Compliance & Records Specialist
Medical coder job in Costa Mesa, CA
JOB PURPOSE: Ensure medical records are accurate, compliant, and complete to support successful claims and minimize denials. Manage record reviews, audits, and appeals while collaborating with internal teams and BPO counterparts to maintain updated guidelines and drive process improvements.
Job Duties and Responsibilities
Ensure accurate record reviews, retrieve medical records, and send out medical record requests as needed within the required time frame.
Ensure medical records are compliant with payer-specific guidelines before submission.
Investigate medical record denials, and communicate actions that need to be taken to resolve them and document findings on CMD and the Jira Project.
Initiate appeals to the payer as necessary to resolve medical record denials.
Thoroughly navigate and manage post-payment and pre-payment reviews, ensuring proper documentation, timely responses, and compliance with regulatory and contractual requirements.
Research and update payer-related guidelines regularly, ensuring all departments follow best practices and have access to the most current documentation.
Support training and day-to-day guidance for BPO team members by sharing knowledge, addressing questions, and escalating needs or issues to the lead or supervisor to strengthen performance and ensure aligned, efficient operations.
Participate in the department's L10 meetings, identify and bring issues, and develop and execute quarterly rocks to drive alignment and improvements toward Cipher VTO.
Ensure clear and efficient communication by responding to partner emails and requests promptly.
Perform facility spot checks to maintain charts/documentation up to date with payer guidelines.
Perform other related duties as assigned.
Minimum Qualifications
Education / Experience
High School Diploma or equivalent
2 years' experience
Proficient with Microsoft Office Suite
Adobe Acrobat Experience
EOS Knowledge/Understanding Preferred
Proficient in Atlassian Products (Jira & Confluence) preferred
Experience in Insurance Payers compliance preferred
CMS HCC Coder
Medical coder job in Orange, CA
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.
The Hierarchical Condition Categories (HCC) Coding Analyst will effectively interface with provider partners, to successfully, monitor and implement HCC coding strategies. Audit all RAPS submissions to ensure accuracy in the data provided to Centers for Medicare and Medicaid Services (CMS). Provide coding expertise as well as administrative oversight to ensure successful integration of AHC's HCC initiatives.
GENERAL DUTIES/RESPONSIBILITIES
1. Monitors coding & abstracting quality by conducting &/or coordinating ongoing audits to ensure coding quality & performance improvement standards are maintained, achieved & improved.
2. Develops, implements, evaluates & improves IPA's educational tools for their respective providers in order to accurately capture acute and chronic conditions.
3. Tracks & reports progress of the audits performed on the coding vendors in order to assure the coding accuracy and quality of the data submitted to CMS.
4. Works with Risk Adjustment Management on any Data Validation and /or RADV coding audit to ensure completeness and coding accuracy of all submissions to CMS.
5. Maintains a comprehensive tracking and management tool for assigned IPA's within Alignments Healthcare provider network.
6. Tracks all Risk Adjustment activities for assigned medical groups and ensure that all tasks are completed in a timely manner. Correlate activities, processes, and HCC results/ metrics to evaluate outcomes.
7. Ensures compliance with all applicable federal, state &local regulations, as well as with institutional/organizational standards, practices, policies & procedures.
8. Supports the Risk Adjustment Management Team in scheduling/training activities. Maintain records of training.
9. Suggests new Physician Group Risk Adjustment coding initiatives. Participate in SCITs/ Education meetings as needed
10. Coordinates Risk Adjustment audit activities as it relates to the assigned groups. Assist with CMS Data Validation activities, including suggested record selections, tracking and submission, in conjunction with Risk Adjustment Healthcare Management
11. Educates and updates:
a. Regularly updates all Risk Adjustment materials for clinical and official guideline changes.
b. Updates all education materials based on CMS-HCC Model and ICD-9/ ICD-10 annual changes
c. Suggests, updates, and enhances clinical educational materials to assist in training physicians and clinical staff on Risk Adjustment Healthcare Programs including CMS-HCC Models, Clinician Chart Reviews, and Encounter Documentation.
d. Suggests customizations of Risk Adjustment education for various audiences, Support Staff, PCPs, Specialists, Employees vs. contracted and Central Departments
e. Stays current of industry coding, compliance, and HCC issues.
f. Maintain professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; and participating in professional societies.
12. Contributes to team effort by accomplishing related results as needed.
13. Other duties as assigned to meet the organization's needs.
Job Requirements:
Experience:
• Required: Minimum 3+ years of coding in a medical group or health plan setting required; Professional Coding experience required. Minimum 1 year experience with strategic planning in risk mitigation.
•Work Hours: Pacific Standard Time
• Preferred: Previous experience and use of Epic, Allscripts, EZCap a plus
Education:
• Required: High School Diploma or GED.
Training:
• Preferred: Certified Coder training courses
Specialized Skills:
• Required:
Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;
Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly
Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.
Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.
Report Analysis Skills: Comprehend and analyze statistical reports.
• Preferred: Proficient user in MS office suite, MS access a plus
Licensure:
• Required: Certified Coder required, HCC/Risk Adjustment experience, Experience with Athena EHR
• Preferred: CCS, CCS-P, CPC, Certified Auditor a plus.
Work Environment:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1 While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
2 The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Pay Range: $58,531.00 - $87,797.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at ******************************* If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email ******************.
