23 jobs found in Orange

Job Description Job Description Description The DRG Coder is responsible for reviewing inpatient medical records and accurately assigning diagnosis and procedure codes using ICD-10-CM and ICD-10-PCS to determine the appropriate Diagnosis-Related Group (DRG) assignment.  This role ensures coding accuracy, reimbursement integrity, and compliance with federal and state regulations, payer guidelines, and internal policies. In an Independent Practice Association (IPA) and Management Services Organization (MSO) environment, the DRG Coder partners with utilization management, care management, finance, and provider network teams to support accurate payment, risk adjustment, quality reporting, and medical expense analysis. What You'll Do Review inpatient hospital records and assign accurate diagnosis and procedure codes Determine the appropriate MS-DRG or APR-DRG assignment based on coding and clinical documentation Conduct coding validation and auditing to ensure compliance with...

MISSION, VISION, AND VALUES Our mission is to provide quality, comprehensive healthcare and supportive services to our community. Our vision is Improving the Health and Well-Being of Our Community. Our core values are Integrity, Compassion, and Excellence. Employees are expected to demonstrate a strong commitment to the mission, policies, goals, and philosophy of Harbor Community Health Centers. JOB SUMMARY Reporting to the Revenue Cycle Manager (RCM), the Medical Biller II independently performs billing, claims submission, payment posting, denial resolution, accounts receivable follow-up, and account reconciliation activities for HarborCHCs primary care, pediatric, behavioral health, and dental services. This position works collaboratively with providers, Patient Experience staff, and other departments to support accurate and timely reimbursement, resolve complex billing issues, and identify opportunities for revenue cycle process improvement. ESSENTIAL DUTIES &...

DRG CoderThe DRG Coder is responsible for reviewing inpatient medical records and accurately assigning diagnosis and procedure codes using ICD-10-CM and ICD-10-PCS to determine the appropriate Diagnosis-Related Group (DRG) assignment. This role ensures coding accuracy, reimbursement integrity, and compliance with federal and state regulations, payer guidelines, and internal policies. In an Independent Practice Association (IPA) and Management Services Organization (MSO) environment, the DRG Coder partners with utilization management, care management, finance, and provider network teams to support accurate payment, risk adjustment, quality reporting, and medical expense analysis.What You'll DoReview inpatient hospital records and assign accurate diagnosis and procedure codesDetermine the appropriate MS-DRG or APR-DRG assignment based on coding and clinical documentationConduct coding validation and auditing to ensure compliance with payer and regulatory requirementsIdentify...

Job Title Radiation Oncology Coder Job Description Responsibilities Reports to: Manager, Coding The radiation oncology coder will be responsible to abstract orders, charges and related diagnoses from radiation oncology records to ensure services billed are consistent with the record documentation The coder will ensure compliance with all the clinical billing and coding regulations and will work with the faculty and staff to ensure accurate documentation of billable services The coder will determine and input appropriate ICD-10 CM and other codes for all radiation therapy procedures and analyze and validate that all charges are interfaced with the appropriate ICD10 and CPT codes The coder will be become efficient with the record and verify system ARIA where they will review the department daily charges for accuracy prior to interface from ARIA to EPIC Is always compassionate and empathetic for both patients and team members; makes eye contact, smiles and or greets...

AAPC is seeking a Medical Billing Specialist in Long Beach, CA to join our revenue cycle team. This role requires detailed billing work across CPT/ICD-10, claims submission, and denial management in a fast-paced outpatient setting. The ideal candidate has 2+ years in medical billing, familiarity with Medi-Cal, and experience with Athena EHR. Strong attention to detail and teamwork are essential for accurate documentation and compliance. #J-18808-Ljbffr

Medical Billing Specialist Location: Long Beach, CA Pay: $27.00 – $31.00 /hr Schedule: Monday–Friday Hours: 9:00 AM – 5:00 PM Job Type: Full-Time About the Opportunity We're partnering with a well-established outpatient healthcare clinic to find a detail-oriented Medical Billing Specialist to join their revenue cycle team. This organization is known for its patient-centered, inclusive approach to care and its commitment to serving the communities it operates in. This is a great opportunity for a billing professional who thrives in a fast-paced clinical environment and wants to make a direct impact on the financial health of a mission-driven healthcare organization. What You'll Do: Submit insurance claims accurately and on time Review, correct, and resubmit denied or rejected claims Monitor accounts receivable and follow up on unpaid or underpaid claims Post payments, adjustments, and denials accurately Coordinate with providers and clinical staff to ensure proper documentation and...

