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Job Description Position Summary The HCC Coder will be responsible for evaluating the accuracy and consistency of coded clinical data quality results and reports in accordance with accepted and established standards. The HCC Coder will collaborate with the Billing Manager and Medical Director in providing expertise in the use and application of current coding classifications including but not limited to ICD-10-CM, CPT, E&M and record documentation to ensure compliance in the collection of outpatient diagnoses and services. Schedule: • Full-time (Non-Exempt), • Flexible, may require some evening and weekends Primary Duties and Responsibilities • Review of medical records to ensure accuracy and claims for proper documentation and coding and completeness., • Communicate with providers when documentation in the record is inadequate, ambiguous, or otherwise unclear for medical coding purposes., • Create training presentations to educate staff in Medicare coding guidelines, with focus on Quality Measures with focus on HEDIS and Risk Adjustment HCC., • Lead the development and implementation of special projects such as new processes, policies and procedures relating to effective coding requirements., • Attend weekly meetings and present HCC Risk Adjustment Coding Department feedback, including data analysis, summary details; provide work flows and worksheets as necessary., • Attend Coding and Billing related Trainings and Webinars and provide debriefings to management and providers., • Other duties as assigned by the Billing Manager, Medical Director, Finance Director, or Executive Director. Qualifications Minimum Requirements • Computer and Software Proficiency including EHR and Microsoft Office (Word/Excel/Outlook/PowerPoint) Excellent Communication Skills, • Knowledge of Payor’s Billing (including Medi-Cal and Medi-Care) rules and guidelines required, • Extensive knowledge of ICD-10-CM outpatient diagnosis coding guidelines (with knowledge and demonstrated understanding of CMS HCC Risk Adjustment coding and data validation requirements is preferred) Ability to work as a team player and work independently, • Reliable transportation, • Must be able to travel from facility to facility., • This position requires 10 % travel outside the local area., • Comply with all federal and state privacy laws and regulations including HIPAA and HITECH Required Education/Experience and/or Licensure/Certification • BA Degree in Healthcare preferred, • Coding Certificate from an accredited institution preferred (CCS, CPC), • 2+ years experience in Healthcare Field as a Coder, • Technical expertise in the use and application of coding classifications such as ICD10, CPT, HCPCS and HCC Coding., • Commitment to goals and philosophy of Northeast Community Clinic, • Valid State Identification Physical Requirements and Working Conditions • OSHA Category 3 Involves no regular exposure to blood, body fluids, or tissues, and tasks that involve exposure to blood, body fluids, or tissues are not a condition of employment., • The work is majority of the time sedentary in nature., • The employee is regularly required to communicate, frequently required to use repetitive motions, move, remain stationary, regularly push, pull and lift up to 20 pounds and occasionally push, pull and lift up to 40 pounds., • Must possess mobility to work in a standard office/clinic setting (in some cases both settings) and to use standard office/clinic equipment, including a computer, stamina to maintain attention to detail despite interruptions, read printed materials and use a computer, and communicate in person and over the telephone. \nCompany Description Join the NECC Team! NECC has been providing primary and preventative healthcare services since 1971 to the low-income, uninsured, and underserved residents of Los Angeles County. Our mission is to provide comprehensive, quality healthcare in a culturally sensitive and linguistically competent manner to low-income, underserved, and indigent patients in the communities of the Los Angeles region, regardless of financial status. We hope you will join our medical professional team who are interested in a professional career serving our patients with dignity, professionalism, and high quality of care. We want you to be part of the NECC legacy of transforming communities one patient at a time. We look forward to hearing from you soon! Join the NECC Team!\r\n\r\nNECC has been providing primary and preventative healthcare services since 1971 to the low-income, uninsured, and underserved residents of Los Angeles County. Our mission is to provide comprehensive, quality healthcare in a culturally sensitive and linguistically competent manner to low-income, underserved, and indigent patients in the communities of the Los Angeles region, regardless of financial status.\r\n\r\nWe hope you will join our medical professional team who are interested in a professional career serving our patients with dignity, professionalism, and high quality of care. We want you to be part of the NECC legacy of transforming communities one patient at a time.\r\n\r\nWe look forward to hearing from you soon!

Job DescriptionDescription: Inpatient Facility Coder – Future Opportunities (Talent Pool) Remote GeBBS Healthcare Solutions, an industry leader in Health Information Management (HIM) and Revenue Cycle Management (RCM) solutions, is building a talent pool of highly motivated Inpatient Facility Coders for future, upcoming opportunities. This posting is to connect with experienced coding professionals who have a passion for excellence and collaboration and would like to be considered as new projects and roles become available. These future roles are anticipated to be full and part-time, remote W-2 positions with flexible schedules. In upcoming opportunities, coders may be responsible for medical coding for one of our facility clients, including reviewing charts, assigning appropriate diagnosis and procedure codes, and ensuring high-quality standards are consistently met. The Inpatient Coder typically assigns diagnostic and procedural codes to patient charts using ICD-10-CM, ICD-10-PCS, or other designated coding classification systems in accordance with coding rules and regulations, and abstracts required clinical information. Requirements: Typical Requirements for Future Roles • RHIA, RHIT, or CCS certification through AHIMA required, • Minimum of 3 years of recent inpatient facility coding experience, • Ability to maintain standard industry productivity rates for inpatient coding, • Demonstrated ability to maintain high quality standards of 95% or greater, • Proficient with technology (computer, VPN, MS Office, coding software), • Strong verbal and written communication skills, • Must have ICD-10 coding experience and have completed an ICD-10 course, • Experience with trauma and highly complex cases preferred Why Join Our Talent Pool? By applying, you’ll be considered for future inpatient coding opportunities with GeBBS as new client needs and projects arise. Our recruiting team may reach out to discuss upcoming roles that align with your background and interests.

Job DescriptionJob Title: Medical Coder Job Type: Contractor Location: Remote Job Overview We are seeking experienced Medical Coders to contribute their healthcare coding expertise to an innovative project focused on improving next-generation AI systems. In this role, you will review and annotate medical records, evaluate coding accuracy, and provide expert feedback to support the development of high-quality medical datasets. No prior AI experience is required—your coding expertise and attention to detail are what matter most. Key Responsibilities Review and annotate medical records to accurately assign ICD-10 and CPT codes based on clinical documentation. Apply Evaluation & Management (E&M) guidelines to assess coding levels and validate healthcare datasets. Ensure compliance with current medical coding standards and guidelines. Analyze clinical documentation and identify coding-related ambiguities or inconsistencies. Provide expert feedback on coding guidelines, edge cases, and documentation scenarios. Collaborate with project teams through written and verbal communication to improve AI training data quality. Required Skills Medical Coding ICD-10 CPT CPC Certification Evaluation & Management (E&M) Clinical Documentation Review Coding Accuracy & Compliance Attention to Detail Written & Verbal Communication Preferred Qualifications Active AAPC Certified Professional Coder (CPC) certification required. Strong knowledge of ICD-10, CPT coding systems, and E&M leveling guidelines. Experience working with diverse clinical documentation types. Ability to interpret complex medical records and apply appropriate coding standards. Strong written and verbal communication skills. Familiarity with digital annotation tools or healthcare data projects is a plus. Commitment to accuracy, quality, and continuous learning in healthcare coding and technology

