- Highmark Health (Sacramento, CA)
- …clinical outcomes, cost, and member experience. + **Operational Integration & Coding :** Engage non-clinical teams to ensure operational guidelines are aligned with ... intent. Develop and maintain a thorough understanding of medical coding (ICD-10, CPT, HCPCS) and ensure accurate coding... coding (ICD-10, CPT, HCPCS) and ensure accurate coding principles are incorporated into policy criteria. + **Policy… more
- Cedars-Sinai (Los Angeles, CA)
- …you be doing in this role?** The Revenue Integrity Spec II, of Compliance and Revenue Integrity, is responsible for fact-finding, organization, and presentation of ... with established timelines. The Specialist: + Performs accurate and timely coding charge posting (CPT, ICD-10, HCPCS, modifiers) + Maintains familiarity with… more
- J&J Family of Companies (Fresno, CA)
- …authorizations and appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations (local payers, government payers, ... of national, regional, local, and account market dynamics including coverage and coding requirements. + Grow the knowledge of hub and specialty distribution channels… more
- Scripps Health (San Diego, CA)
- …gastroenterology. The Coder II is responsible for ensuring accurate and timely coding of diagnoses and procedures for inpatient, outpatient and professional visits ... Conducts concurrent and/or retrospective claims data reviews for physician services, coding and abstracting all services, procedures, diagnoses, and conditions from… more
- Highmark Health (Sacramento, CA)
- …and demographic data, interpret and apply diagnoses and procedures utilizing ICD coding systems and assists in decreasing the average accounts receivable days. ... management of medical information and cash flow as it pertains to the unbilled coding report. (10%) + Keeps informed of the changes/updates in ICD guidelines by… more
- LA Care Health Plan (Los Angeles, CA)
- …configuration errors, contract misinterpretation, pricing defects, authorization discrepancies, coding anomalies, or systemic system defects. Reconstructs claims ... required for regulators, external auditors, and legal proceedings. Works with Compliance to design corrective action plans and support enterprise readiness during… more
- UCLA Health (Los Angeles, CA)
- …You'll ensure that hospital charges are processed promptly, accurately, and in compliance with Centers of Medicare & Medicaid Services (CMS), Medi-Cal, and other ... policies. You'll apply your extensive knowledge of hospital billing, coding , and pricing practices, as well as advanced data analysis skills, to monitor, maintain,… more
- ADP (Pasadena, CA)
- …+ Align IAM and directory strategies with organizational security policies, compliance requirements, and business continuity goals. + Design and enforce Active ... **PowerShell** , **Python** , or similar scripting languages. + Implement secure coding and automated deployment practices into **CI/CD pipelines** to support rapid,… more
- LA Care Health Plan (Los Angeles, CA)
- …of Excellence & Quality Assurance is responsible for leading the quality, compliance , training, and continuous improvement functions that ensure LA Care's Core ... areas. The Director oversees enterprise claims quality auditing, claims compliance oversight, issue detection and validation, corrective action planning, root-cause… more
- Cardinal Health (Sacramento, CA)
- …to resolve claim discrepancies. + Maintain up-to-date knowledge of payer policies, coding changes, and reimbursement guidelines. + Ensure compliance with HIPAA ... and all relevant federal/state billing regulations. + Flag trends or recurring issues for team leads or supervisors. + Meet daily/weekly productivity goals (eg, number of claims worked, follow-ups completed). + Assist with special projects, audits, or other… more
Recent Jobs
-
Director, Digital Solutions Implementations
- Iron Mountain (Dallas, TX)
-
Physician - Emergency Medicine (Per Diem)
- PeaceHealth (Florence, OR)
-
Chaplain I - PRN
- Baylor Scott & White Health (Dallas, TX)