Astrana Health, Inc. is seeking a Senior DRG Coder to ensure coding accuracy and compliance. You will review inpatient medical records, assign appropriate codes, and collaborate with various teams for accurate reimbursement. This role requires at least 5 years of inpatient coding experience with a strong background in ICD-10-CM and ICD-10-PCS methodologies. The position is remote but requires occasional in-person meetings. #J-18808-Ljbffr

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. The Remote Risk Adjustment Compliance Auditor is to conduct provider and coder level reviews and audits to ensure accurate risk adjustment data is being submitted to the CMS. Develops and maintains tracking tools, reviews and audits outcomes / findings and monitors any corrective active plans implemented due to review or audit findings. Monitors...

Astrana Health is seeking a Risk Adjustment Coding Specialist to support Orange County operations. You will conduct high-volume chart reviews to identify coding gaps, then translate findings into education for providers and practice leaders, driving HCC recapture and KPI improvements. olla You will travel to provider offices up to 75% and collaborate with IPA teams, offering auditing and education to ensure CMS, Medicare and payer guidelines are met while staying current on ICD-10/HCC updates. #J-18808-Ljbffr

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.The Remote Risk Adjustment Compliance Auditor is to conduct provider and coder level reviews and audits to ensure accurate risk adjustment data is being submitted to the CMS. Develops and maintains tracking tools, reviews and audits outcomes / findings and monitors any corrective active plans implemented due to review or audit findings. Monitors...

Job Description Job Description Operations & Compliance Auditor Healthcare is increasingly unaffordable for many Americans. Most people believe they have two choices: increasingly expensive, restrictive employer insurance, or an ACA plan that keeps getting pricier. Many don't know there's a third, smarter option. WeShare Health is that option.  WeShare Health’s mission is to make healthcare simpler, more affordable, and more human. We're a nonprofit, faith-inspired healthcare sharing organization where members contribute monthly to share one another's eligible medical expenses. We're proudly not insurance, and that's the point.  Members access a national network of 1 million physicians at 30 to 60 percent less than comparable traditional insurance. Since 2018, WeShare Health has served more than 100,000 members and shared more than $50 million in medical expenses. Our purpose is clear: people before profit. WeShare Health is led by senior executives with deep...

Job Type Full-time Description About Us: Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize accessibility, affordability, and quality in all aspects of our services. Join us in our mission to transform healthcare delivery and make a meaningful difference in the lives of our members. SUMMARY: The Junior Quality Improvement Coder is responsible for providing director support to all departmental QI initiatives. In this role, the Junior QI Coder will partner with the Director to collaborate with network providers and IPA's to improve the quality of care through quality improvement activities that will include RAF, HEDIS, CMS Star Ratings and other health plan reporting. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following: Analyze data from contracted IPA network providers that allows...

Healthcare is increasingly unaffordable for many Americans. For those who can afford it, they are in a health insurance system that has become more confusing, restrictive, and lower value with each passing year. Here at WeShare our mission is to bring better healthcare to America at a better price. We offer consumers a member-to-member health sharing program that is much more cost effective than standard health insurance while providing access to over 1.2 million physicians across the country. Come join us on this important journey to create the next generation of healthcare! WeShare is a rapidly growing faith-based nonprofit that strives to do good while delivering great and affordable healthcare. The company is led by senior executives with an extensive background in both for-profit and not-for-profit enterprises. If you have a bias for action, enjoy challenges, and love creating impact in a massive industry, WeShare might be the place for you! About This Role The Operations...

