29 clinical coder coding jobs found in Los Angeles

Working Nurse in Los Angeles is seeking a Clinical Policy Clinical Coder RN II to ensure accurate medical coding and compliance with regulations. The role requires collaboration with stakeholders to implement policies and oversee utilization management. The ideal candidate has at least 8 years of clinical nursing experience, particularly with Medi-Cal and Medicare, and an Associate's degree in Nursing. This position offers a full-time shift with a competitive salary. #J-18808-Ljbffr

Codes and abstracts documents such as patient charts and pathology reports utilizing diagnostic codes. Enters data into computer system(s). Essential Duties: Abstracts and assigns accurate Evaluation and Management (E&M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers and quantities derived from medical record documentation (paper or electronic). Reviews and edits previously submitted charges as needed due to identified billing errors and/or insurance requirement changes. Provides completed patient data to billing staff or designated personnel. Answer incoming calls from billers, front desk staff and clinical staff as needed assisting in what may be necessary to satisfactory resolution of the issues. Review and resolve insurance denials by examining the provider documentation. Consults with medical providers to clarify missing or inadequate record information and to determine...

Hcc Risk Adjustment Auditor/Coder We are looking for 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...

Clinical Policy Clinical Coder RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Salary Range: $102,183.00 (Min.) - $163,492.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Clinical Policy Clinical Coder RN II is responsible for analyzing, interpreting, and operationalizing medical and utilization management policies to ensure accurate coding, appropriate...

Medical Coding Specialist Codes and abstracts documents such as patient charts and pathology reports utilizing diagnostic codes. Enters data into computer system(s). Essential Duties: Abstracts and assigns accurate Evaluation and Management (E&M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers and quantities derived from medical record documentation (paper or electronic). Reviews and edits previously submitted charges as needed due to identified billing errors and/or insurance requirement changes. Provides completed patient data to billing staff or designated personnel. Answer incoming calls from billers, front desk staff and clinical staff as needed assisting in what may be necessary to satisfactory resolution of the issues. Review and resolve insurance denials by examining the provider documentation. Consults with medical providers to clarify missing or inadequate record information and to...

Lead Outpatient Medical Coder The Lead Outpatient (OP) Medical Coder assists the HIM OP Coding Manager with administrative functions specific to all outpatient coding operations. Duties may be varied and may include many of the following: assisting the OP Coding Manager to organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of production-coder performance, develop and implement quality improvement activities, train and mentor staff, provide feedback coding error findings and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. The Lead OP Medical Coder is responsible for serving as a subject matter expert in coding processes, providing advanced technical guidance, and ensuring coding accuracy, compliance, and productivity standards are met. The position supports coders and auditors through consultation, mentoring, and...

divh2Clinical Policy Clinical Coder RN II/h2pSalary Range: $102,183.00 (Min.) - $163,492.00 (Max.)/ppL.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time./ppJob Summary/ppThe Clinical Policy Clinical Coder RN II is responsible for analyzing, interpreting, and operationalizing medical and utilization management policies to ensure accurate coding, appropriate authorization requirements, compliant claims processing, and effective utilization oversight. This position serves as a key clinical and coding resource, translating medical policy requirements into diagnosis, procedure, and service code logic, including determining which codes require prior authorization. Conducts in-depth research and analysis of legislation and regulatory requirements, clinical outcomes,...

Memorial Hermann Health System is seeking a Clinical Coder responsible for ensuring accuracy in clinical coding, essential for reimbursement and data integrity. This role involves conducting coding audits, providing education, and acting as a resource for coding staff. Key qualifications include a high school diploma or GED, relevant certifications, and four years of coding experience. The position is vital for maintaining high standards of quality and safety in patient care. #J-18808-Ljbffr

DescriptionThe Medical Coder 3 (inpatient and ambulatory surgery) abstracts clinical information from a variety of medical records charts and documents and assigns appropriate ICD-10 - CM/PCS and CPT codes to patient records according to established procedures.Works with coding databases and confirms DRG assignments.Familiar with standard concepts practices and procedures within a particular field.Relies on instructions and pre-established guidelines to perform the functions of the job.This position relies on guidelines and some experience and judgment to complete job and works under general supervision.ResponsibilitiesCoding/Abstracting Assists the Business Office and external agencies in clarification of coding regarding reimbursement issues.Handles all requests in a timely fashion.Quality/Performance Corresponds with other areas of the HIM department to ensure the necessary components are available for accurate coding and the highest quality of the patients medical...

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Summary Position responsible for ensuring the accuracy and completeness of clinical coding resulting in the appropriate reimbursement and data integrity and validation of the coded information for external and internal affairs. This position typically reports to the Coding Compliance Manager. Minimum Qualifications Education: High school diploma or GED, required....

Clinical Policy Clinical Coder RN II Shift: Full Time Pay Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.) Location: Los Angeles, 90017 Job Description The Clinical Policy Clinical Coder RN II is responsible for analyzing, interpreting, and operationalizing medical and utilization management policies to ensure accurate coding, appropriate authorization requirements, compliant claims processing, and effective utilization oversight. This position serves as a key clinical and coding resource, translating medical policy requirements into diagnosis, procedure, and service code logic, including determining which codes require prior authorization. Conducts in-depth research and analysis of legislation and regulatory requirements, clinical outcomes, utilization, claims, and financial data to identify utilization trends, fiscal risk, and opportunities for policy enhancement and cost containment. This position works cross‑functionally with internal teams to ensure...

