15 auditor supervisor jobs found in Los Angeles, CA

Job Description Job Description WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews Oversee audits...

Job Description Job Description Education and/or Experience :   Must have these requirements under the umbrella of the HCC industry: Requires knowledge in HCC Coding documentation guidelines. Requires technical expertise in ICD-9-CM or ICD-10-CM. Strong skills in medical record audit and review. Regulatory requirements for coded data. Medical record documentation requirements. Understanding of healthcare data systems. Proficiency in MS Outlook and Word. Strong proficiency with Excel--must have ability to prepare spreadsheets. Excellent written and verbal communication skills. Certification is a plus with HCC. AHA coding clinic is a plus. Certification required in CPC and/or CCS, and CRC is a plus. Hybrid Schedule Requirements Part A Monday - Wednesday onsite / Thursday - Friday Remote Part B Wednesday - Friday Onsite / Monday - Tuesday Remote   We are looking for HCC Risk Adjustment Auditors/Coders to join our team!   Position...

Primary Job Title: Financial Compliance Auditor III, Claims Location : CA (Hybrid Shift/Work Schedule: Date Posted: 7/10/2025 Employment Type: 3-month Contract Salary Range: $50.53 - $55.53/Hr Job Summary The Financial Compliance Auditor III, Claims is responsible for various tasks within the Financial Compliance Unit, including the audit of claims processed by medical groups and health plans contracted with Client. This role works closely with the Supervisor and/or Lead Auditor on the identification and resolution of issues in a timely and efficient manner. For Claims Emphasis: This position is responsible for all aspects of assigned claim audits, including audit testing and completion of the audit report. This position is responsible for a variety of complex areas of the Medi-Cal, Medicare, Covered California, and PASC-SEIU benefits and processes. This position focuses on audits of contractual and regulatory compliance with timeliness and...

Coding Compliance Auditor In accordance with current federal coding compliance regulations and guidelines, the Coding Compliance Auditor performs 2nd level review of previously coded accounts to ensure appropriate CPT, ICD-10-CM, and HCPCS assignments and accuracy and completeness of all ICD-10-CM, CPT, and HCPCS codes assigned by professional revenue coders and providers. All assigned codes must be supported by professional documentation contained within the medical record and must be in compliance with federal coding compliance regulations, Official Coding Guidelines, AHA Coding Clinic, and CPT Assistant. The Coding Compliance Auditor will also provide detailed reports, Excel spreadsheets, coding audit summary analysis, and data analytics Re: coding accuracy rates, compliance rates, denial analytics, etc. Recommend education topics based on audit findings and assist in the continuing education of professional coders and providers. Understands coding/billing computer systems...

Job Description Job Description Position Purpose: Under the direct supervision of the Director of Quality Assurance, the Licensed Nurse is responsible for supporting the compliance functions of the Quality Assurance and Performance Improvement department of JWCH. The responsibilities include: Maintaining defined review schedule for JWCH agency by (1) doing preparatory work for the audit including developing a scope of work, (2) reviewing the documentation, (3) preparing reports, (4) doing any necessary follow-up reviews and (5) ensuring that appropriate collected data are securely kept and maintained. Serve as a resource to clients in answering compliance questions from Internal Audit and Audit Advisory Services and assisting as necessary in their audit process. Essential Duties and Responsibilities : Conduct Compliance Reviews Complete compliance reviews within established parameters and initiate and carry out all assigned reviews according to defined...

Job Description Job Description Position Purpose: The Certified Medical Coder plays a crucial role in the Billing Department by ensuring precise and compliant coding of medical services. Under the guidance of the Billing Department Supervisor, the Coder will assign appropriate diagnosis and procedural codes for services provided by JWCH physicians, adhering to industry standards and legal requirements. This position involves validating and auditing coding practices to guarantee accuracy in billing, supporting optimal reimbursement, and maintaining adherence to regulatory guidelines. Duties and Responsibilities: Serve as the primary liaison between providers and the Billing Department, effectively communicating to clarify diagnoses, procedures, coding, and documentation requirements. Recommend appropriate ICD-10-CM, CDT diagnosis codes, CPT codes, and HCPCS codes. Regularly review diagnosis and procedure coding within NextGen to ensure optimal billing accuracy....

