Jobs | Healthcare Careers

Full Time

Medical Coder Auditor, Senior - Medi-Cal

Blue Shield of California Hybrid (CA, USA)

Your Role The Medi-Cal Operations team is responsible for Claims processing and ensuring Medi-Cal benefits are applied. The Medical Coder Auditor Senior will report to the Director of Medi-Cal Performance. In this role you will Serve as an expert Medi-Cal resource in the areas of coding, documentation, auditing, including CMS/HHS regulations and compliance issues surrounding requirements for risk adjustment. Review and monitors all Medi-Cal, HIPAA and CMS regulations for updates and changes pertaining to Medi-Cal programs. Determine and implement changes needed for systems and processes. Your Work In this role, you will: Perform audit projects, including and not limited to Government RADVs, and internal compliance audits Support and implement prospective, retrospective and auditing project strategy to support improved clinical documentation and coding Be responsible for facilitating and/or performing an audit of the providers’ medical...

Full Time

AAPC Recruiting Services: External Client seeking an On-Site Certified Coder in CA

AAPC Recruiting Services CA, USA

Certified Coder is a nonexempt position responsible for front office and general coding billing duties. Responsible for Coding Audits, Claim, Billing review and compliance. Performance Requirements Knowledge Knowledge of billing practices and clinic policies and procedures. Knowledge of coding and clinic operating policies. Knowledge of medical terminology Knowledge of health care insurance claim practices and compliance. Knowledge of computer systems, programs, and applications. Skills Proficient skills in computer programs. Skill in using a calculator. Abilities Ability to understand and interpret policies and regulations. Ability to read and interpret medical charts. Ability to examine documents for accuracy and completeness. Ability to communicate effectively and work with others. Major Duties and Accountabilities Coordinates with clinical staff to verify charge and/or documentation information as needed Audits...

Full Time

AAPC Recruiting Services: E/M Breast Surgery Physician Coder - CA Residents Only

AAPC Recruiting Services Hybrid (CA, USA)

Organization benefits for position: 100% remote but candidate must reside in California These are full-time opportunities Full Benefits - Health/Dental/Vision/Life/AD&D/FSA Basic Term Life Insurance and accidental death insurance 401(k) contributions Client to p rovide Codify Equipment supplied Position – OP Ancillary Physician Coder: CPC or CCS required CGSC preferred Minimum of 3 years of current experience in a hospital or physicians office as a medical coder Expert knowledge of ICD10-CM, CPT, and HCPCS EPIC software experience required Proficient with Microsoft Purpose Statement / Position Summary Under the direction of the Manager, Coding Compliance, the OP Ancillary/Physician Coder will play a key role in reviewing and analyzing billing and coding for processing. This role will be responsible for reviewing and...

Full Time

AAPC Recruiting Services: Pro-Fee Oncology Physician Coder - CA Residents Only

AAPC Recruiting Services Hybrid (CA, USA)

Organization benefits for position: 100% remote but candidate must reside in California These are full-time opportunities Full Benefits - Health/Dental/Vision/Life/AD&D/FSA Basic Term Life Insurance and accidental death insurance 401(k) contributions Client to p rovide Codify Equipment supplied Position – OP Ancillary Physician Coder: CPC or CCS required CHONC preferred Minimum of 3 years of current experience in a hospital or physicians office as a medical coder Expert knowledge of ICD10-CM, CPT, and HCPCS EPIC software experience required Proficient with Microsoft Purpose Statement / Position Summary Under the direction of the Coding Compliance Manager, the Pro-Fee Oncology Physician Coder will play a key role in reviewing and analyzing billing and coding for charge processing, specifically with Hematology/Oncology....

