Healthcare Compliance Specialist 26-00251 Alura Workforce SolutionsHealthcare Compliance Specialist 26-00251Rancho Cucamonga, CA$27.43 / hourUtilize advanced Microsoft Excel tools (e.g., pivot tables, Power Query, conditional formatting, formulas, macros) to organize and analyze referral data, generate reports, and support trend identification. The Specialist organizes, analyzes, and reports referral data, and utilizes the Plan's case management application and FWA analytics tools to support the SIU in proactive FWA detection.
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.
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.
Manager - Healthcare Revenue Integrity Consulting RSMManager - Healthcare Revenue Integrity ConsultingIrvine, 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.
Nurse Practitioner/Physician Assistant Choice Healthcare AssociatesNurse Practitioner/Physician AssistantApple Valley, CAThis role focuses on delivering high-quality preventive care through Annual Wellness Visits (AWVs), accurate HCC (Hierarchical Condition Category) recapture, and comprehensive medication reconciliation. Experience with in-home assessments or mobile care, willing to travel to local clinic sites within the Victorville, Apple Valley, Phelan, Hesperia.
Educator-Him Loma Linda University Medical CenterEducator-HimLoma Linda, CALicensures and Certifications: Minimum one of the following certification Clinical Documentation Improvement (CDI) by AHIMA, ICD-10-CM/PCS Trainer by AHIMA, Certified Professional Coder (CPC) by AAPC, Certified Interventional Radiology Cardiovascular Coder (CIRCC) by AAPC, Certified Inpatient Coder (CIC) by AAPC, Certified Risk Adjustment Coder (CRC) by AAPC, Certified Outpatient Coder (COC) preferred. Students will examine how electronic health records (EHRs), clinical decision support (CDS) tools, health information technologies, and advanced technologies are integrated into clinical environments, with a focus on usability, workflow redesign, and data-driven performance improvement.
NewEducator-HIM Loma Linda University Medical CenterEducator-HIMLoma Linda, CALicensures and Certifications: Minimum one of the following certification Clinical Documentation Improvement (CDI) by AHIMA, ICD-10-CM/PCS Trainer by AHIMA, Certified Professional Coder (CPC) by AAPC, Certified Interventional Radiology Cardiovascular Coder (CIRCC) by AAPC, Certified Inpatient Coder (CIC) by AAPC, Certified Risk Adjustment Coder (CRC) by AAPC, Certified Outpatient Coder (COC) preferred. Students will examine how electronic health records (EHRs), clinical decision support (CDS) tools, health information technologies, and advanced technologies are integrated into clinical environments, with a focus on usability, workflow redesign, and data-driven performance improvement.
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.
Manager, Payment Integrity Enablement Inland Empire Health PlanManager, Payment Integrity EnablementRancho Cucamonga, California$104,041.60–$137,841.60 / yearFull timeReporting to the Director of Payment Integrity, the Manager, Payment Integrity Enablement provides strategic and operational leadership over enterprise-wide payment accuracy education, provider billing guidance, and compliance‑aligned intervention programs. Stakeholder Communication & Engagement Strategy : Serve as the operational driver for Payment Integrity Enablement interventions, ensuring programs scale effectively, are audit-ready, and deliver measurable reductions in inaccurate or wasteful spend.
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.
Risk Adjustment Coding Specialist II Astrana Health, Inc.Risk Adjustment Coding Specialist IICA, California$70,000–$85,000 / yearPerform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines. Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements.
DRG Coding Auditor - Ms-Drg And Apr-Drg Elevance HealthDRG Coding Auditor - Ms-Drg And Apr-DrgCosta Mesa, CA$92,880–$160,218 / yearRequires at least one of the following certifications: RHIA certification as a Registered Health Information Administrator, RHIT certification as a Registered Health Information Technician, CCS as a Cert Coding Specialist, CIC as a Certified Inpatient Coder, or Certified Clinical Documentation Specialist (CCDS). Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred.
Risk Adjustment Coding Specialist II - Orange County Astrana Health, Inc.Risk Adjustment Coding Specialist II - Orange CountyOrange, California$70,000–$85,000 / yearPerform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines. Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements.
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 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.
Specialty Physician Coder 26-00243 Alura Workforce SolutionsSpecialty Physician Coder 26-00243Fountain Valley, CARemote$43.75–$46 / hourWe're looking for an experienced Specialty Physician Coder to join a growing Coding Compliance team, remote, with real variety in your day-to-day work. If this sounds like the kind of role where your specialty experience actually gets used, not just your general coding skills, let's talk.
Specialty Physician Coder IconmaSpecialty 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 Specialty Physician Coder – Interventional IconmaSenior 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.