- Robert Half Accountemps (Los Angeles, CA)
- …EMR, athenahealth, Ambulatory Surgery, Ambulatory, Urgent Care, Clinics, Outpatient Clinics, Medical Billing , Leadership Skills, Supervising, Patient Billing ... Description A prestigious healthcare non-profit organization is seeking a talented Medical Revenue Cycle Director to join their organization. The revenue cycle… more
- Cardinal Health (Sacramento, CA)
- …(technical) services, including: detection and correction of documentation, coding, and billing errors and/or medical necessity of services billed. Particular ... documentation and coding related to physician or hospital (inpatient and outpatient) billing and/or medical necessity reviews. + Manages focused audits involving… more
- Molina Healthcare (Long Beach, CA)
- …previously denied cases, in which an appeal has been submitted, to ensure medical necessity and appropriate/accurate billing and claims processing. * Evaluates ... Field. **Preferred Experience** Nursing experience in Critical Care, Emergency Medicine, Medical Surgical, or Pediatrics. Advanced Practice Nursing. Billing and… more
- Highmark Health (Sacramento, CA)
- …to prevent further improper payments.Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. + Responsible for ... to internal and external law enforcement and regulatory agencies, Credentialing or Medical Review Committee. + Engages in delivery of audit results and overpayment… more
- Elevance Health (Los Angeles, CA)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... Related Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs… more
- Amazon (San Francisco, CA)
- …cross functionally with tech and non-tech teams - In-depth knowledge of medical billing processes, healthcare regulations, and compliance requirements - Strong ... a collaborative and growth-oriented team environment. This role oversees commercial billing , charge capture, coding, AR, cash posting and patient financial services.… more
- Datavant (Sacramento, CA)
- …for reviewing records via client's auditing tool, updating coding and submitting for billing . Evaluator experience a plus. **What You Will Do:** + Performs Inpatient ... to ensure optimal workflow and turnaround time + Provides coder education via the auditing process + Function in...via client's auditing tool, updating coding and submitting for billing . Evaluator experience a plus. + 5+ years of… more
- Elevance Health (Costa Mesa, CA)
- …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Fraud Investigator II** is responsible for ... identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to identify opportunities for fraud and abuse… more
- Scripps Health (San Diego, CA)
- …compliance with CMS, third party payers, NCDs and LCDs, coding, and billing regulations. Oversees the development and coordination of ongoing CDI education for ... other relevant industry standard guidelines. * Provides input to coding and medical record documentation guidelines to assure compatibility and compliance with all… more