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).
Medical Claims Resolution Specialist Kinetic Personnel Group, Inc.Medical Claims Resolution SpecialistOrange, CA$25–$31 / hourA full time permanent position includes a pay raise, telecommute options, a CalPERS Pension and excellent government benefits including generous holiday, PTO and sick pay days off, year one! Job duties: Addresses provider inquiries, questions, and concerns in all areas including enrollment, claims submission and payment, benefit interpretation, and referrals/authorizations for medical care.
SVP AI & Data ReveleerSVP AI & DataCARemote$305,000–$355,000 / yearDirect the engineering teams that extract medical codes and quality data from charts: retrospective risk extraction built on Textract OCR, Comprehend Medical, and Gemini; prospective risk extraction that runs PDF and CCDA charts through Gemini and a custom rules engine to surface candidate ICD codes; and quality and HEDIS extraction that applies large language models to chart content. The SVP, AI & Data sets technical direction and architecture, partners with engineering and product leadership on delivery, and stays close enough to the systems to make sound build decisions - while giving team leaders the autonomy to own their domains.
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.
NewClaims Auditor MedPOINT ManagementClaims AuditorSherman Oaks, CARemoteFull timeMedPOINT Management is a leading Independent Practice Association (IPA) management company serving the greater Los Angeles area, dedicated to delivering high-quality, coordinated healthcare to patients across Southern California. Our team enjoys a collaborative work culture, opportunities for professional growth, and the satisfaction of making a meaningful impact in the healthcare industry.
Director - Clinical Research Billing (Remote - CA) Stanford Health CareDirector - Clinical Research Billing (Remote - CA)CARemote$94.35–$125.03 / hourThe Director of Clinical Research Billing will collaborate and have direct interaction with a broad set of stakeholders across the institution, including Principal Investigators, study sponsors, study teams, finance/accounting, revenue cycle, internal audit, compliance, business office leaders, and clinic operational teams. Responsible for overseeing revenue cycle post-award activities, such as research charge review, patient care billing for all clinical trials, reviewing trends in revenue capture and reimbursement, and forecasting financial impacts pertaining to clinical research activities.
Podiatrist - Part-Time | FQHC The Staff PadPodiatrist - Part-Time | FQHCPomona, CaliforniaReporting to the Chief Medical Officer, this role is responsible for diagnosing, treating, and preventing conditions affecting the foot, ankle, and related structures while delivering high-quality, patient-centered care. The Podiatrist collaborates closely with primary care providers and other healthcare professionals to improve patient outcomes and enhance mobility, independence, and overall quality of life.