Job DescriptionDescriptionThe HEDIS Abstractor supports Quality Care Improvement initiatives by conducting comprehensive medical record reviews and abstraction activities to identify and close HEDIS measure care gaps. This role is responsible for ensuring accurate collection, validation, and submission of clinical data in accordance with NCQA HEDIS technical specifications and regulatory guidelines. The HEDIS Abstractor collaborates with internal quality teams, providers, and external audit vendors to improve measure performance, maintain compliance, and support successful HEDIS audits. What You'll Do • Perform medical record abstraction and chart review for HEDIS and quality improvement initiatives, • Identify and close HEDIS care gaps through accurate review and documentation of clinical records, • Interpret and apply HEDIS measure specifications, coding guidelines, and NCQA technical requirement, • Review and validate data for accuracy, completeness, and compliance with HEDIS standards, • Conduct quality assurance (QA) reviews of abstracted records and audit findings, • Collaborate with providers, clinics, health plans, and internal departments to obtain required medical documentation, • Partner with external audit vendors to support medical record retrieval, validation and audit readiness activities, • Analyze abstraction results and identify trends, discrepancies, or opportunities for process improvement, • Ensure compliance with HIPAA and all applicable privacy and confidentiality regulations, • Maintain productivity and accuracy standards while meeting project deadlines, • Support continuous quality improvement initiatives and assist with reporting activities as needed, • Other duties as assigned Qualifications • High school diploma or equivalent required; associate or bachelor’s degree in healthcare-related field, • Have at least 2 years of HEDIS abstraction or medical record review experience, • Strong knowledge of NCQA HEDIS measure specifications and quality improvement processes, • Proficiency with ICD-10, CPT, HCPCS, and other clinical coding systems, • Experience performing QA reviews and supporting HEDIS audit activities, • Familiarity with EMR/EHR systems and healthcare documentation workflows, • Strong analytical, organizational, and problem-solving skills, • Excellent attention to detail and accuracy, • Ability to work independently and manage multiple priorities in a fast-paced environment, • Strong written and verbal communication skillsYou're great for the role if:, • Certified Professional Coder (CPC), RHIT, RHIA, LVN/LPN, RN, or other healthcare-related certification, • Experience working with health plans, managed care organizations, or quality improvement departments, • Knowledge of CMS Stars, risk adjustment, and population health initiatives strongly preferred Environmental Job Requirements and Working Conditions • Our organization follows a hybrid work structure. This role will require travelling locally to provider offices located in San Francisco bay area for up to 35% of the time. When not conducting onsite visits, the role supports remote work., • The annual total compensation target pay range for this role is: $27.00 - $33.00 per hour. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation. Additional Information: The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

Job DescriptionDescription: GeBBS Healthcare Solutions is a leader in Health Information Management (HIM) and Revenue Cycle Management (RCM). We are committed to fostering a culture of excellence, integrity, and collaboration within the healthcare industry. We are building a talent pool of credentialed Outpatient Facility Coding Specialists for upcoming and future opportunities. While we may not have an immediate opening, we regularly partner with large health systems and Level I Trauma facilities and anticipate continued growth in this space. If you have strong outpatient facility coding experience and are interested in being considered for future roles, we encourage you to apply. Position Overview As an Outpatient Facility Coding Specialist, you would be responsible for coding diseases, operations, and procedures for outpatient encounters in accordance with ICD-10-CM, UHDDS, and AMA CPT-4 standards. Opportunities may support large, complex health systems, including Level I Trauma facilities. Potential Responsibilities • Code outpatient procedures according to client-specific guidelines, • Abstract patient data with accuracy and compliance, • Stay current on coding policies and regulatory updates, • Utilize healthcare abstracting software and ICD-10 data sets, • Initiate physician queries per client protocols, • Communicate regulatory or compliance changes to leadershipRequirements: Preferred Qualifications • Credentialed medical coder with 3+ years of experience, • AHIMA credential preferred; AAPC credentials considered, • Experience in facility OP & ED coding within large Level I Trauma facilities (SDS, OBS, ED; IR/Cath preferred), • Strong attention to detail and commitment to accuracy, • US-based candidates Additional Information By applying to this talent pool, you will be considered as upcoming opportunities become available that align with your skills and experience. We look forward to connecting with experienced outpatient facility coders who are interested in growing with GeBBS Healthcare Solutions.

AltaMed is seeking a Certified Coder I to review medical documentation and assign ICD-10-CM, CPT, HCPCS codes to support compliant billing and regulatory reporting.The role emphasizes accuracy, productivity, and ongoing learning.The position offers hourly compensation ranging from $27.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. • Leverage understanding of disease process to identify and extract relevant details and data within clinical documentation and make determinations or identify appropriate medical codes, • Utilize resources and reference materials (e.g., on-line sources, manuals) to identify appropriate medical codes and reference code applicability, rules, and guidelines, • Apply understanding of relevant medical coding subject areas (e.g., diagnosis, procedural, evaluation and management, ancillary services) to assign appropriate medical codes, • Apply understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable medical codes, • Identify areas in clinical documentation that are unclear or incomplete and generate queries to obtain additional information, • Follow up with providers as necessary when responses to queries are not provided in a timely basis, • Utilize medical coding software programs or reference materials to identify appropriate codes, • Read and interpret medical coding rules and guidelines to make decisions (e.g., exclusions, sequencing, inclusions), • Apply post-query response to make final determinations, • Make determinations on medical charting and take initiative to complete reviews independently to avoid delays in the process, • Apply relevant Medical Coding Reference, Federal, State, and Professional guidelines to assign and record independent medical code determinations., • Manage multiple work demands simultaneously to maintain relevant productivity and turnaround time standards for completing medical records (e.g., charts, assessments, visits, encounters), • Provide information or respond to questions from medical coding quality audits, • Perform medical coding audits to evaluate medical coding quality, • Review medical coding audit results - Follow steps per agreement with medical coding audit results to resolve discrepancies, • Provide resources and information to substantiate medical coding audit findings, • Educate and mentor others to improve medical coding quality, • Apply understanding of National Correct Coding Edits to the coding process, • Demonstrate understanding of National and Local coverage determinations, • Demonstrate basic knowledge of the impact of coding decisions on revenue cycle, • Follow relevant professional code of ethics consistent with required certifications, • Attain and/or maintain relevant professional certifications and continuing education seminars as required, • Leverage relevant computer software programs (e.g., Microsoft Office) to record information, analyze data, or communicate with others, • Utilize and navigate across clinical software applications to assign medical codes or complete reviews You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. • High School Diploma / GED, • 2+ years of experience with documentation for procedures, supplies and E&M levels (including ED, OB and OBS), • Intermediate level of Microsoft Office experience, • Intermediate level of EHR experience, specifically with Epic, • Certified Coder with credentials from AAPC with a CPC or AHIMA with CCS, RHIT, RHIA, • Meet metric expectations, • Good communication skills, • Team player *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $24 - $43 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

