- Elevance Health (Costa Mesa, CA)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role enables associates to work virtually ... as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to identify opportunities for...Experiences:** + Fraud and Abuse experienced Nurse with a CPC are highly desired. For candidates working in person… more
- Insight Global (Sacramento, CA)
- …CPT Billing , E/M coding. * Ability to work in collaboration with the Billing Manager to provide clinician education on coding guidelines. * Ability to ... Insight Global's client within the healthcare industry is looking to hire a Billing Medical Coder for a direct hire, hybrid role onsite in Sacramento, CA.… more
- Cardinal Health (Sacramento, CA)
- …conducts investigations to resolve ethics and compliance issues. **Compliance Audit Manager ** Reporting to the Compliance Director, this position supervises and ... manages compliance audits to determine organizational integrity of billing for professional (physician) services and/or hospital (technical) services. This position… more
- Humana (Sacramento, CA)
- …part of our caring community and help us put health first** The Manager , Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. ... The Manager , Fraud and Waste works within specific guidelines and...Conducts on-site audits of provider records ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Decisions… more
- Sharp HealthCare (San Diego, CA)
- …oversight and maintenance of a high-quality, effective, best practices coding, billing , and reimbursement audit compliance program to prevent and detect violations ... compliance audit function and maintaining Sharp HealthCare's view of coding, billing and reimbursement compliance audits. **Required Qualifications** + 5 Years… more
- University of Southern California (Los Angeles, CA)
- …assist in the continuing education of professional coders and providers. Understands coding/ billing computer systems such 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...fashion. 5. Performs other duties as requested/assigned by Director, Manager , Supervisor, or designee. + TIMELINESS OF AUDITING/CODING &… more
- University of Southern California (Los Angeles, CA)
- Under the general direction of the Revenue Manager , the Charge Capture Coordinator is primarily responsible for unit and area specific charge capture of clinical ... main role is to enter charges into existing computerized billing system (Cerner and or PBAR). The Charge Capture...send appropriate notification to other parties such as Coding Manager , Clinical Department Manager , or Patient Accounting… more
- Publicis Groupe (Los Angeles, CA)
- … cycle, including invoice tracking, buy actualization in Prisma, and compiling draft billing for manager approval + Responsible for resolving all billing ... needs/objectives. The Senior Analyst will work closely with their manager in the development and communication of all search...of all core search metric calculations and relationships (eg CPC , CPA, CTR, SOV, weighted averages) + Serve as… more
- Sharp HealthCare (San Diego, CA)
- …1 **Shift Start Time** **Shift End Time** Certified Professional Coder ( CPC ) - AAPC; Certified Coding Specialist--Physician-based (CCS-P) - The American Health ... presenting to a large group of professionals. + Certified Professional Coder ( CPC ) - AAPC **OR** Certified Coding Specialist--Physician-based (CCS-P) - The American… more
- Elevance Health (Costa Mesa, CA)
- …recognizing aberrant coding and documentation patterns such as inappropriate billing for readmissions, inpatient admission status, and Hospital-Acquired Conditions ... Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder ( CPC ) or Inpatient Coding Credential such as CCS or CIC. +… more