Senior Revenue Integrity Specialist - Clinical Rev Integrity - Full Time 8 Hour Days (Remote) (Exempt) (Non-Union) University of Southern CaliforniaSenior Revenue Integrity Specialist - Clinical Rev Integrity - Full Time 8 Hour Days (Remote) (Exempt) (Non-Union)Alhambra, CARemote$99,507–$130,000 / yearThe Senior RI Specialist also coordinates with Keck Medical Center of USC Administration, IS, Compliance, Clinical Informatics and Integration personnel on technology projects impacting charge entry, charge dictionaries, and charge, and provides data derived from multiple entities of Keck Medical Center of USC for the management and support of critical decisions and functions related the Chargemaster, CDM Maintenance, and the improvement of charge capture. As a subject matter expert in the area of compliance and pricing of services, the Senior RI Specialist responds to inquiries regarding Chargemaster issues and is responsible for supervising meetings for projects associated with educating and communicating to clinical revenue generating departmental staff regarding the CDM Maintenance process, coding updates, compliance issues, and charge capture improvement.
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).
NewSpecialist, Customer Service - Wound Care Rare Disease Program Cardinal Health IncSpecialist, Customer Service - Wound Care Rare Disease ProgramCA$22.30–$28.80 / hourSpecialists will verify insurance, handle inbound & outbound calls to customers, collect medical documentation from doctor's offices, review documentation with the customer's insurance medical policy, submit or route for prior authorization and perform final biller tasks to release orders - all while maintaining customer contact throughout the process. The Wound Care Customer Success Team works on all new wound care orders while providing a white glove touch, working with customers from the start of their order through the end.
Lien Specialist DK Law's Open RolesLien SpecialistCosta Mesa, CaliforniaWe are seeking a Liens Specialist to support our Post-Treatment Department in identifying, negotiating, and resolving liens and reimbursement claims related to client settlements or awards. This role is ideal for someone who thrives in high-volume environments, understands the intricacies of medical billing and legal compliance, and can advocate for the best financial outcomes for our clients.
Revenue Cycle Specialist TIS International (USA) IncRevenue Cycle SpecialistCARemote3+ years of revenue cycle experience covering at least two of the following: eligibility/benefits verification, demographic/registration data integrity, billing and claim edit resolution, AR follow-up, ordenial management. Many of ACS Clients accounts require team effort while other accounts may require independent workers to complete all aspects of the billing process.
Government Audit Recovery Specialist Apidel TechnologiesGovernment Audit Recovery SpecialistCosta Mesa, CAContractorAs an essential role and focal point of all government audit activity, the Government Recovery Specialist is responsible for responding to correspondence from Government Agencies related to Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Targeted Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), Quality Improvement Organizations (QIO) and other Medicaid, Medi-Cal regulatory auditing body for pre and post payment audits. Experience working on government, Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Targeted Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), and other Medicaid, Medi-Cal and other regulatory audits.
Medical Collector / Accts Receivable Specialist Surgery PartnersMedical Collector / Accts Receivable SpecialistBeverly Hills, CAKNOWLEDGE AND SKILLS: Has initiative, resourcefulness, analytical ability, problem solving skills, and can deal effectively and harmoniously with all groups and individuals. Must be able to communicate articulately, comprehend written and verbal communications; and must be able to function effectively in a fast-paced work environment.
Lung Transplant Financial Services Specialist Cedars-Sinai Medical CenterLung Transplant Financial Services SpecialistLos Angeles, CAA minimum of 2 years of financial analysis, accounting, auditing, or related administrative experience, with exposure to healthcare operations including financial clearance, revenue cycle, or transplant financial services preferred. Requirements: Associate degree/college diploma - a minimum of two years college with courses in business, accounting, computer science or comparable education and experience required.
Revenue Cycle Specialist III (Gastroenterology) Cedars-Sinai Medical CenterRevenue Cycle Specialist III (Gastroenterology)Los Angeles, CAPrimary duties include: Develops and maintains excellent working relationships with Cedars-Sinai Clinical Departments, external clients, and patients, performing duties that include identifying, analyzing, resolving, and responding to our client's inquiries, concerns, and issues, and following up on accounts to ensure resolution. The Revenue Cycle Specialist III works under general supervision and following established practices, policies, and guidelines of Revenue Cycle Management supporting Hospital, Professional Fee billing and collections.
Workers' Compensation Specialist 26-00225 Alura Workforce SolutionsWorkers' Compensation Specialist 26-00225Simi Valley, CA$26–$30 / hourDESCRIPTION Our client reviews medical bills tied to insurance claims, mainly workers' compensation and liability cases, making sure the charges are accurate and fair. They also help resolve billing disputes and catch questionable billing activity before it becomes a bigger problem.
Workers' Compensation Specialist I & II Alura Workforce SolutionsWorkers' Compensation Specialist I & IISimi Valley, CA$26–$30 / hourOur client reviews medical bills tied to insurance claims, mainly workers' compensation and liability cases, making sure the charges are accurate and fair. They also help resolve billing disputes and catch questionable billing activity before it becomes a bigger problem.
