11 program manager certified coder jobs found in Los Angeles

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...

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...

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 satisfactorily to be successful in this...

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...

Medical Coder Hybrid • Administrative Office - Los Angeles, CA 90029 Overview Salary Range $30.00 - $33.00 Hourly Position Type Full Time Job Shift Day Education Level High School Travel Percentage None Description POSITION: Medical Coder STATUS: Non-exempt; Full time REPORTS TO: Billing Manager SUPERVISES: None DEPARTMENT: Fiscal UNIT: Billing OFFICIAL DUTY STATION: Administrative Office (4216 Fountain Avenue, Los Angeles, CA 90029) SUMMARY: This position performs coding and audit functions. APHCV expects all employees to respond and participate to emergency situation per emergency policies and procedures. APHCV requires all staff to comply with Standards of Conduct and Compliance Program related policies and procedures. Such compliance is part of this position's performance evaluation. DUTIES AND RESPONSIBILITIES: Conduct various activities to improve coding, particularly but not limited to HCC coding for Medicare and other line of products)...

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...

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...

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...

Why Join Us: If you're looking for a role where you can do meaningful work without burnout, you've found it. We've built a stress-free, clinician-first environment that removes unnecessary barriers so you can focus on what you do best-supporting students and making a real impact. Our team is backed by strong administrative, technical, and leadership support, ensuring you're never working alone. About Expatiate Communication, Inc. Expatiate Communications is a management consulting firm specializing in special education. We partner with school districts, COEs, state agencies, and families to strengthen instruction, services, staffing, compliance, and operations. Our work focuses on delivering high-quality, sustainable special education programs that improve outcomes for students with disabilities by meeting IEP needs and building capacity across educator teams. Description The Medical Biller will be responsible for achieving billing standards as defined by the...

Come lead with us at Corporate At Houston Methodist, the Senior Inpatient Coder position is responsible for ensuring diagnostic and procedure codes are assigned accurately to inpatient, emergency room, therapy, and/or clinic encounters based upon documentation within the electronic medical record while maintaining compliance with established rules and regulatory guidelines. FLSA STATUS Non-exempt QUALIFICATIONS EDUCATION Associate’s degree or higher in a Commission on Accreditation for Health Informatics and Information Management accredited program or additional two years of experience (in addition to the minimum experience requirements listed below) in lieu of degree EXPERIENCE Three years of relevant inpatient coding experience or successful completion of the Houston Methodist Senior Inpatient Coder Transition Program LICENSES AND CERTIFICATIONS Required Must have one of the following: RHIT - Certified Health Information Technician (AHIMA) RHIA - Registered Health...