Full Time

TRAUMA REGISTRY CODER (Health Information Management Coder II)

Natividad Salinas, CA, USA

INSPIRING HEALTHY LIVES through community At Natividad, our dedication to the people of Monterey County is at the heart of everything we do—from the health care services we provide to the specialized programs we promote. This commitment to our community spans more than 130 years and, more importantly, has touched countless lives. It has also earned us a Joint Commission ranking in the top percentile of hospitals nationwide. If you believe in inspiring healthy lives by focusing on community-based care, consider joining Natividad today. TRAUMA REGISTRY CODER (Health Information Management Coder II) Natividad is currently seeking a permanent full-time Trauma Registry Coder (Health Information Management Coder II) in the Trauma Services Department. Under general supervision, the incumbent will review, interpret, code and abstract medical records information according to standard classification systems; identify diagnostic categories...

Full Time

Medical Claims Payment Poster

Marin Community Clinics Novato, CA, USA

Responsibilities Review and interpret explanation of benefits (EOB) from insurance carriers to post appropriate payment, adjustment, and denial codes. Accurately and timely post payments received from third-party payers and patients through electronic and paper remittances, online payment portal, and patient payments to patient accounts and ensure that accounts are properly balanced and reconcile payment data to ensure consistency and accuracy. Post zero pays received from third-party payers through electronic and paper remittances. Identify and research discrepancies in payment postings and work with insurance companies to resolve any issues. Reconciling unapplied account balances. Sort and distribute mail to appropriate parties. Managing electronic remittance advice and insurance correspondences. Understand and follow payer guidelines and policies related to payment processing. Maintain/run daily, weekly and monthly payment logs and...

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Medical Coder II

Standard Technology Las Flores, CA, USA

Job Description OUTPATIENT MEDICAL CODER POSITION ONSITE AT CAMP PENDLETON, CA SUMMARY: Responsible for assignment of 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) for outpatient encounters. Trains and educates MTF staff on coding issues and plays a significant role in coding compliance activities. Education/Certification. The following are recognized certifications from American Health Information Management Association (AHIMA) and/or American Academy of Professional Coders (AAPC): Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), CCS-P (Certified Coder Specialist - Physician (CCS-P) with the appropriate level of experience. Experience. A minimum of three year experience in the outpatient...

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Insurance Medical Billing Specialist

PrideStaff Carlsbad, CA, USA

Job Description PrideStaff Carlsbad is looking for an experienced ,Temporary, Insurance Medical Billing Specialist in Carlsbad, CA PART -TIME Insurance Medical Billing Specialist Reports to: Billing and Coding Manager Job Overview Our Client is hiring an experienced Insurance Billing Specialist who will be assisting our company with promptly and accurately managing and billing managed care/health plan encounters. We are looking for someone with experience in insurance requirements such as prior authorization and eligibility verification, revenue cycle, specifically around claims and denial management, preferably at a national level with multiple insurance payors Performance Responsibilities * Assisting across the entire spectrum of revenue cycle management, including eligibility and credentialing claims issues as well as patient collections and health plan disputes/grievances. * Working with billing partners as needed, ensuring encounters are submitted timely and accurately,...

PS

Medical Billing & Coding Specialist

Protouch Staffing Eureka, CA, USA

Medical Billing & Coding Specialist - On-Site Position Type : Full Time Shift : Day Job Summary: Under general supervision of the Director of Finance, provides a variety of medical billing and coding duties for a variety of our medical programs (Redwood Coast PACE, CalAim, Behavioural Health Services) according to departmental, professional, and regulatory standards. Works collaboratively with specific program teams to ensure appropriate agencies, reports, policies, and procedures are engaged and to successfully enroll and dis-enroll participants as appropriate. Essential Duties & Responsibilities: • Processes medical encounters to ensure coding and documentation are in place. • Performs comprehensive review of documentation and other records to ensure documentation, signatures, dates, results, and other documents are complete. Work with the appropriate program team if any documentation is missing or inaccurate. • Review encounters to ensure all coding is supported...

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Health Information Coder II

Kaiser CA, CA, USA

Job Summary:Under indirect supervision, is responsible for accurate coding of all inpatient, and outpatient services, procedures, diagnoses and conditions, working from the appropriate documentation in the medical record. Classification systems include ICD-9-CM, CPT, HCPCS as well as other specialty systems as required by diagnostic category. Â All work is carried out in accordance with the rules, regulations and coding conventions of the American Hospital Association (Coding Clinic), ICD9, CMS, OSHPD, and Kaiser coding guidelines. As needed, Coders II may assist and be a resource for data integrity for other employees who need clarification and assistance in coding.Positions assigned to this classification are differentiated from those assigned to the Hospital Coder I classification in that only the former are typically characterized by the performance of a higher, more complex and responsible level of work generally associated with - but not limited to - the coding of in-patient...