Accounts Receivable Manager Los Angeles Jewish HealthAccounts Receivable ManagerReseda, California$115,000–$120,000In-depth knowledge of SNF medical insurance billing and follow-up procedures, including HMO, PPO, Medicare, Medi-Cal, Medi-Cal Managed Care, and indemnity plans. Los Angeles Jewish Health has been a trusted provider of senior healthcare for over 100 years, offering a wide range of services that prioritize excellence and Jewish values.
Lien Reduction Specialist TORKLAWLien Reduction SpecialistIrvine, CA$60,000–$70,000 / yearThis role offers the opportunity to play an important part in helping clients maximize their recovery while working alongside an experienced and dedicated legal team. We’re looking for professionals who: take ownership, communicate with confidence and empathy, thrive in a collaborative environment, and are passionate about achieving outstanding results for clients.
Authorization Specialist Aveanna Healthcare Holdings IncAuthorization SpecialistSeal Beach, CA$22–$24 / hourAs an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate. The Authorization Specialist facilitates the coordination between healthcare providers, clinical teams, and insurance carriers to ensure that necessary approvals are obtained, and payment processes are streamlined.
Experienced Medical Biller Renew Vein and VascularExperienced Medical BillerLos Angeles, CAFull timeResponsibilities include claim submission, payment posting, denial resolution, and working closely with providers and staff to maintain efficient revenue cycle operations. The ideal candidate will have a strong background in medical billing, coding, and insurance claim management, with a proven ability to ensure timely and accurate reimbursement.
Insurance Specialist (Remote) - Mountain and Pacific Time Zones MeduitInsurance Specialist (Remote) - Mountain and Pacific Time ZonesCaliforniaRemoteboth in-person and by telephone to register patients, gather or update information, obtain referrals and pre-authorizations, complete appropriate forms, conduct evaluations, determine benefits and eligibility (insurance, public programs, etc.), determine financial responsibility and/or to identify sources of payment for servicesâ¯. You will utilize your expertise in patient billing, claims submission, and payer guidelines (Medicare, Medicaid, &, commercial insurers) to effectively work with insurance companies, resolve issues, and ensure accurate and timely payments.
Front Loader - Biller Clínica Monseñor Oscar A. RomeroFront Loader - BillerLos Angeles, CAPrevious experience in medical billing or Medical Front office running eligibilities for all payers, Medi-Cal, Medicare, commercial plans. Position Summary: The Front-Loading Specialist is responsible for ensuring efficient and accurate loading of patient registration information into the Electronic Health Record (EMR) system prior to the patient's scheduled appointment.
Front Loader - Biller Clinica Monsenor Oscar A RomeroFront Loader - BillerLos Angeles, CAPrevious experience in medical billing or Medical Front office running eligibilities for all payers, Medi-Cal, Medicare, commercial plans. Position Summary: The Front-Loading Specialist is responsible for ensuring efficient and accurate loading of patient registration information into the Electronic Health Record (EMR) system prior to the patient's scheduled appointment.
Advanced Therapies Benefits Specialist (Financial Clearance) Shields Advanced TherapiesAdvanced Therapies Benefits Specialist (Financial Clearance)Los Angeles, CAFull timeCredentials & RequirementsIdeal candidate will have 5+ years of experience in healthcare billing, insurance coordination, or patient financial counsellingFamiliarity with healthcare financial systems and the insurance verification process requiredStrong communication and interpersonal skills are crucial for effectively assisting patientsAttention to detail, organizational abilities, and proficiency with healthcare information systems are also importantPrior experience/familiarity with payer navigation specifically related to cellular therapy (CAR T, TIL, etc.), gene therapy, and/or bone marrow transplant patient journeys and applicable prior authorizations required to enable is preferredPrior exposure with both inpatient & outpatient site-of-care also preferred but not required CompensationCompetitive base salary with bonus opportunity tied to outcomes metrics, with comprehensive benefits coverage also offered. Core Responsibilities Benefits Investigation & VerificationWork with all payers (Government, Commercial, and otherwise, including out-of-state Medicaid agencies), pharmacy benefit managers (PBMs), and third-party administrators (TPAs) to identify, investigate and verify patient insurance coverage and benefits as early as possible within the care journey to ensure timely access to care, accurate billing, and minimal claim denials.
APC Coding Validation Specialist MachinifyAPC Coding Validation SpecialistCA$85,000–$100,000 / yearDemonstrate a strong working knowledge of outpatient reimbursement methodologies, including Medicare Outpatient Prospective Payment System (OPPS), Ambulatory Payment Classification (APC), and Enhanced Ambulatory Patient Grouping (EAPG). Apply coding guidelines across a broad range of outpatient services, including but not limited to Interventional Radiology, Radiation Oncology, injections and infusions, outpatient surgeries, implants, and observation services (including carve-outs).