• Diagnosis Related Group Clinical Validation…

    Elevance Health (Los Angeles, CA)
    …letters. + Maintains accuracy and quality standards as established by audit management. + Identifies potential documentation and coding errors by recognizing ... the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How...clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding… more
    Elevance Health (09/30/25)
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  • Principal Software Quality Engineer (Sqae)

    Belcan (Torrance, CA)
    Principal Software Quality Engineer (SQAE) Job Number: 359830 Category: Embedded Sys / Software Eng Description: Job Title: Principal Software Quality Engineer ... able to obtain, a DOD Secret Clearance** A Software Quality Engineer job opportunity is open with our client...in support of AS9100, CMMI, DO-178, and DO-254. * Review program specific software related documents such as Software… more
    Belcan (09/06/25)
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  • Inpatient Medical Coder - PRN - Up to $1,000 Sign…

    Datavant (Sacramento, CA)
    …preferably within an academic medical facility. + Experience with significant level of coding quality review feedback + Experience in computerized encoding ... codes from patient records, ensuring precision and adherence to documentation + Oversee and audit the work of Level 1 & 2 Coders, where applicable + Champion… more
    Datavant (09/24/25)
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  • Medical Billing Specialist II - Patient Financial…

    Ventura County (Ventura, CA)
    …limited to, the following: + Ensures accuracy and compliance with billing, coding , and follow-up requirements and identifies overpayments and lack of documentation ... International Classification for Diseases (ICD)-10 codes, and Health Care Procedure Coding Systems (HCPCS) codes. + Knowledge of Treatment Authorization Request… more
    Ventura County (08/02/25)
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  • Health Care Disputes - Compliance Risk Adjustment,…

    Ankura (Los Angeles, CA)
    …investigation projects for clients. + Oversee and conduct data gathering activities, document review , and quality control of data assessment. + Work with Senior ... + Prepare client communications, both written and oral, for senior level review . + Perform client facing tasks including operational, compliance or regulatory… more
    Ankura (09/09/25)
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  • Revenue Cycle Specialist III (Emergency)

    Cedars-Sinai (Torrance, CA)
    …pseudo-code creation. + Identifies possible coding deficiencies through charge/medical record review and coordinates coding review to ensure accurate ... Award 19 years in a row for providing the highest- quality medical care in Los Angeles. We also were...charge capture, enhancing third-party reimbursement and minimizing audit liability. + Review accounts on OCS… more
    Cedars-Sinai (08/17/25)
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  • Platform Senior Developer

    City National Bank (Los Angeles, CA)
    …Cycle (SDLC). * Identify and recommend improvements * Design and Build high quality software * Ensure work includes necessary audit controls,compliance, and ... performance. Specific tasks may consist of solution design and coding , performing unit testing, and providing on-call technical and...own work and that of peers * Conduct peer review sessions * Develop test plans, use cases and… more
    City National Bank (08/07/25)
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  • Associate Medical Director, Pharmacovigilance…

    Sumitomo Pharma (Sacramento, CA)
    …Characteristics (SmPC), and Canadian Product Monograph (PM) + Ensures timely and quality review and assessment of ICSRs, including seriousness, expectedness, ... safety narratives, adverse event coding , concomitant medication coding , and causality statements....study team meetings and governance committees. + Performs aggregate review of post-marketing safety data in support of safety… more
    Sumitomo Pharma (08/15/25)
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  • Sr. Medical Claims Examiners (3+ years of Xcelys…

    NTT DATA North America (Ontario, CA)
    …system enhancements, audits, and process optimizations. **Responsibilities** Adjudication & Review + Process comprehensive medical claims using Xcelys and associated ... subsystems + Resolve complex pends, coding issues, and contract exceptions + Author overpayment/underpayment determinations and coordinate appeals Quality &… more
    NTT DATA North America (09/27/25)
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  • Social Science Research Professional (1 Year…

    Stanford University (Stanford, CA)
    …scales requiring judgment in applying non-routine procedures. Analyze and summarize results for review with supervisor. Audit the accuracy and validity of data. ... on a participant's schedule. Data analysis also requires detailed coding by multiple coders to ensure scientific rigor. The...+ Review and audit case report forms for completion and accuracy with… more
    Stanford University (09/26/25)
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