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Associate Director, Medical Affairs/Patient Advocacy

Terns Pharmaceuticals San Mateo, CA, USA

Job Description Associate Director, Medical Affairs Operations & Patient Advocacy Job Description Terns Pharmaceuticals, Inc. is a clinical-stage biopharmaceutical company developing a portfolio of small-molecule product candidates to address serious diseases, including oncology, obesity, and non-alcoholic steatohepatitis (NASH). Terns' programs are based on mechanisms of action that have achieved proof-of-concept in clinical trials in indications with large unmet needs. Headquartered in Foster City, CA, Terns combines extensive research and development experience in drug development with a capital-efficient drug discovery and clinical development model to advance its growing pipeline of medicines. We have an exciting opportunity within Medical Affairs for an Associate Director, Medical Affairs Operations & Patient Advocacy. Essential Duties and Responsibilities: The candidate will work in partnership with the Director, Medical Affairs and the Leadership Team to manage...

DR

Medical Biller

Douglas R. Myers, O.D., Inc Chico, CA, USA

Job Description We are looking for an experienced Medical Biller for a busy optometry office. The ideal candidate is someone with great people skills, familiarity with ICD-10, denials and rejections from insurances, processing payments, Accounts Receivable management and the ability to shift between the front and back office. Medical Biller Responsibilities include but are not limited to: • Process vision and medical insurance billings on a daily basis. • Perform posting charges and completion of claims to payers in a timely fashion • Submit billing data to insurance providers • Work claims and claim denials to ensure maximum reimbursement for services provided • Ability to work independently and collaboratively within a team environment • Excellent problem-solving skills • Performs computer skills such as answering e-mails, look up patients' information and respond to e-mail appropriately when needed • Greet and direct patients in a highly professional manner, respecting the...

DH

Medical Billing Specialist

Douglas H.C.L. Chin, M.D at East Bay Plastic Surgery Oakland, CA, USA

Job Description Job Summary We are looking for a Medical Office Manager to help update our office procedures and keep the clinic running smoothly. In this role, you oversee front office staff by setting schedules, approving payroll, and enforcing compliance with HIPAA regulations. Other responsibilities include supervising the creation of electronic health records, which are essential to proper patient care, and assisting with insurance authorizations or medical billing. Applicants should have a degree in healthcare administration and experience working in a medical office. Duties and Responsibilities * Schedule and oversee front desk staff * Prepare payroll and approve overtime * Supervise the creation of patient records * Update office procedures * Assist with insurance authorizations and medical billing * Maintain provider schedule * Ensure compliance with HIPAA as well as internal policies * Assist with receptionist tasks as needed Requirements and Qualifications * Bachelor's...

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Risk Adjustment Coder

Cross Country Workforce Solutions Group Oakland, CA, USA

Job Description The Position : Responsible for the accurate coding, coding review, and submission of eligible participant diagnoses to CMS. DUTIES AND RESPONSIBILITIES: * Oversee all aspects of HCC and frailty coding operations for Center for Elders' Independence. * Interprets, analyzes, and assigns diagnostic codes to ensure compliance with governmental reimbursement policies, regulations and applicable guidelines. * Reviews provider coded encounters for accuracy of diagnoses. * Abstracts all CMS participant eligible diagnoses into a CMS submittal format. * Reviews and analyzes medical documentation to ensure that the final diagnosis listed accurately reflects the care and treatment submitted for reimbursement. * Collaborates and coordinates with external auditors; provides feedback on audit reports as appropriate. * Identifies inconsistencies, discrepancies and/or trends within the medical record and discusses with the appropriate medical providers. Recommends appropriate...