We are seeking a Certified Medical Coder- Remote to join our team. We are deeply rooted in the communities we serve, which means that our patients are often our family, friends, and neighbors, and it is special to be able to care for them. As one of the top healthcare systems, we are committed to your ongoing growth and development. After work, you will find things to do in every season, including beaches, outdoor recreation, unique restaurants, world-class wineries, arts and entertainment. Why work as a Coder Abstractor? • Remote work schedule, • Our dynamic work environment includes many opportunities for growth and development, • Our efforts directly impact patient satisfaction and outcomes, • Our employees work in positive, supportive, and compassionate environments built on our organizational values. Skills • At least 1 years recent coding experience including coding surgical cases preferred., • Experienced in coding hospital inpatient and outpatient E/M services., • Thorough knowledge of medical terminology, ICD-10-CM and CPT4 coding necessary., • Understanding of both the medical and business side of healthcare operations., • Highly organized, self-motivated, detail-oriented and energetic team player., • Excellent verbal and written communication skills., • Strong computer skills including MSOffice, Internet, and E-mail., • Epic experience helpful Summary: Under general supervision, according to established policies, procedures and protocols, codes all disease and operations according to accepted classifications. Insure compliance with PRO data reporting and other regulatory licensing and accrediting agencies. The Benefits of Working: • Competitive salaries, • Full benefits, paid holidays, and paid time off (up to 19 days your first year), • Tuition reimbursement and ongoing educational opportunities, • Retirement savings plan with employer match and personal consulting, • Wellness plans, an employee assistance program and employee discounts Applicant Location: Remote USA Only

This class is online 8 hrs/wk. The application will be considered disqualified if it does not meet the criteria listed below and must have the following documentation attached to your online EdJoin application prior to the position closing date/time: Completed Application A copy of basic skills will be required upon hire (refer to www.ctc.ca.gov for requirements) A detailed online copy of the credentials from the CTC Website. • Letter(s) of Recommendation (Two letters of recommendation), • Resume, • Career Technical Education Teaching Credential - Health Science and Medical Technology Resume (Employee information on the resume must be consistent with the employment information on the Edjoin Application) Letters of recommendation (Two (2) Letters of recommendation are required and must be attached to your application. Both letters must include the following: • Date, • Must be within the last two years., • Must be hand-signed by the author., • Must include contact information (including cell phone numbers) Letters without a hand signature, letters that are electronically signed, and letters without a date or with a date more than 2 years old will not be accepted.

Senior Revenue Integrity Specialist – Clinical Revenue Integrity Los Angeles, CA – Full Time (8‑Hour Days, Exempt, Non‑Union) Overview As the center of clinical charge capture, the Revenue Integrity (RI) Specialist provides leadership to the daily CDM maintenance workflow between the various entities of Keck Medical Center of USC and monitors alignment with standard policy. The RI Specialist is responsible for timely and accurate synchronization of data between the CDM residing in the billing system and CDM management tools. They ensure that the Chargemaster (CDM) is consistent with all coding and billing regulations, represents services accurately, and is kept up to date with Medicare and other third‑party payer requirements. Key responsibilities include documentation of policies, conducting meetings to evaluate charge processes, coordinating with administration, IS, compliance, clinical informatics, and integration personnel on technology projects, and providing supervisory direction to revenue auditors. Responsibilities Maintain the Keck Medical Center of USC Charge Description Master, ensuring all annual updates required by Medicare and other third‑party payers are current. Review and process requests for new code additions, code set corrections, revenue code to CPT/HCPCS code mismatches, and ongoing system changes to maintain regulatory compliance. Lead meetings with operations leaders, revenue auditors, clinical department staff, and gatekeepers to address compliance issues. Serve as subject‑matter expert for projects affecting revenue integrity and the CDM. Coordinate and lead the Revenue/Chart Audit team in resolving CDM and charge capture issues. Synchronize CDM data between the CDM and the CDM Workflow & Management Tool on a monthly basis. Import and extract data from various sources to monitor and maintain CDM integrity. Provide ad‑hoc reports based on identified issues. Guide and educate staff to ensure CDM and charge capture standards are followed, including newly acquired entities such as Verdugo Hills. Conduct charge reconciliation activities, research best practices, and deploy charge capture improvement initiatives. Interpret and explain details of charge services as needed. Collaborate with Revenue Cycle and Ancillary teams on education programs for staff regarding charge master and capture processes. Help develop policies and procedures for late charge monitoring and timely capture. Promote professional growth and development within the team. Participate in team, departmental, and organizational goal achievement. Perform other duties as assigned. Required Qualifications Associate’s degree in Business Administration, Accounting, Finance, Healthcare Administration, Nursing, or a related field. Specialized or technical training certification from an accredited program such as Certified Coder (CPC/CCS/COC) or Certificate of Auditing (CPMA) within one year of hire. Minimum five years of experience in the healthcare field, including coding, provider billing, medical records, charge audit, CDM maintenance, Medicare/Medicaid reimbursement, managed care contracts, and patient accounting. Experience with inpatient and outpatient billing (UB‑04) and CMS Medicare reimbursement methodology. Knowledge of government and third‑party payer reimbursement methodologies. Ability to implement a systematic, self‑motivated approach to problem solving and to coordinate resources for plan execution. Proficient skills in MS Office and Windows. Preferred Qualifications Bachelor’s degree in Business Administration, Accounting, Finance, Healthcare Administration, Nursing, or a related field. Previous charged master experience, including CDM maintenance software (Craneware or Med Assets). Experience with hospital charging practices and operations in an acute care setting. Knowledge of revenue cycle flow across hospital billing systems. Working knowledge of CPT, HCPCs, and ICD9 coding principles. Experience with Cerner and Craneware software. Required Licenses & Certifications Certified Coder (CCS or CPC) or Certified Outpatient Coder‑COC (AAPC) or Certified Auditor (CPMA) obtained within one year of hire. Registered Nurse (RN) – CA Board of Registered Nursing (preferred). Pharmacy Technician – CA DCA (preferred). Fire Life Safety Training (LA City) – must obtain within 30 days of hire if not already possessed. Annual base salary range: $99,507.00 – $164,559.00. #J-18808-Ljbffr

