66 clinical coding analyst experienced jobs found

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. This position is hybrid- remote in Orange, CA. The Hierarchical Condition Categories (HCC) Coding Analyst will effectively interface with provider partners, to successfully, monitor and implement HCC coding strategies. Audit all RAPS submissions to ensure accuracy in the data provided to Centers for Medicare and Medicaid Services (CMS). Provide...

DRG Coder Department: HS - UM Employment Type: Full Time Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Reporting To: Alice Tejeda Compensation: $33.00 - $38.00 / hour Description The Senior 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 Senior 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...

Who We Are UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459‑bed acute care hospital in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties, and ambulatory care centers across the region. Listed among America’s Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange County’s only National Cancer Institute‑designated comprehensive cancer center, high‑risk perinatal/neonatal program and American College of Surgeons‑verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los...

Facility: Copley Drive City San Diego Department Job Status Regular Shift Day FTE 1 Shift Start Time Shift End Time Certified Coding Specialist--Physician-based (CCS-P) - The American Health Information Management Association (AHIMA); Certified Professional Coder (CPC) - AAPC Hours : Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Flex hours are 6:00-9:00 am to 14:30-17:30 pm Weekend Requirements: As Needed On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $34.170 - $44.090 - $49.370 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.? The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates,...

Operations Support Compliance Auditor Candidate should ideally be located in San Diego, CA, Las Vegas, NV or San Francisco, CA Monro's family of brands is one of the leading automotive service and tire dealers in the United States. We work on approximately five million vehicles a year, but with us, it is personal. Every guest is important, and every teammate is valued. That is our people-first approach. Headquartered in our hometown of Rochester, New York, where our founder, Chuck August, opened his first store in 1957, we have grown to 1,115 auto repair shops and tire dealers in 32 states from coast to coast. Monro powers 16 highly respected tire and auto service brands, supporting each company's regional strength and community connections. From big cities to small towns to rural crossroads, you will find us in neighborhoods of every shape, size, and color. Under the Monro banner, we are united TEAM, and share the same mission to bring our guests the highest quality tire...

Clinical Informaticist / Clinical Coder Are you looking for a career that will make an impact? The Leidos Military and Veterans Health Solutions Operation has an opening for a Clinical Informaticist / Clinical Coder to join the Operational Readiness Directorate at the Naval Health Research Center in San Diego, CA. This position will provide support to the Epidemiology and Data Management Support Department and involves clinical coding and data abstraction to support research on the physical and mental health of military personnel to improve overall health and readiness. The person in this position will work closely with department professionals in records management, information technology, and research teams to ensure alignment of clinical coding with research needs. Are you ready for unique and exciting work? This is a full-time position in San Diego. The candidate for this position must be located within commuting distance of San Diego to work on-site at the Naval Health...

Description Are you looking for a career that will make an impact? The Leidos Military and Veterans Health Solutions Operation has an opening for a Clinical Informaticist / Clinical Coder to join the Operational Readiness Directorate at the Naval Health Research Center in San Diego, CA. This position will provide support to the Epidemiology and Data Management Support Department and involves clinical coding and data abstraction to support research on the physical and mental health of military personnel to improve overall health and readiness. The person in this position will work closely with department professionals in records management, information technology, and research teams to ensure alignment of clinical coding with research needs. Are you ready for unique and exciting work? This is a full-time position in San Diego. The candidate for this position must be located within commuting distance of San Diego to work on-site at the Naval Health Research Center as needed....

Medical Biller And Collector Performs highly technical and specialized functions for Comprehensive Community Health Centers. Responsible for taking the data provided by the medical coders and using it to compile and submit claims to insurance companies and then subsequently bill patients, research, resolve, and collect on all unpaid accounts. Essential Duties And Responsibilities Use coded data to produce and submit claims to insurance companies Verify accuracy of billing data and revise any errors Prepare the appropriate claims documents required by each insurer Daily posting of a variety of health service charges to patients' accounts per payer Daily closing and balancing of day posted Prepare billing and/or rebilling Prepare and maintain daily productivity report Enter on a timely basis all charges, payments, credits, and adjustments by payer Prepare clean claims to various insurance companies either electronically or by paper Answer questions from...

Riverside University Health System (RUHS)is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive experience in an acute care...

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...

Riverside Medical Clinic Coding Specialist Responsible for abstracting, reviewing, auditing and the education of all coding and compliance processes, as they relate to CPT, HCPCS and ICD 10 and/or HCC activity. Qualifications: To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: One year minimum experience in the HCC coding field and/or CPT, HCPCS and ICD 10 experience. Proficient in excel and computer friendly. Certificates, Licenses, and Registrations: Current Medical Coding certificate specific to CRC, CPC or CCS required. Essential Functions: Essential functions are those tasks, duties and responsibilities that comprise the means of accomplishing the job's purpose and...