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Medical Billing Specialist

TPIRC/FAI Long Beach, CA, USA

Job Description Salary: $20-24 per hour Job Title: Medical Billing Specialist Company: TPIRC Location: Long Beach, CA Hours: Full Time; Non Exempt; M-F 8AM-5PM Pay Range: $20-24 per hour Who We Are: The Translational Pulmonary & Immunology Research Center (TPIRC) is a cutting-edge research and clinical care center that is revolutionizing treatment for rare and orphan diseases. Through the use of comprehensive diagnostic tools and patient-driven research, we seek to improve the quality of life for children and young adults each and every day. Why TPIRC? TPIRC is home to many innovative thinkers, problem solvers, and passionate leaders. The work we do is truly life-changing for our patients and their families; each member of our team will experience how their role supports our mission! TPIRC provides a challenging and rewarding environment where employees' talents are leveraged, ideas are encouraged and growth is always inspired. Who Are We Looking For? We are seeking a Medical...

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Hospital Outpatient Coder - NCAL

Kaiser CA, CA, USA

Under direct supervision, the Hospital Outpatient Coder is responsible for the accurate coding and abstracting of diagnoses, conditions and procedures from medical record documentation for Hospital Ambulatory Surgery (HAS), Home Health/Hospice (if applicable), Observation (OBS) and Â Hospital complex Outpatient Visit (CHOY) including capture of codes for outpatient services that require monitored anesthesia and conscious sedation. Â Working from appropriate documentation, assign the appropriate codes and modifiers with ICD-CM, CPT and HCPCS Level II codes. Â All work must be performed in accordance with the rules, regulations and coding conventions of ICD-CM Official Guidelines for Coding and Reporting, Coding Clinic published by the American Hospital Association, the ICD-CM, CPT and HCPCS code book, CPT Assistant, NCCI Edits, OSHPD and Kaiser Permanente's organizational and institutional coding guidelines.Â Essential Responsibilities:Review Medical Records to identify...

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Medical Billing Specialist

Active Care Physical Therapy San Francisco, CA, USA

Job Description Active Care Physical Therapy is a world renowned physical therapy clinic seeking highly motivated, professional, out-going and customer-service oriented individual who enjoys working in a fast-paced environment. MEDICAL BILLING Job Description: · Must have experience and knowledge of medical billing · Orthopedic terminology is a plus · Must have knowledge insurance; HMO, PPO; POS; Workers Comp · Answer incoming billing calls, check voicemails daily and respond accordingly and timely · Verify patient eligibility and benefits · Request/process for authorizations · Post patient and insurance payments · Process patient and insurance payments daily · Weekly patient statements · Request for refunds · Follow up on aging accounts receivable; check status on claims and appeals · Scan daily explanation of benefits to billing drive · Submit secondary claims with primary explanation of benefits · Compile deposits as needed · Analyze reports and problem solve · Assist on other...

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Medical Biller

David B Kaye MD Inc Fresno, CA, USA

Job Description Dynamic opportunity for experienced Medical Billers to join our team! Qualified candidates will be accurate, multi-tasking with excellent work ethic. A strong understanding of ICD-10 codes, CPT codes, modifiers, Insurance Authorizations, Copays and Deductibles is a must. This is a full time position in a fast paced environment. Company Description Well established ophthalmology/optometry clinic providing high-quality services to our patients. Company Description Well established ophthalmology/optometry clinic providing high-quality services to our patients.

SD

Medical Biller/Program Assistant

San Diego Youth Services San Diego, CA, USA

Job Description San Diego Youth Services JOB ANNOUNCEMENT Medical Biller/Program Assistant San Diego Youth Services seeks a Medical Biller/Program Assistant for our Our Safe Place Program (OSP) program to be based at our Uptown Youth Center. This is a part-time, hybrid & non-exempt position reporting to the OSP Program Manager. San Diego Youth Services: Who we are San Diego Youth Services has helped improve the lives of more than 780,000 homeless, runaway and vulnerable youth since its beginning in 1970. We provide safe places to live and long-term solutions through shelter, foster homes, community centers and housing to more than 28,000 youth every year at 100+ community and school locations. Through prevention, early intervention and treatment, we also help youth before they need higher levels of care or become homeless. We aim to: * Meet the basic needs of youth. Hunger, poverty and youth homelessness are on the rise for many youth and their families today. We help meet...

