57 jobs found in Los Angeles

A healthcare organization based in Los Angeles seeks a Coding Auditor to conduct comprehensive reviews of medical documentation and billing processes. You will manage AI-generated coding recommendations for compliance and revenue integrity, ensuring accurate assignment of coding standards. Collaboration with team members and dedication to the organization's mission are crucial. Ideal candidates should have strong skills in ICD-10 and CPT coding. A comprehensive benefits package is offered alongside this role. #J-18808-Ljbffr

Description In this role, you shape and support respiratory therapy education across UCLA Health, guiding orientation, competencies, and ongoing development. You're a trusted clinical resource and preceptor, stay connected to patient care, and work closely with teams and partners to strengthen practice and patient outcomes. The Respiratory Therapy Clinical Educator's responsibilities include but are not limited to: Leading and overseeing departmental education programs, including orientation, competency validation, certifications, in-services, and continuing education Serving as a clinical educator, resource, and preceptor for respiratory therapists and clinical specialists Providing direct patient care as needed, including assessment, intervention, patient and family education, and clinical documentation Supporting quality assurance and performance improvement initiatives, including staff chart audits and KPI monitoring Developing, maintaining, and updating...

Benefits: Free parking 401(k) Bonus based on performance Dental insurance Health insurance Paid time off 401(k) matching Vision insurance MEDICAL LIEN NEGOTIATOR SUPERVISOR FOR PERSONAL INJURY LAW FIRM - (Beverly Hills, CA) A busy, well-respected, personal injury law firm in Beverly Hills seeks a hands on, full-time experienced and well-mannered Medical Lien Negotiator Supervisor to join our growing Personal Injury Law Firm. Experience in a personal injury law firm is mandatory. Key Responsibilities: Supervise, train, and mentor a team of lien negotiators handling a high volume of personal injury cases. Develop and enforce procedures for efficient lien resolution and settlement disbursement. Review and approve negotiated liens and settlement breakdowns to ensure accuracy and compliance. Negotiate complex liens with health care providers, hospitals, insurance carriers, and government entities (e.g., Medicare, Medi-Cal). Collaborate closely with...

Compliance Auditor, MAPD Support compliance excellence at UCLA Health by joining our team as a Compliance Auditor, MAPD, focused on Medicare Advantage (Part C) and Prescription Drug (Part D) programs. In this vital role, you will conduct Risk Adjustment Data Validation (RADV) audits, compliance risk-based audits, support external audit coordination, and ensure alignment with CMS and DMHC regulations across the organization. Reporting to the Compliance Manager, MAPD Audit, you will contribute to the organization's audit work plan, assess operational risk areas, and prepare audit findings that help guide regulatory readiness and operational improvement. This position calls for a strong foundation in CMS guidelines, managed care compliance, and effective collaboration with both internal teams and external partners. In this role, you will: Conduct compliance audits related to operational functions, vendor performance, data validation, RADV, Triennial Review, pre-delegation...

Overview Bright Vision Technologies is a forward-thinking software development company dedicated to building innovative solutions that help businesses automate and optimize their operations. We leverage cutting-edge technologies to create scalable, secure, and user-friendly applications. We are looking for a skilled Financial Compliance Auditor III, Finance to join our dynamic team and contribute to our mission of transforming business processes through technology. This is a fantastic opportunity to join an established and well-respected organization offering tremendous career growth potential. Position: Financial Compliance Auditor III, Finance Location: Los Angeles, CA 90017 Duration: Contract Job Summary The Specialty Health Plans Auditor III, Finance is responsible for all aspects of planning, execution, reporting and corrective action plans monitoring of financial solvency for specialty health plans and vendors. This includes medical, vision, dental,...

Medical Coder Job Duties: Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications. Researches and analyzes data needs for reimbursement. Analyzes medical records and identifies documentation deficiencies. Serves as resource and subject matter expert to other coding staff. Reviews and verifies documentation supports diagnoses, procedures and treatment results. Identifies diagnostic and procedural information. Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes. Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines. Follows coding conventions. Serves as coding consultant to care providers. Identifies discrepancies, potential quality of care, and billing issues. Researches, analyzes, recommends, and facilitates plan of action...

