6 jobs found in Costa Mesa

Experienced Associate, Healthcare Forensics The Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients. Job Duties: Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance matters Contributes to forensic engagements related to medical coding and...

DRG Coding Auditor - MS-DRG and APR-DRGSign On Bonus: $1,500Virtual: 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 if candidates reside within a commuting distance from an office.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.The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and its clients. Also responsible for performing clinical reviews of medical records and other documentation...

Experienced Associate, Healthcare ForensicsThe Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients.Job Duties:Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance mattersContributes to forensic engagements related to medical coding and...

The medical biller position responsibilities are to submit accurate and timely claim billing and reports based on health plan, payor, or contract requirements. This also involves accounts receivable payment follow-up, appeals, and refunds if necessary. Schedule: This is an in-office position with day, swing and night shifts available. Essential Functions: Complete health plan billings based on requirements. Compile proper paperwork and conduct appropriate research to appeal claim denials, including requests for refunds/credits when applicable. Review and monitor reimbursements due from different payors to determine appropriate collection methods. Communicate effectively and professionally with external customers. Resolve payment issues with carriers, (e.g. denials, partial payments, etc.) Review, modify, and re-bill rejected/denied claims. Assist Cash department on payor backup as needed for payments received. Adhere to and comply with information systems...

Location: Costa Mesa, California, United StatesCompany: AAPCPosted: AAPC is seeking a Coder II in Costa Mesa, CA to review clinical documentation, apply ICD-10-CM codes, and support billing, reporting, and compliance. The role requires 2+ years of coding experience, CPC/COC/CCS-P/CCS/CPMA certifications, and proficiency with Epic EMR.The Coder II will ensure accurate coding, participate in quality meetings, and act as a subject matter expert for providers while maintaining 95% accuracy or higher.#J-18808-Ljbffr

Sign On Bonus: $1,500; paid in two installments: $500 at the time of hire and $1,000 after one year of service. DRG Coding Auditor - MS-DRG and APR-DRG Virtual: 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 if candidates reside within a commuting distance from an office. 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. The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of...