess clinical validity, and to support denial prevention, analysis, and appeals across inpatient and outpatient settings; continuously communicating with department staff; educating physicians, residents, and mid-levels; and assisting with appropriate documentation strategies. You will prepare and submit high quality appeal letters supported by clinical evidence, regulatory guidelines, and payor-specific medical necessity criteria, while identifying denial trends and root causes and provide feedback to the CDI and Clinical teams.
NewCertified Medical Coder Feed My People Food BankCertified Medical CoderLos Angeles, CaliforniaRemoteAfter work, you will find things to do in every season, including beaches, outdoor recreation, unique restaurants, world-class wineries, arts and entertainment. Under general supervision, according to established policies, procedures and protocols, codes all disease and operations according to accepted classifications.
Gastroenterologist - Long Beach, CA UnitedHealth Group IncGastroenterologist - Long Beach, CALong Beach, CAClinical › Corporate and business operations › Customer and support services › Early careers› Sales and account management › Technology and data› Physicians› Advanced practice clinicians› Pharmacy› Behavioral health› Nursing› Medical coding› Clinical support› U.S. › Ireland & UK › India › Philippines › Culture of Belonging› Employee Benefits› Blog. Technology and data Artificial intelligence Architecture Business systems analysis Data analytics Data engineering Data science Network infrastructure Product management & development Security and risk Software engineering.
Medical Director, Clinical Policy L.A. Care Health PlanMedical Director, Clinical PolicyLos Angeles, CAThis position ensures clinical policies and utilization management frameworks are evidence-based, operationally sound, compliant with regulatory and accreditation requirements, and aligned with organizational goals related to quality, safety, affordability, and member experience. The Medical Director oversees policy architecture, authorization strategy, and utilization oversight across all lines of business, ensuring clinical intent is accurately translated into authorization requirements, coding structures, and system configuration through partnership with internal teams.
Nurse Practitioner Family Medicine, Administrative Providence Health & ServicesNurse Practitioner Family Medicine, AdministrativeAnaheim, CA$183,822–$217,790 / yearJob ID Number: 31388 Facility Name: St. Joseph Heritage Medical Group Location Name: Anaheim Brand Name: Providence Provider Profession: Nurse Practitioner Medical Specialty: Family Medicine Job Setting: Medical Clinic Type of Role: Administrative Type of Role: Clinical Email: jamie.wright@psdrecruit.org In addition, conducting telehealth visits once a week, a key success factor of this position is educating providers to improve the completeness, accuracy, and reliability of clinical documentation and HCC coding to accurately reflect the patient''s true clinical picture.
Clinical Documentation Integrity Specialist Adventist Health SystemClinical Documentation Integrity SpecialistLos Angeles, CAJob Summary: Reviews, evaluates and assesses medical records of patients, looks for specificity of an illness, the accuracy of the clinician's documentation, coding requirements and documentation of important medical details to ensure the overall quality and completeness of clinical documentation of the patient medical record and ensure it is in compliance with government and other regulations. Essential Functions: Evaluates and assesses medical records of patients, looks for specificity of an illness, the accuracy of the clinician's documentation, coding requirements and documentation of important medical details to ensure the overall quality and completeness of clinical documentation of the patient medical record.
Coder III Henry Mayo Newhall Memorial HospitalCoder IIIValencia, CAThe Coder III is responsible for analyzing medical records for completion by Medical Staff, clinical or ancillary department; performing coding and abstracting functions; efficiently navigating the electronic medical record to find patient information required for coding; and accurately abstracting medical records for quality assessment screens. Acute hospital experience in an acute care hospital, with three years of inpatient and outpatient coding experience utilizing automated encoder.
Business Development Executive (MedInsight) Milliman IncBusiness Development Executive (MedInsight)Pasadena, CARemote$120,635–$199,065 / yearMedInsight is a subsidiary of Milliman; a global, employee-owned consultancy providing actuarial consulting, retirement funding and healthcare financing, enterprise risk management and regulatory compliance, data analytics and business transformation as well as a range of other consulting and technology solutions. Primary Responsibilities: Develop deep expertise in MedInsight's risk adjustment software and analytics, and in the surrounding market (CMS-HCC models, RADV, quality programs, value-based care, and the competitive landscape) to engage prospects as a credible advisor.