The Revenue Integrity Analyst is responsible for supporting the hospital's revenue cycle by ensuring accurate charge capture, compliant billing practices, and optimal reimbursement. This role analyzes clinical and financial data to identify revenue leakage, resolve billing discrepancies, and ensure adherence to regulatory and payer requirements within an acute care hospital environment. The analyst collaborates with clinical departments, coding, patient financial services, and compliance teams to maintain revenue integrity across all service lines. Key Responsibilities: • Monitor and analyze charge capture processes to identify missing, incorrect, or duplicate charges., • Conduct revenue integrity audits across hospital departments including inpatient, outpatient, and ancillary services., • Collaborate with coding, HIM, and patient financial services teams to ensure accurate coding and billing compliance., • Analyze payer policies and regulatory requirements to ensure compliance with federal and state guidelines., • Participate in process improvement initiatives to enhance revenue cycle efficiency and reduce revenue leakage., • Provide education and guidance to clinical and operational staff regarding proper charge capture and documentation., • CDM maintenance and governance, including adding, revising, and retiring charge codes., • Charge capture review and reconciliation to ensure services are billed appropriately., • Compliance monitoring related to CPT/HCPCS coding, payer guidelines, and regulatory requirements., • Pricing validation and updates within the Charge Description Master., • Coordination with departments to ensure accurate charge mapping and revenue capture., • Charge audits and variance analysis to identify revenue leakage or compliance risks. Strong knowledge of medical terminology, coding guidelines, NCCI edits, and billing regulations. Strong communication and interpersonal skills, with the ability to work collaboratively with clinical and administrative staff. Ability to prioritize tasks and manage time effectively in a fast-paced environment. Performs other job related duties as assigned. Job Qualifications: Minimum Education: Bachelor's Degree in Healthcare Administration, Health Information Management, Finance, Business Administration, or a related field Preferred Education: Master's degree in Healthcare Administration, Business Administration, or related field Required Work Experience and Qualification: Strong understanding of hospital revenue cycle operations including charge capture, coding, billing, and reimbursement. Knowledge of Medicare, Medicaid, and commercial payer regulations Experience with electronic health records (EHR) and hospital billing systems Advanced analytical and problem-solving skills Strong proficiency in Microsoft Excel and data analysis tools Ability to interpret financial, clinical, and operational data Possess excellent written/verbal communication skills in addition to the ability to work with minimal supervision Preferred Work Experience and Qualifications: Proven experience in charge capture, medical billing, or a similar role within a hospital setting 3-5 years' experience. Certified Revenue Integrity Professional (CRIP) Certified Coding Specialist (CCS) Certified Professional Coder (CPC) Certified Healthcare Financial Professional (CHFP) Required Licensure, Certification, Registration or Designation: Current Los Angeles County Fire Card (or must be obtained within 30 days of employment) Assault Response Competency (ARC) required (within 30 days of hire) Shift: Days Hours: 8 Weekly Hours: 40 Type: Exempt FTE: 1.0

As the center of clinical charge capture, the Revenue Integrity (RI) Specialist provides leadership to the daily CDM maintenance workflow between the various entities of Keck Medical Center of USC and monitors the alignment of the various entities to the standard policy for maintaining the CDM. The RI Specialist is responsible for the timely and accurate synchronization of data between the CDM residing in the billing system and CDM management tools. The Senior RI Specialist shall ensure that the Chargemaster (CDM) is consistent with all coding and billing regulations and accurately represents services provided. This includes ensuring all annual updates required by Medicare and other third-party payers are up to date. The Senior RI Specialist delivers direction to the documentation of all policies and procedures regarding CDM Maintenance and charge process; and conducts meetings to evaluate department charge processes to improve charge capture and coding compliance. The Senior RI Specialist also coordinates with Keck Medical Center of USC Administration, IS, Compliance, Clinical Informatics and Integration personnel on technology projects impacting charge entry, charge dictionaries, and charge, and provides data derived from multiple entities of Keck Medical Center of USC for the management and support of critical decisions and functions related the Chargemaster, CDM Maintenance, and the improvement of charge capture. As a subject matter expert in the area of compliance and pricing of services, the Senior RI Specialist responds to inquiries regarding Chargemaster issues and is responsible for supervising meetings for projects associated with educating and communicating to clinical revenue generating departmental staff regarding the CDM Maintenance process, coding updates, compliance issues, and charge capture improvement. The Senior RI Specialist works closely with revenue auditors and provides leadership by providing direction to the revenue auditor team to all entities of Keck Medical Center of USC in the research and resolution of requests in a timely manner; and aid in the training and skill development of auditors to maximize available tools for Chargemaster and billing compliance. • Performs maintenance to the Keck Medical Center of USC Charge Description Master (Keck & Norris) ensuring all annual updates required by Medicare and other third-party payers are up to date. Assists the Revenue Cycle in annual coding review and processing of updates., • Reviews and process requests for new code additions, code set corrections, revenue code to CPT/HCPCS code mismatch corrections and on-going identified changes for current systems to maintain compliance with both state and federal regulatory agencies., • Leads and conducts meetings with Operations Leaders, Revenue Auditors, Clinical Department Staff, and Gatekeepers to address issues involving compliance with government regulations, third party payor needs and industry standards., • Acts a subject matter expert for projects that impact revenue integrity and CDM. Subject matter expert to meet and/or communicate with various stakeholders for projects that impacts revenue integrity and the CDM., • Takes the lead and exercises significant judgement and discretion on projects that have a broad, organizational impact., • Coordinates and provides leadership to Revenue/Chart Audit team associated with research and resolution of account issues related to the CDM, charge capture, and other issues considered to be revenue integrity., • Synchronizes CDM data between CDM and CDM Workflow & Management Tool for Keck Medical Center of USC entities on a monthly basis., • Imports/extracts data from various sources and in various formats as needed to review, monitor, track, and maintain the integrity of the CDM and associate charge flow process., • Provides CDM data as necessary based on identified issues in form of ad-hoc reports., • Provides guidance and education to ensure that CDM's and Charge Capture as needed of exist and newly acquired entities (i.e. Verdugo Hills) follow the standards and policies of Keck Medical Center of USC., • Performs charge reconciliation activities, industry best practice research, and identifies and deploys charge capture improvement initiatives., • Interprets and explains on details of charge services provided as needed., • Participates collaboratively with Revenue Cycle and Ancillary team in the development, execution, and follow-up of education programs for USC Administration, Managers and Staff on all issues related to the charge master, charge capture, and new applications related processes., • Participates in the development of policies and procedures, monitoring tools for late charges and establishment of procedures for timely and accurate charge capture mechanisms., • Enhances professional growth and development, • Actively participates in team development, contributes to dashboards, and in accomplishing team, departmental, and organizational goals and objectives., • Performs other duties as assigned., • Req Associate's Degree Business Administration, Accounting, Finance, Healthcare Administration, Nursing, or similar/related field., • Req Specialized/technical training Certification from an accredited program of Certified Coder (CPC/CCS/COC) or Certificate of Auditing (CPMA) within one year from date of hire., • Req 5 years Experience in healthcare field required. Related experience may include a combination of clinical service delivery (nursing or allied health), coding, provider billing, medical records, charge audit environment, CDM maintenance, Medicare/Medicaid reimbursement, managed care contractual arrangements, and patient accounting., • Req Experience with inpatient and outpatient billing requirements (UB-04) and CMS Medicare reimbursement methodology., • Req Knowledge of other government and third-party payer reimbursement methodology required., • Req Must be able to implement a systematic, self-motivated approach to problem solving and be able to identify, coordinate and optimize resources needed to execute plan, • Req Proficient skills and knowledge in MS Office/ Windows, • Pref Bachelor's Degree Business Administration, Accounting, Finance, Healthcare Administration, Nursing, or similar/related field., • Pref Experience and knowledge of Hospital charging practices., • Pref Healthcare operations experience, particularly in an acute care hospital setting., • Pref Current knowledge of the Revenue cycle, specifically the flow of charges in and across hospital billing systems., • Pref Previous hospital Chargemaster experience, including the use of CDM Maintenance software (Craneware or Med Assets)., • Pref Working knowledge of CPT, HCPCs and ICD9 coding principles., • Pref Skills and knowledge on the following software: Cerner and Craneware, • Pref Registered Nurse - RN (CA Board of Registered Nursing), • Pref Pharmacy Technician (CA DCA), • Req Specialty Certification Certified Coder (CCS or CPC), Certified Outpatient Coder-COC (AAPC) or Certified Auditor (CPMA) obtained within one (1) year of date of hire., • Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only) The annual base salary range for this position is $95,680.00 - $158,230.00. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations. USC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other characteristic protected by law or USC policy. USC observes affirmative action obligations consistent with state and federal law. USC will consider for employment all qualified applicants with criminal records in a manner consistent with applicable laws and regulations, including the Los Angeles County Fair Chance Ordinance for employers and the Fair Chance Initiative for Hiring Ordinance, and with due consideration for patient and student safety. Please refer to the Background Screening Policy Appendix D for specific employment screen implications for the position for which you are applying. We provide reasonable accommodations to applicants and employees with disabilities. Applicants with questions about access or requiring a reasonable accommodation for any part of the application or hiring process should contact USC Human Resources by phone at (213) 821-8100, or by email at uschr@usc.edu . Inquiries will be treated as confidential to the extent permitted by law.