Overview The Billing Medical Coder is responsible for the day-to-day coding and billing operations for all services billable under grants, federal, state, and county programs including Medicare, Medi-Cal, managed care and private insurances. Starting Bonus : $5,000 Location: Midtown - Sacramento, CA (95811). This role allows a hybrid schedule requiring 1-2 days per week on site. Training Training Period: 4–6 weeks onsite, 5 days per week Essential Functions Review and adjudicate coding of services from documentation in a timely manner. Code physician/provider visit procedure notes to identify appropriate ICD10 and CPT4 codes for charge processing. Ensures that all diagnosis ICD10 codes and procedure CPT, HCPCS codes are identified, sequenced, and coded in an accurate and ethical manner for optimized reimbursement. Assigns Evaluation and Management codes and key concepts/elements documented in the patient note, utilizing defined coding guidelines applicable to professional and...

Job Description Job Description Job Summary Medical Biller The Medical Biller reports to the Billing Manager in person at out office in Ontario, CA and is responsible for the accurate, compliant, and timely billing of clinical laboratory services, including blood testing, microbiology/culture testing, and toxicology services. This role requires strong expertise in Medicare Part A vs Part B billing, skilled nursing facility (SNF) workflows, and commercial payer laboratory billing rules. The Medical Biller manages claims from Pending Review through payment resolution while ensuring full compliance with Medicare, Medicaid, and commercial payor regulations. No Remote Work Available Supervisory Responsibilities None Essential Duties and Responsibilities Laboratory Billing & Claims Management Review laboratory patient demographics, insurance, ordering provider, and facility information. Prepare, review, and submit insurance claims for laboratory...

Job Description Job Description Description We are currently seeking a highly motivated Medical Biller. This role will report to our Director - Revenue Cycle and enable us to continue to scale in the healthcare industry. Our Values: Put Patients First Empower Entrepreneurial Provider and Care Teams Operate with Integrity & Excellence  Be Innovative Work As One Team What You'll Do Ensures accounts are billed accurately and timely by providing oversight and direction to Billing staff. Maintain current knowledge of billing systems and payor systems, including applicable federal/state laws, regulations, and third-party reimbursement policies and practices. Update trackers and live spreadsheets of billing progress and project deadlines Claim submission: Prepare and submit claims to insurance companies using billing software. Insurance verification: Verify patient insurance information, eligibility, and benefits. Payment and invoicing: Process payments,...

Job Type Full-time Description Hospice Medical Billing Specialist Pay: $26-$32 per hour Schedule: Full Time, 40 hours/week Location: In-person (Walnut Creek / Bay Area) Overview Alameda Care Hospice is a compassionate, community-focused hospice provider serving patients and families throughout the Bay Area. We are committed to high-quality, patient-centered care while maintaining operational excellence and regulatory compliance. We are seeking an experienced Hospice Medical Billing Specialist to manage our revenue cycle operations. This role is critical for ensuring accurate billing, timely reimbursement, and regulatory compliance across Medicare, Medi-Cal, VA, and private payors. The ideal candidate is detail-oriented, proactive, and experienced in hospice-specific billing processes . This is an excellent opportunity to join a collaborative, mission-driven team and directly contribute to the financial health and sustainability of our organization....

Health Information Coder 3, Per Diem The Health Information Coder III is a senior-level inpatient coder with the knowledge and skill set to utilize the ICD-10-CM and ICD-10-PCS classification systems to code acute academic, teaching inpatient cases. The skill set extends to knowledge and comprehension of code sequences into Diagnoses-Related Groups on acute academic, teaching inpatient cases. Cases are coded to comply with the official guidelines for coding and reporting, practice standards and code of ethics for HIMS coder. Cases are abstracted according to UCSF Health policies and procedures. The focus of coding and abstracting is on a range of all primary hospital services. There is minimal review of coding for quality. Duties and Essential Job Functions Retrieve and analyze comprehensive medical records and information systems for appropriate documentation and follow-up as appropriate. Evaluate full episode of care of clinical data for inpatient cases and assign...

Health Coder - Hcc & Risk Adjustment Burlingame, CA 94010 Overview Salary Range $42.79 - $48.75 Hourly Description The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization's quality outcomes and financial performance. Essential Job Functions: Hcc Coding and Risk Adjustment (Ra) Program Support Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with Hcc and risk adjustment guidelines. Ensure all...

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....