Medical Biller We are seeking an experienced and diligent Medical Biller who wants to make a difference in our community. We want to hear from you if you thrive in a fast-paced, caring, and compassionate environment! The Mission of South-Central Family Health Center is to improve the quality of life for the diverse community of inner-city Los Angeles by providing affordable and comprehensive health care and education in a welcoming and multi-cultural environment. To lead the way in health care in South Los Angeles, as the premier provider and employer of choice offering comprehensive, high quality, affordable, efficient and culturally responsive services. Under the supervision of the Revenue Cycle/Billing Administrator, the Medical Biller I will be responsible for the processing and responding to all patient-related billing and the submission of bills for reimbursement from various programs (i.e. Medi-Cal, CPSP, EAPC, etc.). The ideal candidate will have to perform some of...

Description: Job Title: Quality / Compliance Auditor Pay Rate: Starting at $30 / hr (DOE) Location: Los Angeles, CA Area Code: 213, 310, 323, 424, 747, and 818 ZIP Code: 90032 Start Date: Right Away Keywords: #QualityAuditor #GMPJobs #ManufacturingJobs Benefits Medical / Health Benefits with multiple plan options, Flexible Spending Accounts, Dental and Vision 401k On the job training / cross-training Life Insurance, disability insurance, and voluntary life insurance for family members available. Accident and critical illness insurance optional. Scheduled performance reviews Referral program Job Description Performing routine GMP audits as well as specialty and technical audits in relation to current products and prospective in?license agreements, providing compliance guidance and support throughout the Quality organization, training delivery, and leading multi?departmental teams and initiatives. Responsibilities Prepare and execute internal...

A leading nonprofit treatment provider in California is seeking a Billing Specialist to ensure accurate and timely billing for services. Responsibilities include preparing and submitting claims, resolving denials, and maintaining compliance with regulations. The ideal candidate will have at least three years of hands-on medical billing experience, knowledge of medical coding, and be proficient in EHR systems. This is a full-time position that offers competitive pay and benefits. #J-18808-Ljbffr

Medical Billing Specialist A healthcare company is looking for an experienced medical billing specialist to join its revenue cycle team. The medical billing specialist will play a vital role in managing the revenue cycle by ensuring accurate billing, payment processing, and authorizations. This medical billing specialist requires someone with strong attention to detail who can navigate insurance claims, resolve discrepancies, assist patients with explanation of benefits, and maintain compliance with healthcare regulations. Responsibilities: Prepare and submit medical claims to insurance companies, including commercial payers and private, ensuring accuracy and compliance. Monitor and track the status of submitted claims to ensure timely reimbursement. Post payments from insurance companies and patients with precision and accuracy. Manage patient account balances, including collections and establishing payment plans when necessary. Investigate and address claim...

This is a remote-based position. Applicants can be located nationwide. About You Are you an experienced coder with a background in Profee Outpatient Coding? We are seeking a highly motivated individual responsible for the precise assignment of Evaluation and Management (E&M) ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes from both paper and electronic medical records. Share your Profee Outpatient Coding experience with us. Are you a collaborative team player who excels as a self-starter? What sets you apart as a professional who enhances a company’s reputation? Bring your problem-solving skills to manage multiple projects effectively. We are looking for someone exceptional—what makes you unique? If you are dedicated, value teamwork, and uphold integrity and professionalism, we are excited to meet you! About The Position Thoroughly review medical documentation to assign principal and secondary diagnoses and procedures utilizing your understanding of...

We are looking for experienced HCC Risk Adjustment Auditors/Coders to join our team! Position Summary: The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. Essential Duties and Responsibilities include the following: Works as an integral member of the Finance Department. Code review super bills and patient medical records for proper use of diagnosis and...