The manager, HIM coding auditing and education provides leadership and operational oversight for the inpatient and outpatient coding audit and education programs. This position is responsible for ensuring coding accuracy, regulatory compliance, and continuous improvement in coding quality across the organization. The manager supervises coding auditors, educators, denials management specialists, and coder editor team, and is responsible for planning, organizing, and directing coding audit activities, coding education initiatives, and pre-bill coding-related-edits from billing systems. This role collaborates closely with coding operations, clinical documentation integrity (CDI), compliance, revenue integrity, patient financial services, physician-providers, and non-physician providers to support revenue cycle performance and regulatory compliance. The manager serves as a subject matter expert in coding regulations and provides leadership in the development and implementation of coding education, audit programs, facilitating educational webinars and seminars, planning and delivering effective presentations, and process improvement initiatives. essential duties: • manage IP & OP coding audit programs & team, • coding education program leadership, • manage OP coding editor program, functions, & team, • denials management, • regulatory, coding & clinical research oversight, • root cause analysis & process improvement, • reporting & performance monitoring, • communication & collaboration, • information systems & technology, • perform other duties as assigned. required qualifications: • req bachelor's degree health information management (HIM), or health information technology (HIT), or health information systems (HIS), • req specialized/technical training successful completion of college courses in medical terminology, anatomy & physiology and a certified coding course. Must possess a thorough knowledge of ICD-10-CM/PCS, MS-DRG, APR-DRG, and CPT/HCPCS coding principles, and the recommended American Health Information Management Association (AHIMA) coding competencies., • req 10 years experience in ICD-10-CM, ICD-10-PCS, CPT/HCPCS coding of inpatient & outpatient medical records in an acute care facility., • req 2 years leadership experience., • req experience in using a computerized coding & abstracting database software and encoding/code-finder systems [e.g., 3M 360 Encompass/CAC and 3M coding and reimbursement system (CRS)]. preferred qualifications: required licenses/certifications: • req advanced knowledge of: ICD-10-CM ICD-10-PCS CPT HCPCS MS-DRG APR-DRG, • req knowledge of coding compliance and regulatory requirements, • req knowledge of CMS coding and billing rules, • req strong analytical and problem-solving skills, • req excellent organizational and time management skills, • req strong written and verbal communication skills, • req ability to work independently and collaboratively, • req ability to interpret and apply official coding guidelines, • req strong presentation and training skills, • req certified coding specialist - CCS (AHIMA) AHIMA certified coding specialist (CCS) only; or AAPC certified inpatient coder (CIC) only; or either the CCS or CIC in conjunction with any one of the following national HIM credentials: 1. AHIMA registered health information technician (RHIT) 2. AHIMA registered health information administrator (RHIA) successful completion of the hospital specific coding test with a passing score of ?90%. The coding test may be waived for 10+ years experienced inpatient coding professionals, or a former USC or agency/contract HIM coding dept. coders who historically/previously met the ? 90% internal/external audit standards of the previously held USC job code., • req fire life safety training (LA city) if no card upon hire, one must be obtained within 30 days of hire, and maintained by renewal before expiration date. the annual base salary range for this position is $110,240.00 - $181,896.00. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations. USC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other characteristic protected by law or USC policy. USC observes affirmative action obligations consistent with state and federal law. USC will consider for employment all qualified applicants with criminal records in a manner consistent with applicable laws and regulations, including the Los Angeles County Fair Chance Ordinance for employers and the Fair Chance Initiative for Hiring Ordinance, and with due consideration for patient and student safety. Please refer to the Background Screening Policy Appendix D for specific employment screen implications for the position for which you are applying. We provide reasonable accommodations to applicants and employees with disabilities. Applicants with questions about access or requiring a reasonable accommodation for any part of the application or hiring process should contact USC Human Resources by phone at (213) 821-8100, or by email at uschr@usc.edu . Inquiries will be treated as confidential to the extent permitted by law. • notice of non-discrimination, • employment equity, • read USC's Clery Act Annual Security Report, • USC is a smoke-free environment, • digital accessibility

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. • Leverage understanding of disease process to identify and extract relevant details and data within clinical documentation and make determinations or identify appropriate medical codes, • Utilize resources and reference materials (e.g., on-line sources, manuals) to identify appropriate medical codes and reference code applicability, rules, and guidelines, • Apply understanding of relevant medical coding subject areas (e.g., diagnosis, procedural, evaluation and management, ancillary services) to assign appropriate medical codes, • Apply understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable medical codes, • Identify areas in clinical documentation that are unclear or incomplete and generate queries to obtain additional information, • Follow up with providers as necessary when responses to queries are not provided in a timely basis, • Utilize medical coding software programs or reference materials to identify appropriate codes, • Read and interpret medical coding rules and guidelines to make decisions (e.g., exclusions, sequencing, inclusions), • Apply post-query response to make final determinations, • Make determinations on medical charting and take initiative to complete reviews independently to avoid delays in the process, • Apply relevant Medical Coding Reference, Federal, State, and Professional guidelines to assign and record independent medical code determinations., • Manage multiple work demands simultaneously to maintain relevant productivity and turnaround time standards for completing medical records (e.g., charts, assessments, visits, encounters), • Provide information or respond to questions from medical coding quality audits, • Perform medical coding audits to evaluate medical coding quality, • Review medical coding audit results - Follow steps per agreement with medical coding audit results to resolve discrepancies, • Provide resources and information to substantiate medical coding audit findings, • Educate and mentor others to improve medical coding quality, • Apply understanding of National Correct Coding Edits to the coding process, • Demonstrate understanding of National and Local coverage determinations, • Demonstrate basic knowledge of the impact of coding decisions on revenue cycle, • Follow relevant professional code of ethics consistent with required certifications, • Attain and/or maintain relevant professional certifications and continuing education seminars as required, • Leverage relevant computer software programs (e.g., Microsoft Office) to record information, analyze data, or communicate with others, • Utilize and navigate across clinical software applications to assign medical codes or complete reviews You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. • High School Diploma / GED, • 2+ years of experience with documentation for procedures, supplies and E&M levels (including ED, OB and OBS), • Intermediate level of Microsoft Office experience, • Intermediate level of EHR experience, specifically with Epic, • Certified Coder with credentials from AAPC with a CPC or AHIMA with CCS, RHIT, RHIA, • Meet metric expectations, • Good communication skills, • Team player *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $24 - $43 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

