5 jobs found in Costa Mesa

DRG Coding Auditor Principal This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case rate and per diem, generating...

Coder III (Hospital Billing): Medical Coding Join to apply for the Coder III (Hospital Billing): Medical Coding role at Hoag Health System Primary Duties And Responsibilities The Coder (Hospital Billing) reviews clinical documentation and diagnostic results and applies appropriate ICD-10-CM and ICD-10-PCS codes to support diagnoses, procedures, and treatment results. Codes are used for billing, internal and external reporting, research, and regulatory compliance activities. Abides by the standards of Ethical Coding as set forth by the American Health information Management Association (AHIMA) and adheres to official coding guidelines. Responsibilities Verifies that all ICD-10-CM and ICD-10-PCS codes are correctly captured. Verifies that physician and other key information is correctly abstracted. Resolves billing related errors and assists with workflow changes and process improvement projects. Meets ongoing productivity and quality accuracy rate of 95% or better. Coder III...

A regional healthcare provider in California is seeking a Coder III for hospital billing and medical coding duties. The ideal candidate will review documentation, apply ICD-10 codes for diagnoses, and ensure billing accuracy. A CCS certification and five years of inpatient coding experience are required. This role involves collaboration within the coding team and focuses on maintaining high-quality coding standards. #J-18808-Ljbffr

Medical Billing Specialist: Revenue Cycle Operations Apply for the Medical Billing Specialist: Revenue Cycle Operations role at Hoag Health System . Responsibilities Resolve inquiries related to claims, eligibility, & authorization; liaise with various parties to keep records up-to-date. Ensure first‑call‑resolution standards are followed and refer & follow‑up as per Hoag guidelines. Maintain accuracy, report issues, and work to resolve them. Ensure compliance with regulatory guidelines & health‑plan requirements; document actions following HIPAA guidelines. Provide customer service and member support; collaborate with providers and billing offices when needed. Identify & report issues with the management team to minimize re‑work and address front‑end process problems. Serve additional duties as assigned. Revenue Cycle Duties Maintain databases, audit information, and assist patients with payment processing. Follow up on outstanding or unpaid claims,...

Job Description Job Description Are you the missing piece in protecting America’s safety net? We don’t just hire talent—we build purpose-driven teams. At ERN Enterprises, we stand in the gap for emergency safety net providers and the patients they serve. We hold health plans accountable. We speak up for those who can’t, and we’re looking for more than just a resume—we’re looking for you. ERN in the news: https://youtu.be/mw1TQhVFBKk The Mission Our Healthcare Claims Compliance Auditors are warriors for justice in Revenue Cycle Management. You’ll analyze unfair trends, initiate corrective actions, support prelitigation strategy, and make sure regulatory timelines are honored—not ignored. You’ll change lives and challenge systems. Do You Belong Here? We’re looking for people with: Competency – Do you have the skills or the hunger to learn them? Character – Are you ethical, reliable, and honest—even when no one’s watching? Chemistry – Can you collaborate, communicate,...