13 reimbursement coder specialist jobs found in Santa Monica, CA

Description In this role, you will assist with coding reviews, charge corrections, and staff education.Youwill optimize reimbursement by ensuring correct infusion, injection, and procedure coding.You will be responsible for clinic billing and coding questions and assisting with charge review work queue edit corrections.Youwill assist the Revenue Integrity Specialist Manager with conducting comprehensive analysis of monitoring claims to ensure timely and appropriate reimbursements and will work with Authorizations Pharmacists on medical necessity reviews when needed. You will also assist with treatment cash quotes, the Copayment Assistance Team, free drug assistance, and other assigned duties. Salary range: $40.04/hr - $52.83/hr Qualifications Required: Minimum of 2 years active Certified Professional Coder (CPC).Successfully completes required education courses to maintain current coding certification. Knowledge of oncology CPT and ICD-10 codes and medical office...

Description In this role, you will assist with coding reviews, charge corrections, and staff education. You will optimize reimbursement by ensuring correct infusion, injection, and procedure coding. You will be responsible for clinic billing and coding questions and assisting with charge review work queue edit corrections. You will assist the Revenue Integrity Specialist Manager with conducting comprehensive analysis of monitoring claims to ensure timely and appropriate reimbursements and will work with Authorizations Pharmacists on medical necessity reviews when needed. You will also assist with treatment cash quotes, the Copayment Assistance Team, free drug assistance, and other assigned duties. Salary range: $40.04/hr - $52.83/hr Qualifications Required: Minimum of 2 years active Certified Professional Coder (CPC). Successfully completes required education courses to maintain current coding certification. Knowledge of oncology CPT and ICD-10 codes and medical...

Payment Integrity Nurse Coder RN III 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 include concept and cost avoidance development. This position trains and mentors Payment Integrity Nurse Coder, RN staff. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff. Performs Quality Audits to include validation of accuracy and completeness of ICD, Rev Code, CPT, HCPCs, APR, DRG, POA, and all relevant coding...

Job Description Job Description Medical Billing Specialist (CPC) at Zócalo Health Remote, California residents only (Full Time) Compensation: $28- $32 per hour About Us Zócalo Health is the first tech-driven provider built specifically for Latinos, by Latinos. We are developing a new approach to care that is designed around our very own shared and lived experiences and brings care to our gente . Founded in 2021 on the idea that our communities deserve more than just safety nets, we are backed by leading healthcare and social impact investors in the country to bring our vision to life. Our mission is to improve the lives of our communities—communities that have dealt with generations of poor experiences. These experiences include waiting hours in waiting rooms, spending mere minutes with doctors who don't speak their language, and depending on their youngest kids to help them navigate our complex healthcare system. At Zócalo Health, we meet our members where they...

This is a remote based position. Applicants can be located nationwide Back Medical Coder #2621 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who has Profee Outpatient Coding experience. We need someone who is responsible for assignment of accurate Evaluation and Management (E&M) ICD-10-CM, ICD-10- PCS, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, modifiers and quantities derived from medical record documentation (paper or electronic) for encounters dependent upon record type. Tell us about your experience with Profee Outpatient Coding. Are you a team player and a self-motivator? What is your experience with conducting business in a way that is credit to a company? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you...

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 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company’s Workplace of the Year. We provide an outstanding benefit package that includes healthcare, paid time off and a 403(b). Join us! Discover why U.S. News & World Report has named us one of America’s Best Hospitals. What Will I be Doing in this Role? Under the general direction of the HID Audit Supervisor, the role operates as a Coding Auditor and shall:  Monitor coding compliance through prebill and retrospective reviews or audits of ICD and/or CPT codes assigned by coding staff. Monitor coding compliance by performing focused audits on high-risk areas identified by the Office of Inspector General (OIG) and the Centers of Medicare and Medicaid Services (CMS)....

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don't just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it's a calling that drives us forward every day. Job Overview Assigned codes to patient symptoms, diagnosis, operations, and treatments to process reimbursements; knowledge and expertise in reviewing and adjudicating coding services procedures and diagnoses on medical claims. Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes and CPT codes into the NextGen system. Minimum...