The Compliance Consultant IV, Medical Coding independently reviews inpatient, outpatient, professional, and supplemental medical records to assign supported ICD-10-CM diagnosis codes and applicable hierarchical condition categories. The coder validates that each reported condition is documented by an eligible provider, supported by the medical record, captured from an acceptable encounter, and coded in accordance with official guidelines, regulatory requirements, and organizational policies. The role requires advanced proficiency in risk adjustment coding platforms, electronic medical records, encoder applications, understanding of documentation cues, and production reporting tools. The Senior Coder is expected to resolve complex documentation and coding issues, recognize unsupported or conflicting diagnoses, document coding rationale, and escalate potential compliance concerns. All coding decisions must be defensible, traceable, and suitable for internal review or external audit. In addition to the responsibilities listed below, the position is responsible for serving as a compliance subject matter expert related to coding functions within all settings of care, maintaining compliance with national coding policies and procedures, assisting with coding questions and related topics, and auditing all lines of business for coding. Additionally, this position is responsible for assisting with the development of audit result reports to regional staff and senior management and supporting compliance and the Principles of Responsibility (KPs code of conduct). Essential Responsibilities: • Practices self-development and promotes learning in others by proactively providing information, resources, advice, and expertise with coworkers and customers; building relationships with cross-functional stakeholders; influencing others through technical explanations and examples; adapting to competing demands and new responsibilities; listening and responding to, seeking, and addressing performance feedback; providing feedback to others; creating and executing plans to capitalize on strengths and develop weaknesses; supporting team collaboration; and adapting to and learning from change, difficulties, and feedback., • Completes work assignments and supports business-specific projects by applying expertise in subject area; supporting the development of work plans to meet business priorities and deadlines; ensuring team follows all procedures and policies; coordinating resources to accomplish priorities and deadlines; collaborating cross-functionally to make effective business decisions; solving complex problems; escalating high priority issues or risks as appropriate; and recognizing and capitalizing on improvement opportunities., • Conducts company compliance activities by collaborating with internal and external stakeholders; applying established regulations and standards to compliance efforts; providing insight and recommendations for the design, development, and execution of strategic compliance initiatives; and documenting compliance activities., • Develops compliance reports by evaluating and summarizing compliance data, audit information, and potential risks and remedies; reporting to management on key compliance drivers, liabilities, and performance indicators (for example, adherence to standards, incorporation of new regulations); and developing draft presentations to convey key findings., • Conducts compliance investigations by collecting and analyzing quantitative and qualitative data; conducting interviews as appropriate; researching key business issues; identifying potential action steps; and providing input for the creation of corrective action plans for substantiated allegations., • Assists with and supports the management of projects or compliance components of larger cross-functional projects by coordinating stakeholder contacts; recommending team resources based on project needs and team member strengths; assisting in the development, analysis, and management of project plans; and coordinating project schedules and resource forecasts., • Assists with ensuring regulatory compliance by monitoring regulatory changes; conducting analysis on regulatory impacts; and supporting the implementation of designated changes., • Coordinates the implementation of compliance efforts by identifying compliance requirements; assessing the current state of compliance to identify gaps and corrective actions; creating or revising moderately complex compliance standards, policies and procedures, and training; and monitoring ongoing compliance adherence. Minimum Qualifications: • Minimum four (4) years medical coding experience., • Bachelors degree in Health Care Administration, Clinical, Law, Public Health, Business or related field and Minimum six (6) years experience in health care compliance, health care operations (quality, risk, etc.), audit, finance, regulatory or public policy development, investigations, information security, or insurance/health plan governance or a directly related field. Additional equivalent work experience in a directly related field may be substituted for the degree requirement., • Certified Risk Adjustment Coder from American Academy of Professional Coders OR Certified Coding Specialist from American Health Information Management Association OR Certified Professional Coder from American Academy of Professional Coders Preferred Qualifications: • Four (4) years hospital coding experience., • Four (4) years coding audit experience. Primary Location: California, Pasadena, Walnut Center - Regional Offices Additional Locations: • Pleasanton, CA, • Atlanta, GA, • Denver, CO, • Portland, OR, • Hyattsville, MD, • Fairfax Station, VA, • Renton, WA Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 08:00 AM Working Hours End: 05:00 PM Job Schedule: Full-time Job Type: Standard Worker Location: Remote Employee Status: Regular Employee Group/Union Affiliation: NUE-PO-01|NUE|Non Union Employee Job Level: Individual Contributor Department: Po/Ho Corp - 3YP Core - 0308 Pay Range: $106900 - $138270 / year

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 you be doing in this role? Under general direction of the Coding Supervisor, (using knowledge of CSMC and Official Coding guidelines, medical terminology, anatomy and physiology, and pathological basis of disease, documented treatment and procedures performed at CSMC and Cedars-Sinai Affiliates and their locations) assigns ICD-10-CM and CPT codes for patients receiving services at CSMC. Accurately assigns all applicable modifiers for all patients to assure optimal reimbursement and the highest quality data possible Duties of this Coder II include: • Performs accurate and timely coding (CPT, ICD-10, HCPCS, modifiers)., • Maintains familiarity with issues like coding regulations, Medicare rules, visits and procedures on the same day, consultation vs. referral, surgeries, etc., • Understands and implements coding guidelines for multi-specialty surgical practices and/or complex surgical coding., • Attends seminars and workshops, as applicable, for updates on new coding rules and regulations., • Elevates issues, as appropriate, to the Coding Supervisor and Manager., • Meets productivity and quality standards as designated by Coding Supervisor and Manager., • Understands coding trends to include NCD, LCD, and CMS guidelines., • Identifies trends and issues with overall division and individual physician coding practices and presents solutions., • Maintains confidentiality of patient care and business matters., • Follows policies and procedures pertinent to the coding and compliance departments. Approved Remote States: Arizona, California, Colorado, Florida, Georgia, Minnesota, Nevada, Oregon, Texas Please provide a cover letter detailing your specific cardiothoracic and/or cardiovascular coding experience. Requirements: Certified Procedural Coder (CPC) required. CIRCC (Certified Interventional Radiology Cardiovascular Coder) Preferred. High school diploma or GED required. Please provide a cover letter detailing your specific cardiothoracic and/or cardiovascular coding experience. Experience we are Seeking: Minimum of 3 years of surgical coding experience within a multi-specialty medical group or multi-specialty physician practice (i.e., Orthopedics, Cardiothoracic Surgery, Neurosurgery, General Surgery, Obstetrics/Gynecology, Gastroenterology) Familiarity with ICD-10-CM, CPT-4 coding and payment methodologies. Working knowledge of all California and National reporting requirements. Beyond outstanding employee benefits including health and vacation, and a 403(b) we take pride in hiring the best, most passionate employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation.

