- University of Southern California (Los Angeles, CA)
- … Specialist " analyze, investigate, mitigate, and resolve all coding-related ' claims denials' and ' claims rejections,' specific to ICD-10-CM, ICD-10-PCS, ... the denial management process for coding-related denials, triage denied claims to distinguish coding-related denials versus clinical-related denials, evaluating … more
- Zurich NA (Sacramento, CA)
- …workstreams + Experience in a transactional, operational or customer service environment + Quality auditing experience + Knowledge of the insurance industry and ... Sr Supplier Medical Process Specialist 128416 Zurich North America is seeking am...continuous process and system enhancements to improve operational efficiencies, quality and/or timeliness. At Zurich North America Claims… more
- Cedars-Sinai (CA)
- **Job Description** The Managed Care Compliance Specialist is responsible for assisting with the implementation of the internal auditing and monitoring program ... rules and regulations including but not limited to AB1455 and Medicare Claims Processing Guidelines. This position is responsible for maintaining routine auditing… more
- Elevance Health (Los Angeles, CA)
- …at least one of the following: AA/AS or minimum of 15 years of experience in claims auditing , quality assurance, or recovery auditing . + Requires at ... spending. The **DRG Coding Auditor Principal** is responsible for auditing inpatient medical records on claims paid...and generate audit findings letters. + Validates accuracy and quality standards as set by audit management for the… more
- Elevance Health (Walnut Creek, CA)
- …in applicable state(s). + Requires a minimum of 10 years of experience in claims auditing , quality assurance, or clinical documentation improvement, and a ... The **Diagnosis Related Group Clinical Validation Auditor-RN** is responsible for auditing inpatient medical records to ensure clinical documentation supports the… more
- LA Care Health Plan (Los Angeles, CA)
- Payment Integrity Nurse Coder RN III Job Category: Clinical Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ... the right time. Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents… more
- University of Southern California (Los Angeles, CA)
- …as Cerner, MediTech, Epic, and Athena IDX in a manner to assure clean claims release for billing in a timely manner. Participate in response to inquiries regarding ... other coding department related duties as assigned by Coding management. + CODING AUDITING 1. Performs monthly internal coding audits to evaluate accuracy of coding… more