Special Investigation Unit Investigator II (ATL) The Intersect GroupSpecial Investigation Unit Investigator II (ATL)Los Angeles, CARemote$43–$48 / hourThis position plays an important role in identifying risk patterns, supporting enforcement actions, and safeguarding healthcare program integrity through data driven insights and detailed case development. Our client operates one of the largest public health programs in the country, delivering essential services to millions while maintaining a strong focus on compliance, integrity, and accountability.
Clinical Documentation Improvement Specialist (CDI) II - Full Time, Days (CBO - Foothill) NOR Healthcare SystemsClinical Documentation Improvement Specialist (CDI) II - Full Time, Days (CBO - Foothill)Bellflower, CAFull timeRequired QualificationsCDIP or CCDS Medical Graduate, Physician Assistant or Registered Nurse (Current CA License) Minimum 1 year of previous practical floor CDI experience in an acute care setting Ability to multitask and maintain a work pace appropriate to workload Must demonstrate customer service skills appropriate to the job Excellent written and verbal communication skills in English Ability to effectively communicate with physicians in a clear and concise manner Computer literacy and proficiency Hospital Fire and Life Safety Card (Los Angeles City Employees only) Preferred QualificationsCCS Physical RequirementsIndicate physical requirements for performing the essential functions of the job by double clicking and selecting 'checked' on the boxes below. Standing - Frequently Walking - Frequently Sitting - Frequently Reaching with Hands and Arms - Occasionally Climb or Balance - Occasionally Stooping, Kneeling, Crouching, or Crawling - Occasionally Talking - Frequently Hearing - Constantly Seeing - Constantly Performing repetitive motions with arms or hands - Frequently Lifting, carrying, pushing or pulling up to 10 lbs - Constantly Lifting, carrying, pushing or pulling up to 25 lbs - Occasionally Lifting, carrying, pushing or pulling up to 50 lbs - None Lifting, carrying, pushing, or pulling greater than 50 lbs - None Driving - NonePay Rate: Min - $93,800 | Max - $128,950
Clinical Documentation Improvement Specialist (CDI) II - Full Time, Days (CBO Tustin) NOR Healthcare SystemsClinical Documentation Improvement Specialist (CDI) II - Full Time, Days (CBO Tustin)Tustin, CAFull timeRequired QualificationsCDIP or CCDS Medical Graduate, Physician Assistant or Registered Nurse (Current CA License) Minimum 1 year of previous practical floor CDI experience in an acute care setting Ability to multitask and maintain a work pace appropriate to workload Must demonstrate customer service skills appropriate to the job Excellent written and verbal communication skills in English Ability to effectively communicate with physicians in a clear and concise manner Computer literacy and proficiency Hospital Fire and Life Safety Card (Los Angeles City Employees only) Preferred QualificationsCCS Physical RequirementsIndicate physical requirements for performing the essential functions of the job by double clicking and selecting ‘checked’ on the boxes below. Standing - Frequently Walking - Frequently Sitting - Frequently Reaching with Hands and Arms - Occasionally Climb or Balance - Occasionally Stooping, Kneeling, Crouching, or Crawling - Occasionally Talking - Frequently Hearing - Constantly Seeing - Constantly Performing repetitive motions with arms or hands - Frequently Lifting, carrying, pushing or pulling up to 10 lbs - Constantly Lifting, carrying, pushing or pulling up to 25 lbs - Occasionally Lifting, carrying, pushing or pulling up to 50 lbs - None Lifting, carrying, pushing, or pulling greater than 50 lbs - None Driving - None Essential Job Functions / Major Areas of ResponsibilityThe essential functions below are not intended to be an exhaustive list of all duties that may be assigned to this position, nor does it restrict the duties which may be assigned to this position if such duties reasonably relate to the position.
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.
SIU Investigative Analyst III (ATL) The Intersect GroupSIU Investigative Analyst III (ATL)Los Angeles, CARemote$32–$41.99 / hourYou will act as a subject matter expert, overseeing reporting processes, analyzing fraud patterns, and collaborating with internal teams and regulatory agencies to strengthen program integrity. Our client supports large scale public healthcare programs and emphasizes compliance, accountability, and innovation to protect critical resources.
Medical Billing & Coding Specialist CrewBloomMedical Billing & Coding SpecialistLos Angeles, CARemoteYou will work closely with healthcare practitioners in private practices and medical clinics to accurately review, assign, and manage medical codes, ensuring compliant billing, timely reimbursements, and efficient revenue cycle operations. While industry certifications are a plus, what matters most is hands-on experience with medical billing and coding, particularly a strong understanding of Eye Care Practice (ECP) coding guidelines and regulations.
Home Health Quality Assuranc / Coding Specialist CbHome Health Quality Assuranc / Coding SpecialistSanta Ana, CaliforniaThe Home Health Quality Assurance (QA) / Coding Specialist is responsible for reviewing clinical documentation to ensure compliance with Medicare Conditions of Participation (CoPs), state and federal regulations, and agency policies. This position performs ICD-10 coding, OASIS review, chart audits, and quality assurance activities to support accurate reimbursement, regulatory compliance, and high-quality patient care.