Claims Edit Coder (Coder II) 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. This annual award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. We provide an outstanding benefit package that includes health care, 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 you will be doing in this role: The Claims Edit Coder (Coder II) operates under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team. In this role, the Coder II reviews ICD-10-CM diagnosis coding and Current Procedural Terminology (CPT) procedure code for claim edit fall outs. The position entails conducting modifier review and assignment, handling complex coding edits that necessitate research and resolution, and validating key data elements like the billing physician and date of service. You are expected to abstract coded data accurately and promptly into the applicable system using relevant applications such as EPIC (CS-Link), EPIC HB and PB modules, Solventum 360Encompass, Solventum Standalone Encoder, and Select Coder. This role demands proficiency in these systems to ensure the integrity and efficiency of coding operations. Duties include: • Review medical documentation and health information within various electronic medical or health systems., • Assign applicable codes such as clinical modification (ICD-10-CM), current procedural terminology (CPT), evaluation and management (E&M), and healthcare common procedure coding system (HCPCS) while adhering to productivity and quality standards for the area(s) of assignment or specialty (Facility or Professional)., • Focus on specialties including, but not limited to: Professional Multispecialty E&M, Facility Emergency Room (non-Single Path), and Outpatient Visits (Facility or Professional)., • Resolve complex edits and alerts with consistent accuracy using current guidelines for the area(s) of assignment or specialty., • Handle edits such as: Simple Visit, Local and National Coverage Determination, and other Related Edits., • Communicate with physicians, providers, and external departments regarding documentation clarity, specificity, ensure the completeness of documentation required for code assignment within area(s) of assignment or specialty., • Expanding skills in procedural coding such as CPT or PCS. Requirements: • Certified Coding Specialist (CCS), Certified Procedural Coder (CPC), Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) required upon hire., • High school diploma or GED required., • Minimum of 2 years of experience working doing code assignment in a healthcare setting., • Ability to produce quality work product within the established standards per hour. Why work here? Beyond outstanding employee benefits including health, paid vacation, and a 403(b) we take pride in hiring the best, most passionate employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation.

The mission of The Los Angeles Cancer Network is to provide unparalleled care to each patient that comes through our doors. We offer individualized treatment using the most recent and relevant proven advances in cancer care, curated with deliberation and compassion. LACN is committed to educating and supporting our patients and their families through every step of the way. We deliver a unique approach for every patient to ensure they receive treatment best suited to their condition, age, and other important factors. We do this by participating in important clinical research, encouraging screenings for early detection, and providing innovative treatment. We are proud to be at the forefront of cancer research through our partnership with OneOncology. Why Join Us? We are looking for talented and highly-motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve. The Director of Compliance is responsible for developing, implementing, and overseeing the organization's Corporate Compliance Program across all physician practice locations. This position ensures compliance with federal, state, and local laws and regulations governing physician practices, specialty oncology services, infusion centers, pharmacy operations, laboratory services, and clinical research (if applicable). The Director serves as a strategic advisor to executive leadership while promoting a culture of ethics, integrity, and regulatory compliance. • Develop, implement, and maintain an effective Corporate Compliance Program., • Conduct annual enterprise-wide compliance risk assessments., • Develop annual compliance work plans based on identified risks., • Present compliance reports to Executive Leadership and the Board or Compliance Committee., • Maintain the organization's Code of Conduct and compliance policies., • Centers for Medicare & Medicaid Services (CMS), • California Department of Public Health (CDPH), • California Medical Board requirements, • California Department of Health Care Services (DHCS), • Office of Inspector General (OIG), • Department of Justice (DOJ), • HIPAA Privacy and Security Rules, • OSHA, • California labor regulations affecting healthcare operations, • Federal and California Fraud, Waste, and Abuse laws, • False Claims Act, • Anti-Kickback Statute, • Stark Law, • Medicare and Medi-Cal regulations, • Monitor compliance across multiple satellite physician offices., • Ensure provider credentialing and licensure compliance., • Oversee medical record documentation compliance., • Evaluate coding and billing practices., • Monitor incident-to billing requirements., • Oversee provider enrollment compliance., • Coordinate internal compliance audits., • Monitor chemotherapy and biologic administration compliance., • Ensure compliance with infusion center standards., • Oversee hazardous drug handling standards., • Monitor oral oncology dispensing compliance (if applicable)., • Ensure compliance with prior authorization requirements., • Support oncology quality initiatives., • Assist with accreditation readiness (e.g., oncology-specific accreditation programs)., • Serve as Privacy Officer or collaborate closely with the Privacy Officer., • Investigate privacy incidents and breaches., • Oversee HIPAA training., • Conduct HIPAA risk assessments., • Ensure Business Associate Agreements are maintained., • Develop and oversee audits including:, • Medical record documentation, • Evaluation & Management coding, • Chemotherapy administration documentation, • Infusion billing, • Modifier usage, • Incident-to billing, • Medical necessity, • Clinical documentation integrity, • Provider documentation, • Laboratory compliance, • Pharmacy compliance, • Investigate compliance concerns., • Manage anonymous reporting hotline., • Conduct internal investigations., • Recommend corrective actions., • Monitor corrective action plans., • Develop annual compliance education for:, • Physicians, • Advanced Practice Providers, • Nurses, • Medical Assistants, • Clinical Research staff, • Revenue Cycle, • Front Office staff, • Leadership, • Develop and revise compliance-related policies., • Ensure policies remain current with changing regulations., • Standardize compliance practices across all satellite offices., • Perform compliance risk assessments., • Identify emerging regulatory risks., • Develop mitigation strategies., • Monitor corrective actions., • Coordinate readiness for organizations such as:, • Accreditation surveys, • State inspections, • CMS audits, • OIG audits, • Commercial payer audits, • Collaborate with Revenue Cycle to monitor:, • Coding accuracy, • Charge capture, • Billing compliance, • Refunds and overpayments, • Credit balance management, • Denials related to compliance, • Ensure compliance with research regulations., • Monitor informed consent requirements., • Coordinate with Institutional Review Boards (IRBs)., • Support Good Clinical Practice (GCP) standards., • Monitor specialty pharmacy regulations., • Ensure compliance with drug storage requirements., • Oversee controlled substance policies., • Monitor drug diversion prevention., • Bachelor's degree required., • Master's degree in Healthcare Administration, Business Administration, Public Health, Nursing, Law, or related field preferred., • 810 years of progressive healthcare compliance experience., • At least 5 years in physician practice compliance., • Multi-site healthcare organization experience required., • Oncology experience strongly preferred., • Experience with Medicare and Medi-Cal regulations., • Experience managing compliance investigations and audits., • Certified in Healthcare Compliance (CHC), • Certified in Healthcare Privacy Compliance (CHPC), • Certified Professional Coder (CPC) (preferred), • Registered Health Information Administrator (RHIA) (preferred), • Extensive knowledge of physician practice regulations., • Oncology regulatory expertise., • Medicare and Medi-Cal billing compliance., • HIPAA Privacy and Security.