Job Description Align yourself with an organization that has a reputation for excellence! Cedars-Sinai was awarded the National Research Corporation’s Consumer Choice Award 19 times for providing the highest-quality medical care in Los Angeles. We were also awarded the Advisory Board Company’s Workplace of the Year. Discover why U.S. News & World Report has named us one of America’s Best Hospitals! What will you be doing in this role? In this remote role, under the general direction of the Coding Supervisor, (using knowledge of CSMC and Official Coding guidelines, medical terminology, anatomy and physiology, and pathological basis of disease, documented treatment and procedures performed at CSMC and Cedars-Sinai Affiliates and their locations) assigns ICD-10-CM and CPT codes for patients receiving services at CSMC. Accurately assigns all applicable modifiers for all patients to assure optimal reimbursement and the highest quality data possible Duties of this Coder II...

This is a remote based position. Applicants can be located nationwide Back Medical Coder #2621 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who has Profee Outpatient Coding experience. We need someone who is responsible for assignment of accurate Evaluation and Management (E&M) ICD-10-CM, ICD-10- PCS, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, modifiers and quantities derived from medical record documentation (paper or electronic) for encounters dependent upon record type. Tell us about your experience with Profee Outpatient Coding. Are you a team player and a self-motivator? What is your experience with conducting business in a way that is credit to a company? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you...

An automotive company located in Los Angeles seeks an experienced warranty auditor to ensure dealer compliance with policies and regulations. The role involves performing audits, providing training, and monitoring warranty handling. Ideal candidates should have 5+ years of automotive experience and a relevant degree along with strong interpersonal and analytical skills. Benefits include a competitive salary, vacation, and health coverage. #J-18808-Ljbffr

A leading healthcare institution in Los Angeles seeks a Compliance Auditor to ensure Medicare Advantage program compliance. Responsibilities include conducting audits, maintaining documentation, and preparing professional reports. Ideal candidates will have a Bachelor's degree in a related field, 5 years of experience in managed care, and strong analytical skills. This role offers a salary range of $86,400-$184,800 annually, along with opportunities for collaboration and contribution to regulatory excellence. #J-18808-Ljbffr

Job Description Job Description Benefits: Employee discounts Training & development Wellness resources Role Overview Own the end-to-end medical billing lifecycle for a multi-specialty healthcare clinic. Drive clean claims, fast reimbursements, and zero leakage. This is an execution-heavy, accountability-driven rolenot a passive billing position. Core Responsibilities Manage full-cycle billing: charge entry, claim submission, payment posting, and follow-up. Bill and reconcile across multiple payor types: Commercial insurance Medicare Personal injury (PI) Workers compensation Cash-based services Ensure accurate CPT, ICD-10, and modifier usage across: Medical Chiropractic Physical therapy Acupuncture Massage therapy Aggressively work A/R: Identify denials, underpayments, and delays. Execute timely appeals and corrections. Maintain compliance with: Medicare rules State and federal billing regulations Payor-specific policies Communicate clearly...

Benefits: 401(k) 401(k) matching Competitive salary Dental insurance Health insurance Opportunity for advancement We are seeking a motivated, punctual, and outgoing Orthodontic Dental Biller and Coder to join our team! In this role, you will be responsible for customer focused, compassionate, and dedicated to facilitating solutions to patient's dental health needs. The Orthodontic Dental Billing Specialist will work in a growing practice with a great team that makes coming to work engaging and supportive. We offer training to those who are looking for a career with growth potential and the opportunity to fulfill our mission to provide quality affordable dental care to our patients. In working with new & existing team members with an open heart & mind; additional responsibilities including the below: SPECIFIC DUTIES Accurately prepare and submit insurance claims, including working with state-sponsored insurance programs Ensure all billing codes...