Home Health Quality Assuranc / Coding Specialist Green Meadows Home Health Care IncHome Health Quality Assuranc / Coding SpecialistSanta Ana, CAFull timeThe Home Health Quality Assurance (QA) / Coding Specialist is responsible for reviewing clinical documentation to ensure compliance with Medicare Conditions of Participation (CoPs), state and federal regulations, and agency policies. This position performs ICD-10 coding, OASIS review, chart audits, and quality assurance activities to support accurate reimbursement, regulatory compliance, and high-quality patient care.
Financial Eligibility Worker Northeast Community ClinicsFinancial Eligibility WorkerHawthorne, CAConduct follow-up with applicants to ensure any and all required documentation and paperwork is submitted and inform patients of any approved health insurance coverage. This position will be responsible for assisting patients with the application process and enrolling the patient into various insurance programs if qualified.
Manager - Healthcare Revenue Integrity Consulting RSMManager - Healthcare Revenue Integrity ConsultingLos Angeles, CA$112,100–$225,500 / yearThe salary range (or starting rate for interns and associates) for this role represents numerous factors considered in the hiring decisions including, but not limited to, education, skills, work experience, certifications, location, etc. More specifically, qualified candidates must have experience with revenue integrity process management and optimization, including experience with Charge Data Master, Pricing, Coding, and CDI including the identification, qualification and quantification of opportunities.
NewClinical Documentation Integrity Specialist II - Hybrid FT Days Torrance Memorial Medical CenterClinical Documentation Integrity Specialist II - Hybrid FT DaysTorrance, CaliforniaUses clinical/nursing/coding knowledge to concurrently review and assess the medical record within 24-48 hours of admission including but not limited to physician documentation, lab and radiology results, nursing, nutrition, physical therapy and other provider’s documentation to determine that the most accurate severity of illness and expected risk of morality is reflected in the patient’s health record. Obtains additional documentation from physician or other qualified healthcare provider for clarification when there is conflicting, incomplete or ambiguous information in the healthcare record regarding any reportable data elements dependent on health record documentation.
Clinical Documentation Specialist GuidehouseClinical Documentation SpecialistLos Angeles, California$74,000–$124,000 / yearInitiates compliant physician queries when documentation is confusing, ambiguous, or missing and follows up with MD to seek immediate response to query (utilizing the following AHIMA practice briefs as a guide: “ Managing an Effective Query Process ,” October 2008 and “Guidance for Clinical Documentation Improvement Programs” , May 2010). Reviews daily admissions to assigned unit, perform initial code assignment for a working DRG and complete CDI software data entry for initial and follows up case reviews (or worksheet to include code and DRG assignment) and submit to Program Assistant.
Charge Master Analyst - Revenue Integrity - FT Days University of California, IrvineCharge Master Analyst - Revenue Integrity - 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.
Director of Compliance The Los Angeles Cancer NetworkDirector of ComplianceGlendale, CaliforniaThis position ensures compliance with federal, state, and local laws and regulations governing physician practices, specialty oncology services, infusion centers, pharmacy operations, laboratory services, and clinical research (if applicable). We are looking for talented and highly-motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve.
Backend Engineer FancyBackend EngineerIrvine, CaliforniaFancy is a pioneering financial rewards platform that transforms rent payments into financial opportunities for renters in the U.S. By offering meaningful cashback rewards, flexible payment options, and personalized financial insights, Fancy addresses the critical challenges faced by renters while creating value for property managers and advertisers. This role is ideal for someone who thrives in a highly collaborative environment, is experienced in microservice architecture, and enjoys solving complex backend problems with elegant, scalable code.
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.
HEDIS Abstractor Astrana Health, Inc.HEDIS AbstractorSan Francisco, CA$27–$33 / hourThe HEDIS Abstractor collaborates with internal quality teams, providers, and external audit vendors to improve measure performance, maintain compliance, and support successful HEDIS audits. The HEDIS Abstractor supports Quality Care Improvement initiatives by conducting comprehensive medical record reviews and abstraction activities to identify and close HEDIS measure care gaps.
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.
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).
HIM Coding Manager Auditing and Education - HIM Financial - Full Time 8 Hour Days (Exempt) (Non-Union) University of Southern CaliforniaHIM Coding Manager Auditing and Education - HIM Financial - Full Time 8 Hour Days (Exempt) (Non-Union)Los Angeles, CaliforniaEnsure effective use of coding and electronic health record systems including: Cerner/PowerChart and Coding mPage Solventum/3M 360 Encompass (CAC/CRS) Solventum/3M HDM, HRM, and ARMS Soarian Financials and CHC Assurance PFS systems • Promote effective use of system tools to support coding accuracy, audit activities, and denial prevention. The Manager serves as a subject matter expert in coding regulations and provides leadership in the development and implementation of coding education, audit programs, facilitating educational webinars and seminars, planning and delivering effective presentations, and process improvement initiatives.