34 regulatory analyst coder jobs found

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: This role is located in Midtown - Sacramento, CA (95811). This role allows a hybrid schedule requiring 1-2 days per week on site. 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 technical standards Research and...

Default Work Shift: Day (United States of America) Hours: 40 Salary range: $23.97 - $36.42 Schedule: Full Time Shift Hours: 8 Employee Department: Patient Financial Services Job Objective Responsible for performing revenue cycle integrity audits within the Charge Descriptive Master and other revenue cycle charge capture and reconciliation processes. Job Description Education: Required: High school diploma, GED or higher level degree if hired after March 1, 2025. Preferred: Medical coding coursework or bachelor’s degree in related field. Licensure/Certification: Required: Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) within one (1) year if hired into position after January 1, 2021. Experience: Required: Two (2) years of medical billing, charge capture, coding or patient account auditing experience. Preferred: Revenue cycle experience, hospital/clinical experience. Reports To: Manager or Director. Supervises: N/A. Ages of Patients: N/A. Blood Borne...

Description 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. This is a full‑time position in San Diego. The candidate must be located within commuting distance of San Diego to work on‑site at the Naval Health Research Center as needed. Work hours will coincide with the standard command business hours of 0700‑1630. Primary Responsibilities Obtain and...

Lead Medical Biller Skilled Wound Care is looking for a Lead Medical Biller to join our rapidly growing company! We are a mobile surgical physician wound care group expanding into new markets of the United States. The Lead Medical Biller is a critical leader responsible for ensuring the financial health of our organization by overseeing the daily operations of the billing team. This role requires advanced expertise in the end-to-end claims lifecycle, ensuring maximum revenue capture through accurate, compliant, and timely submission of medical claims across all payer types (private, government, and third-party). You will be the primary subject matter expert, driving team performance, resolving complex billing issues, and upholding strict adherence to all federal, state, and FQHC-specific billing regulations. Position is hybrid at our office in Playa Vista, CA Responsibilities: Supervise & Train: Lead the training and mentorship of new billing hires, ensuring rapid...

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...

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,...

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 satisfaction. Learn more about us at...

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,...

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...

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...

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 Benefits: Competitive salary 401(k) Health insurance Paid time off About the Role: At Renew Vein and Vascular we are seeking an experienced in-house Medical Biller to join our team. The ideal candidate will have a strong background in medical billing, coding, and insurance claim management, with a proven ability to ensure timely and accurate reimbursement. Responsibilities include claim submission, payment posting, denial resolution, and working closely with providers and staff to maintain efficient revenue cycle operations. Candidates should be detail-oriented, organized, and knowledgeable in current billing regulations and payer requirements. Experience with EHR/PM systems is preferred. Responsibilities: Process and submit insurance claims accurately and efficiently. Review and verify patient information and insurance coverage. Resolve billing discrepancies and respond to inquiries from patients and insurance companies. Maintain...

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....

Medical Billing Specialist III/IV – Ventura County Behavioral Health The County of Ventura seeks experienced Medical Billing Specialists to manage billing and claim processing for Medi‑Cal, Medicare and other insurance for behavioral health services. Under general direction, applicants perform billing, coding, compliance, and quality assurance duties to ensure timely reimbursement and regulatory adherence. Ideal Candidate Qualified candidates will possess: Specialized mental health billing expertise, including CPT, ICD‑10, and HCPCS coding for Medicare and Medi‑Cal. Proficient knowledge of the Medi‑Cal Provider Manual and TAR process. Strong communication skills with peers, patients, and payers and ability to resolve billing disputes. Experience leading and training staff in Managed Care, Medicaid, and commercial insurance billing. Experience with multiple EHR systems such as Cerner, HURON, or Claim Source. Responsibilities Review and analyze bills, transmit claims...

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 in the Operational Readiness Directorate at the Naval Health Research Center in San Diego, CA. This is a full‑time position. The employee must be located within commuting distance of San Diego to work on‑site at the Naval Health Research Center as needed. The number of days on‑site may vary, and the schedule is subject to change based on program and customer requirements. Work hours will coincide with the standard command business hours of 0700–1630. Primary Responsibilities Obtain and maintain required access to military electronic health records (EHR) systems, such as Joint Longitudinal Viewer (JLV) and Theater Medical Data Store (TMDS). Perform detailed reviews of health records and supporting documentation in multiple systems throughout the continuum of care to assign precise medical coding. Assign...

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...

Overview Who We Are: At Dendreon, we’re transforming the battle against cancer with personalized immunotherapy. Our flagship product, PROVENGE® (sipuleuc‑T) , was the first FDA‑approved immunotherapy for metastatic castrate‑resistant prostate cancer, utilizing a patient’s own immune cells to fight the disease. If you’re driven by the opportunity to make a meaningful impact on cancer patients’ lives, we invite you to join our team. With Immunotherapy Manufacturing Facilities in Seal Beach, CA, and Union City, GA, a strong Research & Development group in Seattle, WA, and a highly skilled Commercial team across the nation, Dendreon is at the forefront of cancer treatment innovation. Core Values: Put Patients First: Every day is an opportunity to improve the lives of those living with cancer. Act with Integrity: We commit to transparency, honesty, and always doing what’s right. Build Trust: Trust is earned through candid, open communication and a collaborative approach. Raise...

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...

This position is responsible for daily operation of the department, which includes supervising staff and dispatching scheduled interpreters to in-person and video assignments throughout the day (spoken languages and ASL), prioritizing patient requests, answering multiple phone lines and responding to requests after hours & on weekends. This position is also responsible for interpreter and provider training, externship coordination, vendor request management, department website management, language proficiency assessments, multicultural development through department events coordination, vendor equipment coordination, and written translation services coordination. This person is responsible for leading a team of varied language translators, serving as the primary contact for UC Health written translation projects. Coordinate and supervise department staff in translation, proofreading, editing and preparation of final copy or written materials from the source language to the...

Salary : $178,776.00 - $223,496.00 Annually Location : County of San Mateo, CA Job Type: Full-Time Job Number: D144BG Department: San Mateo Medical Center Opening Date: 11/14/2025 Bargaining Unit: 50D Description Note: This recruitment schedule was amended on December 5, 2025 to extend the final filing date. This recruitment has been changed to "Continuous". San Mateo Medical Center is currently seeking a professional, goal-oriented Clinical Services Manager I- Nursing Supervisor who will plan, organize, direct and supervise the operations of a nursing unit and float pool. As a Clinical Services Manager I -Nursing Supervisor , you will have the opportunity to manage patient care while ensuring appropriate quality of care and compliance with regulations. In addition, your responsibilities will include 24/7 oversight of the Nursing Team, Medical Services Assistants Float Pool and the Staffing Coordinator. This role requires participation in...

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...