Job Description Job Description TTF is looking for a Prior Authorization/Verification Biller to work for a client in Costa Mesa, CA. The starting salary will depend on experience and our client offers a pleasant work environment.   Job duties include: Verify insurance information for upcoming procedures, obtain pre-authorization for procedures, explain to patients what their financial responsibilities will be, answer questions related to billing and submit insurance claims.  Experience working on ZirMed and Waystar knowledge is a plus.   Please send your resume to Chelle at CBodnar@TTFrecruit.com for consideration.   Qualified candidates should have previous experience in medical claim billing, insurance follow-up, and have knowledge of Medi-Cal guidelines. In addition, qualified candidates must have a stable work history and have the ability to pass a drug screen and background check.   TTF is a search and staffing company that partners with hospitals, physician groups,...

A bit about us: We are a long-standing nonprofit treatment provider with over five decades of service in the recovery community. For over 40 years, we've helped more than 50,000 individuals overcome health challenges through compassionate, evidence-based care. With 300+ residential beds and a dedicated team of 150+ staff, interns, and volunteers, we offer comprehensive services that promote long-term sobriety and personal growth. Why join us? Medical Dental Vision 401K Growth Options Job Details The billing specialist ensures accurate and timely billing for services provided. This role is responsible for preparing, reviewing, and submitting claims, resolving denied or unpaid claims, and maintaining compliance with local, state, and federal billing regulations. The ideal candidate is detail-oriented, tech-savvy, and experienced in medical billing systems and procedures. Key Responsibilities Daily Billing Operations Reconcile billing records for accuracy,...

Job Type Full-time Description Health Advocates is seeking a Medical Biller I for our main office in Chatsworth, CA . Job Summary The Biller is responsible for achieving billing standards as defined by the established billing timeliness policy. The Biller is also responsible for the timely resolution of outstanding accounts receivable due from all available sources of reimbursement according to established policies and procedures. Job duties include: bill accounts according to established policies and procedures within time frames, responsible for billing Hospital, Physician, Outpatient, Medi-Cal, Managed Care, HMO/PPO and out of state Medicaid claims, follow up on Outpatient Medi-Cal, Managed Care, HMO/PPO and out of state Medicaid claims, verify Insurance payment accuracy and assigning payment posting code, and perform miscellaneous related duties, as required. Qualifications • High School diploma or GED equivalent required; Medical Billing and Coding or...

Job Title: Medical Biller II Salary: $25hr-$28hr DOE Location: Tustin, CA Openings: 1 Position Purpose: The Medical Billing Specialist II supports the revenue cycle team by independently performing a broad range of billing functions with moderate complexity. This role is responsible for accurate insurance verification, charge entry, claim submission, payment posting, and resolution of routine denials to ensure compliance with payer requirements and timely reimbursement. Core Duties and responsibilities, include but are not limited to: Insurance & Eligibility Verification Verify complex insurance coverage (Medi-Cal, Medicare, Managed Care, Commercial, PPO/HMO). Research and resolve discrepancies in patient coverage or eligibility. Document eligibility outcomes in the EHR/PM system. Charge Entry & Coding Support Perform charge entry and apply CPT, ICD-10, and HCPCS codes. Review encounter forms for accuracy; flag missing or incorrect...

Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360 outpatient locations in 14 states providing more than 2.5 million patient visits annually. It is one of the nation’s leading health systems with nearly 57,000 employees and physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team! Responsibilities The Outpatient Coder Auditor Trainee reviews and analyzes documentation present in the medical record for outpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Outpatient Coder Auditor Trainee finalizes the coding and abstracting of the medical record upon ensuring the assignment of...

Medical Billing Specialist III/IV - Behavioral Health Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5037514) Apply  Medical Billing Specialist III/IV - Behavioral Health Salary $54,060.11 - $76,162.64 Annually Location Ventura and may require travel throughout Ventura County, CA Job Type Full-Time Regular Job Number 0840HCA-25AA (NW) Department Health Care Agency Division Behavioral/Mental Health Opening Date 08/27/2025 Closing Date Continuous Description Benefits Questions Description THE POSITION Under general direction (III, IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare, and general insurance reimbursement requirements. IDEAL CANDIDATE The ideal candidate has specialized expertise in mental health billing, including CPT, ICD-10, and HCPCS coding for Medicare and Medi-Cal....