Orange Park Foot Solutions LLC is seeking a detail-oriented Medical Billing Associate to support our DME footwear practice in Orange Park, FL. The role focuses on accurate claims submission, payment posting, and denials management to maximize reimbursement. Ideal candidates have proven experience in medical billing, familiarity with ICD-10/CPT, and HIPAA compliance, along with strong communication and organizational skills. #J-18808-Ljbffr

Medical Billing Specialist Is this your next job Read the full description below to find out, and do not hesitate to make an application. Location: Long Beach, CA Pay: $27.00 – $31.00 /hr Schedule: Monday–Friday Hours: 9:00 AM – 5:00 PM Job Type: Full-Time About the Opportunity We're partnering with a well-established outpatient healthcare clinic to find a detail-oriented Medical Billing Specialist to join their revenue cycle team. This organization is known for its patient-centered, inclusive approach to care and its commitment to serving the communities it operates in. This is a great opportunity for a billing professional who thrives in a fast-paced clinical environment and wants to make a direct impact on the financial health of a mission-driven healthcare organization. What You'll Do: Medical Billing & Revenue Cycle Submit insurance claims accurately and on time Review, correct, and resubmit denied or rejected claims Monitor accounts receivable and follow up on unpaid...

DRG CoderThe DRG Coder is responsible for reviewing inpatient medical records and accurately assigning diagnosis and procedure codes using ICD-10-CM and ICD-10-PCS to determine the appropriate Diagnosis-Related Group (DRG) assignment. This role ensures coding accuracy, reimbursement integrity, and compliance with federal and state regulations, payer guidelines, and internal policies. In an Independent Practice Association (IPA) and Management Services Organization (MSO) environment, the DRG Coder partners with utilization management, care management, finance, and provider network teams to support accurate payment, risk adjustment, quality reporting, and medical expense analysis.

Job TitleRadiation Oncology CoderJob DescriptionResponsibilities• Reports to: Manager, Coding• The radiation oncology coder will be responsible to abstract orders, charges and related diagnoses from radiation oncology records to ensure services billed are consistent with the record documentation• The coder will ensure compliance with all the clinical billing and coding regulations and will work with the faculty and staff to ensure accurate documentation of billable services• The coder will determine and input appropriate ICD-10 CM and other codes for all radiation therapy procedures and analyze and validate that all charges are interfaced with the appropriate ICD10 and CPT codes• The coder will be become efficient with the record and verify system ARIA where they will review the department daily charges for accuracy prior to interface from ARIA to EPIC• Is always compassionate and empathetic for both patients and team members; makes eye contact, smiles and or greets every...

Job Title Radiation Oncology Coder Job Description Responsibilities • Reports to: Manager, Coding • The radiation oncology coder will be responsible to abstract orders, charges and related diagnoses from radiation oncology records to ensure services billed are consistent with the record documentation • The coder will ensure compliance with all the clinical billing and coding regulations and will work with the faculty and staff to ensure accurate documentation of billable services • The coder will determine and input appropriate ICD-10 CM and other codes for all radiation therapy procedures and analyze and validate that all charges are interfaced with the appropriate ICD10 and CPT codes • The coder will be become efficient with the record and verify system ARIA where they will review the department daily charges for accuracy prior to interface from ARIA to EPIC • Is always compassionate and empathetic for both patients and team members; makes eye contact, smiles...

Wellness Avenue Surgery Center is seeking a Business Office Coordinator to assist the Business Office Manager with daily operations, supervise Registration and Medical Records, and oversee AR/AP processes. The role involves staff hiring, training, and policy development to minimize bad debt while maximizing productivity. We offer a comprehensive benefits package including medical, dental, vision, prescription coverage, life and AD&D, disability, FSAs/HSAs, 401(k), and paid holidays and vacation. #J-18808-Ljbffr

Astrana Health Management is seeking a Risk Adjustment Coding Specialist II to support the Orange County market. Candidates should have 3-5 years of risk adjustment coding experience and be able to travel up to 75% for the role. You will review provider documentation, conduct education sessions, and ensure compliance with coding regulations. AAPC or AHIMA certification is required. The role offers a competitive salary range of $70,000 - $85,000 per year. #J-18808-Ljbffr