Medical Billing Customer Representative University of CaliforniaMedical Billing Customer RepresentativeLos Angeles, CA$30.79–$40.60 / 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. We're seeking detail-oriented, self-directed professional with: REQUIRED - Two years recent professional billing collection experience as well as two years of customer service experience.
Pharmacy Biller/Office Manager Oncare PharmacyPharmacy Biller/Office ManagerDowney, CaliforniaCompletion of classes in medical terminology, anatomy and physiology, ICD-9 and Current Procedural Terminology (CPT) coding conventions, and disease process from an accredited program. At least two (2) year billing experience in private or health care organization (preferred but required); Experience with physician or ambulatory setting coding preferred.
Nurse Itemized Bill Reviewer IBR Analyst MachinifyNurse Itemized Bill Reviewer IBR AnalystCA$80,000–$90,000 / yearAt Machinify, we're constantly reimagining what's possible in our industry-creating disruptively simple, powerfully clear ways to maximize our clients' financial outcomes today and drive down healthcare costs tomorrow. As part of the Complex Payment Solutions team, you will, as a Nurse Itemized Bill Reviewer (IBR Analyst), be responsible for reviewing facility insurance claims to determine true and accurate charges.
Claims 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.
Finance Systems Analyst Hogan LovellsFinance Systems AnalystLos Angeles, CA$100,000–$125,000 / yearThis will involve attending project meetings and working with other departments in Finance and Technology as required in relation to the projects concerned, keeping the appropriate manager regularly informed of progress and developments. The team currently consists of the Finance Systems Manager with analysts based in London and Hong Kong, a Senior Finance Systems Manager with analysts based in the US, and a Finance Systems Manager - Product Owner based in London.
AVP, Medicare Risk Adjustment Performance Alignment Healthcare IncAVP, Medicare Risk Adjustment PerformanceCA$198,219–$297,329 / yearThe role partners closely with Market Operations, Network Management, Clinical Operations, Finance, Compliance, and Data & Technology teams to ensure enterprise Risk Adjustment goals are achieved while supporting audit readiness, provider performance improvement, and long-term organizational growth. The AVP leads the development and execution of enterprise prospective, concurrent, and retrospective Risk Adjustment strategies and serves as the executive responsible for operational performance across provider engagement, coding operations, chart retrieval, submission, analytics, vendor management, and revenue realization.
Medical Assistant/ Insurance verifier , authorization specialist Apex Practice Management GroupMedical Assistant/ Insurance verifier , authorization specialistNorthridge, CAFull timeThe ideal candidate will be responsible for obtaining insurance authorizations and check eligibility for medical procedures and services, ensuring timely approvals to facilitate patient care. - Communicate with healthcare providers, insurance companies, and patients to gather necessary information.
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.
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.
Financial Counselor - OC Hospital City of HopeFinancial Counselor - OC HospitalIrvine, CACity 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. Works with Patient Business Services on Pending Medi-Cal cases to verify status of application and once the case is approved and/or denied makes sure the registration system is updated accurately.
BioMed Tech I Prime Healthcare Services IncBioMed Tech IInglewood, CA$25–$34.91 / hourJoin our team of dedicated professionals who provide services and operational support to award winning hospitals through roles in supply chain, IT and cybersecurity, clinical engineering, capital procurement, medical coding, project management and more. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
Physician Urgent Care Medical Director ConcentraPhysician Urgent Care Medical DirectorCity Of Industry, California$280,000–$330,000 / yearMonitors key clinical center metrics that are provided by Clinical Analytics and relate to quality outcomes: Practice Indicators, COP, GRV, LOS, TAT, Specialist Referral Rate, Primary Care Case Duration, Days to First Recheck, % of cases with Lost Time, Limited Duty, and Full Duty. The Center Medical Director supports the Director of Medical Operations by providing exceptional clinical care delivery within the center, consistent with Concentra’s clinical model, and ensuring optimal clinical outcomes for our workforce patient population.