Rooted Talent Solutions is actively seeking remote medical billers and coders to join our healthcare support team.

Job DescriptionBenefits: • 401(k), • 401(k) matching, • Bonus based on performance, • Company parties, • Dental insurance, • Employee discounts, • Free food & snacks, • Health insurance, • Opportunity for advancement, • Paid time off, • Parental leave, • Savings bank, • Training & development, • Vision insurance, • Wellness resources About the Role: MedPOINT Management in Sherman Oaks, CA is looking for a detail-oriented HCC Coding Specialist to join our growing team. This is an exciting opportunity to play a critical role in risk adjustment accuracy and quality healthcare documentation. If you're passionate about medical coding and making a meaningful impact in managed care, we want to hear from you! Responsibilities: • Review and analyze medical records to assign accurate HCC (Hierarchical Condition Category) codes, • Ensure proper documentation of chronic conditions and risk adjustment diagnoses in compliance with CMS guidelines, • Conduct retrospective and prospective chart reviews to identify coding gaps and opportunities, • Collaborate with physicians and clinical staff to clarify documentation and support coding accuracy, • Prepare and submit coding findings and reports to support risk adjustment programs, • Stay current with ICD-10-CM coding updates, CMS risk adjustment models, and payer-specific requirements, • Support audit processes and respond to coding queries in a timely mannerRequirements:, • Certified Professional Coder (CPC), CRC, or equivalent coding certification required, • Minimum 2+ years of experience in HCC coding and/or risk adjustment, • Strong working knowledge of ICD-10-CM coding guidelines and CMS-HCC risk adjustment models, • Experience with medical record review in a managed care or health plan environment preferred, • Proficiency with electronic health records (EHR) and coding software, • Exceptional attention to detail and commitment to coding accuracy and compliance, • Strong communication skills with the ability to work collaboratively across clinical and administrative teamsAbout Us: MedPOINT Management is a leading Independent Physician Association (IPA) management company based in Sherman Oaks, CA, dedicated to supporting high-quality, coordinated patient care across Southern California. Our provider partners and health plan clients trust us for our expertise, integrity, and commitment to operational excellence. We foster a collaborative and supportive work environment where talented professionals can thrive and grow their careers in healthcare management. Flexible work from home options available.

Job DescriptionDescriptionWe are currently seeking a highly motivated Risk Adjustment Coding Specialist. This role will report to the Supervisor - Risk Adjustment and enable us to continue to scale in the healthcare industry. The staff is required to frequently travel to provider sites depending on projects. 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 • Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company, • Review medical record information on both a retrospective and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC), • Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines, • Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation, • Meets or exceeds productivity targets as established by management. Regularly meets due dates assigned, • Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing, • Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements., • Keeps management apprised of project activities through regular written and oral status reports. Proactively identifies risks that may hinder project success., • Provides recommendations to management related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives., • Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work., • Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager., • May assist or lead projects and/or higher work volume than Risk Adjustment Coding Specialist I Qualifications • Required Certification/Licensure: Must possess and maintain AAPC or AHIMA certification – Certified Coding Specialist (CCS) and/or Certified Professional Coder (CPC). Certified Risk Adjustment Coder (CRC) is a plus but not required, • 3+ years experience in risk adjustment coding required. Billing experience is a plus., • Reliable transportation/Valid Driver’s License/Must be able to travel at least 75% of work time, • PC skills and experience using Microsoft applications such as Word, Excel, and PowerPoint, • Excellent presentation, verbal and written communication skills, and ability to collaborate, • Must possess the ability to educate and train provider office staff members, • Proficiency with healthcare coding software and Electronic Health Records (EHR) systems. You’re great for the role if:, • Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage, • Ability to work independently and collaborate in a team setting, • Strong organizational and time-management skills, • Ability to work in a home office for continuous periods of time for business continuity, • Ability to travel across the Provider Clinic service region for meetings and/or training as needed, • Able to work independently and within time constraints, • Able to efficiently prioritize multiple high-priority tasks Environmental Job Requirements and Working Conditions • This position blends on-site fieldwork (approximately 75% travel) with hybrid support to help practices. The Company reserves the right to modify the work arrangement, including transitioning to a hybrid or onsite model, based on business needs. Disclaimer: This job description is intended to describe the general nature and level of work performed. It is not intended to be an exhaustive list of all responsibilities, duties, or qualifications required. Responsibilities may change based on business needs and organizational priorities., • The national target pay range for this role is $75,000 - $85,000. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation. Additional Information: The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

Job DescriptionDescriptionWe are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Houston market. In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps, trends, and opportunities for improved accuracy for our providers. You’ll translate your findings into actionable insights, creating and delivering education to providers and practice leaders while navigating complex conversations. Additionally, you’ll track and report on key performance metrics—such as HCC recapture rates, AWVs, and other KPIs, helping drive provider performance and overall program success. We are seeking candidates who have experience with provider education and at least 3-5 years of risk adjustment experience! This position requires travel to provider offices twice a week in the Houston area. 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 • Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company, • Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC), • Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines, • Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation, • Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing, • Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements., • Provides recommendations to management related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives., • Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work., • Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager., • May assist or lead projects and/or higher work volume than Risk Adjustment Coding Specialist I, • Other duties as assigned Qualifications • Required Certification/Licensure: Must possess and maintain AAPC certification, CPC and CRC., • At least 3 years of experience in risk adjustment coding and/or billing experience required., • At least 1 year of experience with targeted provider education., • Reliable transportation/Valid Driver’s License/Must be able to travel up to 75% of work time, • PC skills and experience using Microsoft applications such as Word, Excel, and Outlook, • Excellent presentation, verbal and written communication skills, and ability to collaborate, • Must possess the ability to educate and train provider office staff members, • Proficiency with healthcare coding software and Electronic Health Records (EHR) systems.You're great for this role if:, • Strong billing knowledge and/or Certified Professional Biller (CPB) through APPC, • Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage, • Strong PowerPoint and public speaking experience, • Ability to work independently and collaborate in a team setting, • Experience with Monday.com, • Experience collaborating with, educating, and presenting to provider teams in a face-to-face setting Environmental Job Requirements and Working Conditions • The national target pay range for this role is $70,000 - $85,000 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors., • This position is remotely based in the U.S. The home office is located at 1600 Corporate Center Dr. Monterey Park, CA 91754. Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation. Additional Information: The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

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