Job Type Full-time Description Health Advocates is seeking an experienced hospital billing and collections Supervisor for our main office in Chatsworth, CA . Job Summary This position is responsible for the day-to-day operations of the Insurance and Liens Department, including third-party liability collections and general department support functions to ensure accounts are worked timely and appropriately. Job responsibilities: functions as a liaison between clients and Health Advocates, assists in the management of work flow and helps to maintain the organization and structure of the department, assists in the management of work flow, monitors staff inventory levels and performances, reviews accounts with staff and performs quality control audits, reviews and updates department procedures and training manual, prepares staff reviews and addresses other issues timely and performs disciplinary actions as needed, assists in the planning and execution of accounts...

Are you a college graduate looking for a challenging and rewarding career? Do you enjoy the satisfaction of making sure that information is accurate? Do you want to be part of a large team where the leadership is focused on your development and success? In this entry level compliance auditor role, you may have found your perfect fit! What you'll be doing... As a payroll compliance auditor, you will receive paid training to learn the ins and outs of the job requirements. Once trained, you will review employer payroll records to ensure that participants are receiving the benefit contributions promised in their labor contract (collective bargaining agreement). It can be repetitive work but it's extremely important and plays a crucial role when retirees apply for benefits and in the amount they actually finally receive. We're hiring several auditors for our February 24th training class in Pasadena! Review and analyze payroll records to ensure compliance with appropriate...

Overview Monitor and ensure dealer compliance with PAG/PCNAs policies and procedures. The auditor presents the audit findings to the Porsche Centers. The auditor will communicate best practices and act as trusted advisor to the Porsche Center. Roles & Responsibilities Responsible to perform Porsche Center warranty, parts, labor and part rate, sales, and CPO and related service operational audits; recommend corrective action where needed within policy guidelines and direction from Manager, Warranty and Compliance for the U.S. Provide cost/volume statistical analysis and administer cost containment programs. Perform in-dealership compliance reviews of all dealership supporting documents, parts, and accounting data (travel > 50%). Write warranty compliance audit reports, and action plan to dealer to remedy in-dealership shortcomings as pertaining to warranty, service and parts operation. Provide training to Porsche Center and field on the Warranty Compliance...

Payment Integrity Nurse Coder RN III The Payment Integrity Nurse Coder RN III is responsible for investigating, reviewing, and providing clinical and/or coding expertise/judgement in the application of medical and reimbursement policies within the claim adjudication process through medical record review for Payment Integrity and Utilization Management projects. The position serves as a subject matter expert (SME), performing medical records reviews to include quality audits as well as validation of accuracy and completeness of all coding elements. The position is also responsible for guidance related to Payment Integrity initiatives to include concept and cost avoidance development. This position trains and mentors Payment Integrity Nurse Coder, RN staff. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff. Performs Quality Audits to include validation of accuracy and completeness of ICD, Rev Code, CPT, HCPCs, APR, DRG, POA, and all relevant coding...

Job Summary: Leads the development of applicable policies and procedures for audit and process improvement projects. Identifies an appropriate plan for correcting deviations from expected quality control results. Promotes the use of strategies to ensure that tests are performed properly and results are verified before being shared. Monitors the management of specimens to ensure they are collected and processed according to established time and quality standards. Removes obstacles that prevent adherence to all requirements related to the recruitment, processing, testing, storage, and distribution of materials and samples. Researches, reports, and responds to technical and/or non-technical deficiencies in regulatory/accreditation inspection processes. Implements new testing methodologies, processes, and technology that have the potential to improve service, quality and/or efficiency. Leads the development and implementation of technical and/or non-technical training materials while...

Job Summary: Leads the development of applicable policies and procedures for audit and process improvement projects. Identifies an appropriate plan for correcting deviations from expected quality control results. Promotes the use of strategies to ensure that tests are performed properly and results are verified before being shared. Monitors the management of specimens to ensure they are collected and processed according to established time and quality standards. Removes obstacles that prevent adherence to all requirements related to the recruitment, processing, testing, storage, and distribution of materials and samples. Researches, reports, and responds to technical and/or non-technical deficiencies in regulatory/accreditation inspection processes. Implements new testing methodologies, processes, and technology that have the potential to improve service, quality and/or efficiency. Leads the development and implementation of technical and/or non-technical training materials...