Job Description Job Description South Los Angeles based FQHC looking for onsite Certified HCC coder . *This is not a remote position Conduct the necessary audits of medical record to verify the physicians have appropriately documented the diagnoses then code these diagnoses in ICD-10 for Medicare Risk Adjustments/Medicare Advantage. Evaluate medical information (Outpatient/Inpatient) documentation from a clinical standpoint for evidence of the possibility of additional medical conditions that may not have been documented in the past, and ensure accurate coding of the encounter data and recommend processes for accurate coding practices. This process involves a very strong understanding of medical coding. Ascertain that medical record documentations have accurate diagnoses and conditions to assure not to up-code, fraudulently or misrepresent the patient condition and ensure compliance to prepare for random CMS medical records audit HEDIS coding and record collection...

Job Description Bring your whole self to exceptional care. Cedars‑Sinai was tied for #1 in California in U.S. News & World Report's 'Best Hospitals 2024‑25' rankings, and it's all thanks to our team of 14,000+ remarkable employees! What you will be doing in this role: The Claims Edit Coder (Coder II) operates under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team. In this role, the Coder II reviews ICD‑10‑CM diagnosis coding and Current Procedural Terminology (CPT) procedure code for claim edit fall outs. The position entails conducting modifier review and assignment, handling complex coding edits that necessitate research and resolution, and validating key data elements like the billing physician and date of service. You are expected to abstract coded data accurately and promptly into the applicable system using relevant applications such as EPIC (CS‑Link), EPIC HB and PB...

Description 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 reviews, and...

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...

Abstractor/Coder The University of Chicago Physicians Group (UCPG) team is responsible for the overall management of clinical revenue for physician billing. This includes frontend revenue capture, working of edits and conducting audits for physician education. Ensuring the workflow of charge capture through invoice creation. UCPG is seeking an Abstractor/Coder to work with providers and staff on professional billing and compliance activities. Strong knowledge of evaluation and management coding guidelines and requirements is strongly preferred. This position is eligible for a flexible work arrangement. Responsibilities: Obtain appropriate reimbursement levels for professional services by reviewing and coding medical procedures, diagnoses, and physician visits. Analyze denial and rejection reports, and appeal wherever appropriate. Submit charges in a timely manner. Work in collaboration with the Clinical Revenue Supervisor and others, provide guidance to faculty and staff on...

Job Summary As a Registered Nurse/Clinical Supervisor I, you'll play a vital role in leading staff in delivering safe patient care. This role functions as a clinical expert, resource, and role model for customer service. The Clinical Supervisor is responsible for adjusting shift schedules, facilitating patient throughput, and staff workflow to meet patient care needs. Critical thinking, effective communication, and collaboration with patients, families, staff, and physicians are essential to achieving care goals and desired outcomes. Education Bachelor of Science degree in Nursing required Licenses and Certifications Current licensure with the California Board of Registered Nursing Must successfully complete and maintain BLS certification. Must successfully complete and maintain LA City Fire Card certification at the time of hire or within the first 30 days of employment RNC preferred in specialty area(s). Active involvement as a leader/participant in a...

Posted 1 day ago – 25 applicants waiting. Salary: $25.00/hr – $29.00/hr. Billing Specialist – Leading TX Center A Bit About Us We are a long-standing nonprofit treatment provider with over five decades of service in the recovery community. For over 40 years, we’ve helped more than 50,000 individuals overcome health challenges through compassionate, evidence-based care. With 300+ residential beds and a dedicated team of 150+ staff, interns, and volunteers, we offer comprehensive services that promote long-term sobriety and personal growth. Why Join Us? Medical Dental Vision 401K Growth Options Job Details The billing specialist ensures accurate and timely billing for services provided. This role is responsible for preparing, reviewing, and submitting claims, resolving denied or unpaid claims, and maintaining compliance with local, state, and federal billing regulations. The ideal candidate is detail-oriented, tech-savvy, and experienced in medical billing systems and...

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 self‑inspections and supplier...

A bit about us: We are a long-standing nonprofit treatment provider with over five decades of service in the recovery community. For over 40 years, we've helped more than 50,000 individuals overcome health challenges through compassionate, evidence-based care. With 300+ residential beds and a dedicated team of 150+ staff, interns, and volunteers, we offer comprehensive services that promote long-term sobriety and personal growth. Why join us? Medical Dental Vision 401K Growth Options Job Details The billing specialist ensures accurate and timely billing for services provided. This role is responsible for preparing, reviewing, and submitting claims, resolving denied or unpaid claims, and maintaining compliance with local, state, and federal billing regulations. The ideal candidate is detail-oriented, tech-savvy, and experienced in medical billing systems and procedures. Key Responsibilities Daily Billing Operations Reconcile billing records for accuracy,...