4 drg validation coding auditor jobs found

Salary : $105,597.80 - $145,114.92 Annually Location : Riverside Job Type: Regular Job Number: 26-74191-01 AL Department: RUHS-Medical Center Opening Date: 03/03/2026 Closing Date: Continuous For questions regarding this position, please contact the Recruiter listed in the Supplemental Information section. ABOUT THE POSITION 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...

Coding Compliance Auditor 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...

Medical Biller The Medical Biller is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims. Must work with other departments to facilitate the meeting of both departmental and facility goals and objectives. Demonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers. Has an extensive knowledge of billing requirements mandated by payers and/or governmental regulations. This position will perform any and all related job duties as assigned. The medical biller will be working a hybrid schedule two days in either the San Marcos, CA or El Segundo, CA offices and three days from home. Essential Job Functions Hospital Billing Emphasis Correcting and billing electronic and hardcopy claims Submits adjusted claims Provides follow-up billing Prepares billing...

Payment Integrity Nurse Coder RN III Salary Range: $102,183.00 (Min.) - $163,492.00 (Max.) 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. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Job Summary 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...