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 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company’s Workplace of the Year. This annual award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. We provide an outstanding benefit package that includes health care, paid time off and a 403(B). Join us! Discover why U.S. News & World Report has named us one of America’s Best Hospitals. What you will be doing in this role: The Claims Edit Coder (Coder II) operated 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)...

We are looking for experienced Sr. 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 Works as an integral member of the Finance Department. Code review super bills and patient medical records for proper use of diagnosis and procedure codes. Interface...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

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...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Medical Billing Specialist- Certified Coder Full Time Professional Los Angeles, CA, US 7 days ago Requisition ID: 1269 Salary Range: $30.00 To $38.00 Hourly We welcome all backgrounds, gender identities, and expressions. We seek team members who embrace and champion diversity. Candidates should be comfortable with exposure to imagery, events, and materials that reflect our culture of acceptance and expression, ensuring alignment with our values. Organization Background Men’s Health Foundation connects men at risk to comprehensive healthcare and wellness through education, collaboration and advocacy, inspiring and empowering all men to live longer, healthier and happier lives. We see a world where inequity and stigma do not separate men from healthcare. At Men’s Health Foundation we are reimagining men’s healthcare. Job...

Medical Billing Specialist $25 - $29 per hour | Los Angeles, CA | On‑Site | Permanent Billing Specialist - Leading 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...

UCLA Health Coding Specialist Play a key role within a world-class healthcare organization. Support accurate and efficient coding processes to enhance operational success. Elevate your professional expertise at UCLA Health. You will be responsible for coding diagnoses and procedures for emergency department cases. This will involve utilizing your knowledge of UCLA, AHA Coding Clinic, AMA CPT Assistant guidelines, medical terminology, anatomy and physiology, and the pathological basis of diseases. You will assign ICD-10-CM and CPT/HCPCS codes for emergency department patients while ensuring accurate charge assignments using ASAP software within EPIC (CareConnect). You will abstract all coded data efficiently and accurately, meeting state and national reporting requirements. Salary Range: $40.04 - $52.83/hourly Job Qualifications We're seeking an independent, detail-oriented, self-directed individual with: Associate degree in Health Information Science, Bachelor's degree in...

Job Description Job Description 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 is responsible for the billing and collection activities for the clinic’s primary care, pediatric, behavioral health, and dental services. This position works closely with providers, Front Office staff, and the Quality Improvement Department. ESSENTIAL DUTIES & RESPONSIBILITIES Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. An individual must be able to perform each essential duty...

Job Description Job Description Victory Hematology and Oncology has a Medical Billing Specialist position available for a well-organized and knowledgeable Medical Billing and Coding Specialist with a Hematology and Oncology practice in Sherman Oaks, California. Qualifications: · The successful candidate must have an excellent understanding of medical billing, which includes Insurance billing and payments processing: EOBs, ICD-10 and CPT coding. · Candidates must have a strong understanding and working knowledge of the appeals and denials processes for Medicare, Medi-Cal and other commercial health insurances. · Candidate is going to ensure all compliance and quality requirements are met. · Candidate can efficiently communicate insurance company, clinical staffs and patients regarding billing issues. · In addition, this position is the main link between our facility and our referring clients. In this role, you will maintain a solid rapport with all our clients...

# **We value your privacy**Certified Professional Coder page is loaded## Certified Professional Coderremote type: Hybridlocations: Commerce, CA 90040time type: Full timeposted on: Posted Todayjob requisition id: JR7419**Grow Healthy**If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day.**Job Overview**Assigned codes to patient symptoms, diagnosis, operations, and treatments to process reimbursements, knowledge and...

Arroyo Vista Family Health Center in Los Angeles is looking for a Billing Clerk II responsible for maintaining clinic billing for all patients and resolving insurance issues. The role demands effective communication, bilingual skills, and knowledge of medical billing codes. Candidates should have a Medical Billing/Coding Certification and two years of relevant experience. The position includes various responsibilities such as verifying insurance eligibility and assisting patients with account issues, along with the need for reliable transportation. #J-18808-Ljbffr

Job Description Job Description Benefits: 401(k) 401(k) matching Dental insurance Health insurance Paid time off Victory Hematology and Oncology has a Medical Billing Specialist position available for a well-organized and knowledgeable Medical Billing and Coding Specialist with a Hematology and Oncology practice in Sherman Oaks, California. Qualifications: The successful candidate must have an excellent understanding of medical billing, which includes Insurance billing and payments processing: EOBs, ICD-10 and CPT coding. Candidates must have a strong understanding and working knowledge of the appeals and denials processes for Medicare, Medi-Cal and other commercial health insurances. Candidate is going to ensure all compliance and quality requirements are met. Candidate can efficiently communicate insurance company, clinical staffs and patients regarding billing issues. In addition, this position is the main link between our facility and our referring...

Job Summary: Supervises team to review and request primary source information and verifications. Proactively identifies, suggests improvements to, and provides resolution for complex gaps in vendor relationships. Serves as an escalation point of contact for external queries regarding practitioner status. Evaluates applications and supporting highly complex documents. Guides team to conduct improvements to credentialing and privileging processes. Guides and supervises team to evaluate complex practitioner sanctions. Participates in surveys and audits of credentialing entities. Facilitates and implements strategic initiatives cost-effective due process. Identifies and provides leadership to resolve adverse actions/issues. Leads and evaluates audits of data between different departments. Conducts and supervises the facilitation and orientation and training to newly appointed physician leaders. Develops highly complex informational documents. Maintains working relationships with key...