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Associate Director, Medical Writing

Ventyx Biosciences Encinitas, CA, USA

Job Description Salary: Ventyx Biosciences, Inc. is a clinical-stage, public biopharmaceutical company focused on advancing new therapies for millions of people living with inflammatory diseases and autoimmune disorders. We are developing novel and differentiated therapeutics that target both the innate and adaptive immune system. Our clinical-stage programs include an allosteric TYK2 inhibitor for the treatment of a broad range of autoimmune diseases, an S1P1 receptor modulator for the treatment of ulcerative colitis, and a peripheral inhibitor of the NLRP3 inflammasome, which is a mediator of multiple inflammatory conditions. Join this team of life science professionals to bring this portfolio of programs to fruition. The Opportunity: Associate Director Medical Writing This position will be responsible for leading the medical writing activities for one or more development programs. This role will play a critical part in managing the timely development and completion of clinical...

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Medical Billing Specialist

GLIA HEALTH MANAGEMENT LLC Chula Vista, CA, USA

Job Description The Neuron Clinic is a busy outpatient neurology practice with locations in Chula Vista, Temecula, and San Marcos, CA. We are passionate about delivering high-quality patient care. We accept Medicare, Medi-Cal, Tricare, and most HMOs and commercial PPOs. We are seeking a healthcare professional that is passionate about quality care and making a difference in our patients lives. Why Join the Team? * Competitive Compensation * Generous Health Insurance Coverage: Medical & Dental * Retirement Plan - Dollar for Dollar match * Paid Vacation Accruals * Paid Holidays * Paid training * Work alongside extremely talented highly specialized doctors * Excellent Work-life Balance SummaryThe Medical Billing Specialist oversees billing processes and serves as a point of contact for providers, patients, staff, IPAs and insurance companies. Works closely with clinic management on the timely submission of accurate encounter data for claims processing. They serve as the liaison...

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HCC Coder

To Help Everyone Health & Wellness Centers Los Angeles, CA, USA

Job Description South Los Angeles based FQHC looking for onsite Certified HCC coder . *This is not a remote position Conduct the necessary audits of medical record to verify the physicians have appropriately documented the diagnoses then code these diagnoses in ICD-10 for Medicare Risk Adjustments/Medicare Advantage. Evaluate medical information (Outpatient/Inpatient) documentation from a clinical standpoint for evidence of the possibility of additional medical conditions that may not have been documented in the past, and ensure accurate coding of the encounter data and recommend processes for accurate coding practices. This process involves a very strong understanding of medical coding. * Ascertain that medical record documentations have accurate diagnoses and conditions to assure not to up-code, fraudulently or misrepresent the patient condition and ensure compliance to prepare for random CMS medical records audit * HEDIS coding and record collection * Report Coding...

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Dermatology Medical Biller

Saperstein MD Inc Beverly Hills, CA, USA

Job Description Immediate opening for an experienced Dermatology Biller and Coder with 3 years minimum experience. Experience with Advanced MD a plus. This is a temporary job with possibility of transitioning to a full time position

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Medical Billing Specialist - Collector

Beverly Hills Cancer Center Los Angeles, CA, USA

Job Description The Medical Billing Specialist (Collector) is responsible for planning, organizing, and coordinating daily operations to ensure quality patient financial services and streamlined access to service for all patients. Responsibilities include providing administrative, and clerical services, coding, billing, collection of payments, and input into process improvement, with a focus on collections. Qualifications and Requirements * Strong focus on collections from patients and insurance companies * Insurance verification for new and current patients, review of incoming authorizations, and accurate input into electronic medical records system ("EMR"). * Responsible for determining patient financial responsibility as determined by the insurance company. * Research and verify patient demographic information through online verification systems. * Verify insurance eligibility; get authorization and ability to identify different kinds of insurance coverage and limitation. *...

122 jobs found