Physician Medical Director ConcentraPhysician Medical DirectorGardena, California$285,000–$320,000 / yearMonitors key clinical center metrics that are provided by Clinical Analytics and relate to quality outcomes: Practice Indicators, COP, GRV, LOS, TAT, Specialist Referral Rate, Primary Care Case Duration, Days to First Recheck, % of cases with Lost Time, Limited Duty, and Full Duty. This position is eligible to earn a base compensation rate in the range of $285,000- $320,000 depending on job-related factors as permitted by applicable law, such as level of experience, geographic location where the work is performed, and/or seniority.
CNC Controls Engineer Hadrian AutomationCNC Controls EngineerLos Angeles, CaliforniaBacked by leading investors including JPMorgan Chase, Valor Equity Partners, Andreessen Horowitz, Founders Fund, 137 Ventures, Lux Capital, T. Rowe Price, and Morgan Stanley, we’re building the future of American manufacturing—and looking for exceptional people to help make it happen. Series D at a $7.87B valuation, Hadrian is rapidly expanding our manufacturing footprint, launching new capabilities across welding, casting, forging, electronics, additive manufacturing, and more, while scaling our Factory-as-a-Service platform to transform how critical products are built.
Senior Architect, Data Engineering West Monroe Partners, LLCSenior Architect, Data EngineeringLos Angeles, CA$199,100–$223,400 / yearThis is an excellent opportunity to work with clients developing Big Data strategy and roadmaps, while gaining exposure to a variety of industries including Healthcare, Financial Services, Insurance, Consumer & Industrial Products, and Energy & Utilities. Proven experience in supporting business development efforts, including identifying client needs, crafting technical solutions, contributing to proposals, and participating in pre-sales activities to drive revenue growth.
Medical Director Utilization Management Cohere Health Technologies LLCMedical Director Utilization ManagementCARemote$240,000–$250,000 / yearBy 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. With an enterprise approach that streamlines payer-provider decision-making across the care continuum-including policy, prior authorization, payment accuracy, and more-the company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction.
Medical Patient Language Writing Specialist Cohere Health Technologies LLCMedical Patient Language Writing SpecialistCARemote$85,000–$92,000 / yearBy 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. With an enterprise approach that streamlines payer-provider decision-making across the care continuum-including policy, prior authorization, payment accuracy, and more-the company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction.
Medical Director - Radiation Oncology - MD or DO CVS Health CorpMedical Director - Radiation Oncology - MD or DOCA$174,070–$374,920 / yearThe Radiation Oncology Medical Director supports the CVS Health Specialty oncology business in managing oncology specific utilization of providers, clinical reviews of oncology specific data, and assist with growing our oncology footprint. In the Medical Director role, you will provide oversight for medical policy implementation; you will support the ensuring timely and consistent responses to members and providers; you will focus on prior authorization cases and consultation cases.
NewSr Analyst Revenue Cycle Management (RCM) Analytics Baylor Miraca Genetics Laboratories LLCSr Analyst Revenue Cycle Management (RCM) AnalyticsCAThe role maintains recurring reporting, checks data for accuracy, investigates performance changes, and gives leaders clear information they can use to improve cash, reimbursement, turnaround time, productivity, quality, and payer performance. Analyze RCM performance across workflows, payers, tests, teams, aging, and denial types to identify trends, root causes, bottlenecks, and improvement opportunities.
Strategic Medical Director, Diagnostic Imaging Cohere Health Technologies LLCStrategic Medical Director, Diagnostic ImagingCARemote$285,000–$305,000 / yearProvide leadership in the creation of comprehensive research packages, investigating specific clinical areas/offerings and strategic partners of interest to strengthen the offering, then execute on cultivating any external partnerships and/or vendor relationships as necessary. Build and expand client relationships by partnering with the Growth and Client Experience teams to uncover client pain points, deliver solutions, assign clients to managers as appropriate, and support upsell opportunities (e.g., Sleep programs).