Coder page is loaded## Coderlocations: Arcata, CAtime type: Full timeposted on: Posted 2 Days Agojob requisition id: JR100530**Committed to Our Community in the Heart of the Redwoods. Removing Barriers to Healthcare Access**Greenway AdminOpen Door Community Health Centers (ODCHC) relies on billing for services rendered and generated revenue for a significant portion of its operating budget. ODCHC is committed to proper billing procedures, documentation and review in compliance with federal and state laws and regulations and private payor requirements. The Coder I, working in collaboration with other Billing and Coding staff and the Coding Manager, is responsible for ensuring that documentation submitted by providers are accurately coded, including a congruence of final diagnoses, professional services, and procedures. As needed, Coder I will query providers as needed to resolve discrepancies in documentation, apply proper assignment of ICD, CPT and HCPCS codes and/or...

Job Details Job Location: Burlingame, CA 94010 Salary Range: $42.79 - $48.75 Hourly ESSENTIAL JOB FUNCTIONS HCC Coding and Risk Adjustment (RA) Program Support Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines. Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance. Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy. Provider Training and Clinical Documentation Improvement (CDI) Develop and deliver provider education sessions and materials on best practices for clinical documentation and HCC/RA coding. Provide one‑on‑one and group training to providers and clinical staff to improve documentation quality and accuracy. Serve as a resource and subject matter expert on HCC, risk adjustment, and related coding standards. Data Analysis and Reporting Analyze coding data to identify trends,...

Coder I Committed to Our Community in the Heart of the Redwoods. Removing Barriers to Healthcare Access Open Door Community Health Centers (ODCHC) relies on billing for services rendered and generated revenue for a significant portion of its operating budget. ODCHC is committed to proper billing procedures, documentation and review in compliance with federal and state laws and regulations and private payor requirements. The Coder I, working in collaboration with other Billing and Coding staff and the Coding Manager, is responsible for ensuring that documentation submitted by providers are accurately coded, including a congruence of final diagnoses, professional services, and procedures. As needed, Coder I will query providers as needed to resolve discrepancies in documentation, apply proper assignment of ICD, CPT and HCPCS codes and/or perform coding addendums to assure timely reimbursement. Compensation Range: $30.00-$34.68 All new hires will begin at the base wage of this...

Description Base Pay: $22.00 - $32.50 / hour JOB SUMMARY Certified coder with strong analytical skills to review charges and ensure accurate and appropriate billing to all payers including preferred experience with managed care plans. Knowledge of Medicare & Medi-Cal guidelines, including use of CCI, NCD, LCD edits and familiar with Medi-Cal modifiers & eTAR requirements. Experience in electronic claims submission, electronic health records, posting payments, working A/R including completion of CIF's & appeals. Works closely with the Billing Manager and the Director of Electronic Data Interchange as a team to maintain all aspects of the revenue cycle. JOB DUTIES AND RESPONSIBILITIES Accurate and review of appropriate billing of all charges based on CPT/ICD-10-CM and payer guidelines, especially Partnership HealthPlan. Use of EHR to verify correct coding and medical necessity. With assistance from training staff, provide training to medical front...

Mission Healthcare, located in seven states, is the largest home health and hospice company in the western United States. Our critical mission—to take care of our people. We provide a comprehensive array of services that meet the needs of patients and families across the healthcare continuum. We believe our people, partners, patients and their families deserve care delivered with C ompassion, A ccountability, R espect, E xcellence and S ervice (CARES), Mission Healthcare’s core values. By joining our team, you will have an opportunity to impact patient lives daily and grow your career in a culture of collaboration, compassion, and commitment. We are excited to continue to grow our mission family. Benefits Available to All Benefit-Eligible Employees 401(k) retirement savings plan Employee Assistance Program (EAP) Paid vacation, sick leave, and holidays Additional Benefits for Employees Regularly Scheduled 30+ Hours per Week: Medical, dental, and vision insurance Flexible...

Job Description Job Description Lifekind Health is looking for a full-time Certified Coder III (CPC or CCS) to join our team. The Medical Coder III is a senior-level role responsible for highly complex coding assignments. This role serves as a subject matter expert and contributes to coding education and process improvement within the Coding Team. Our mission is to bring care that’s whole, human, and healing. Blending medical, behavioral, and lifestyle support into a single plan because restoring life takes more than a prescription. At Lifekind Health we strive every day to live up to that definition by providing the best care possible for our complex patient population. Our team of medical doctors, psychologists, chiropractors, acupuncturists, and dietitians work together within a revolutionary transdisciplinary model that addresses the quadruple aim of healthcare: enhancing patient experience, improving patient health, reducing healthcare costs, and increasing employee...