Auto-ApplyCreative Audio - Creative Coder
Medical coder job in Los Angeles, CA
Creative Audio is a centralized team that touches every product Meta produces, making our team integral to the company. We collaborate with product and creative teams across Meta to design audio for video, post-production audio, final mixing and mastering, audio field recording, sound effects, and large scale content projects across a wide range of software and hardware, including but not limited to your phone, glasses, VR headsets a mix of Augmented Reality/Mixed Reality across these devices. We're a team of over 60 audio experts who design the experiences that connect people through the power of sound. The Creative Audio team is seeking a Creative Coder for the Tech & Prototypes department. This role collaborates closely with Engineering and Product Design to define sound functionality and deliver advanced audio features. It involves developing advanced audio solutions, optimizing performance, refining tools, leveraging machine learning and generative AI, and solving complex technical challenges at the intersection of audio and artificial intelligence. As a key contributor to Meta's day-to-day sound design, the Creative Coder provides creative and technical insights to drive innovative, immersive audio experiences offering a long runway for creativity, innovation, and empowerment to push the boundaries of sound technology and make a meaningful impact.
Minimum Qualifications
* 6+ years implementing and coding sonic experiences for products in mobile, hardware, and/or non-traditional immersive environments
* 5+ years development experience with Python, C#, Kotlin, JavaScript, or C++
* Experience with object-oriented programming and design
* Experience with game engine audio implementation and middleware (e.g., Wwise, FMOD Studio, Unreal MetaSounds)
* Understanding of DSP and audio signal processing
* Hands-on experience integrating machine learning models (TensorFlow, PyTorch, ONNX) into production pipelines for tasks such as inference, data processing, and generative workflows
* Experience debugging code across various development environments
* Experience managing collaboration tools and version control systems (e.g., GitHub, Perforce)
* Experience prioritizing tasks and adapting quickly to changes in scope
* Time-management and organizational skills to meet delivery specifications and deadlines
* BA/BS in Audio or Music Technology, Computer Science, Transmedia, or equivalent work experience
* Technical skills and a track record of leading cross-functional teams, bridging design and engineering to create impactful audio experiences
Preferred Qualifications
* Audio Implementation experience and/or design for shipping AR and VR experiences using platforms such as Unity, Unreal Engine, Spark, React, Snap, and MARS
* Experience with large language models (LLMs), prompt engineering, and retrieval-augmented generation (RAG) methodologies
* Understanding of Spatial Audio, DSP, and experience implementing immersive sound experiences
* Experience with generative sound or music creation, speech synthesis, and natural language processing (NLP)
* Experience with WebAudio, Tone.js, and OpenAL for interactive audio applications
* Knowledge of acoustics, equipment set ups and calibration experience with hardware and electronic prototypes and configuration
Responsibilities
* Collaborate with design and engineering teams to deliver cutting-edge audio functionality, tooling, and pipeline solutions
* Provide technical audio leadership, empowering sound designers, composers, and creators, while elevating audio quality across all Meta products and platforms
* Apply creativity and product thinking to develop innovative, audio-focused prototypes and experiences that enhance user experience and drive team and company success
* Build functional prototypes from early concepts at various levels of fidelity, utilizing a range of design tools and programming languages, and implement them across multiple platforms
* Translate emerging technical domains and knowledge into actionable ideas and explorations
* Clearly articulate prototype design decisions to internal stakeholders and offer constructive feedback to partners
* Collaborate closely with a global team to create unique sonic experiences and drive projects to completion
* Prepare and test for implementation accuracy, working with internal and external teams to resolve bugs and optimize audio within products
* Leverage code as a design medium to bridge the gap between product goals and engineering implementation, as well as unlock features for external developers
* Establish pipelines & best practices for leveraging ML / AI models in prototypes
* Work closely with PMs, engineers, researchers, sound designers to lead the creation and execution of engaging audio-driven user experiences
About Meta
Meta builds technologies that help people connect, find communities, and grow businesses. When Facebook launched in 2004, it changed the way people connect. Apps like Messenger, Instagram and WhatsApp further empowered billions around the world. Now, Meta is moving beyond 2D screens toward immersive experiences like augmented and virtual reality to help build the next evolution in social technology. People who choose to build their careers by building with us at Meta help shape a future that will take us beyond what digital connection makes possible today-beyond the constraints of screens, the limits of distance, and even the rules of physics.
Equal Employment Opportunity
Meta is proud to be an Equal Employment Opportunity employer. We do not discriminate based upon race, religion, color, national origin, sex (including pregnancy, childbirth, reproductive health decisions, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, genetic information, political views or activity, or other applicable legally protected characteristics. You may view our Equal Employment Opportunity notice here.
Meta is committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans in our job application procedures. If you need assistance or an accommodation due to a disability, fill out the Accommodations request form.
Risk Adjustment Coding Specialist II (SGV or IE, CA)
Medical coder job in Monterey Park, CA
DescriptionWe are currently seeking a highly motivated Risk Adjustment Coding Specialist. This role will report to a Sr. Manager - Risk Adjustment and enable us to continue to scale in the healthcare industry. *Requires travel to provider sites in San Gabriel Valley OR Inland Empire
*May be open to considering Level I Specialists based on experience and skills
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
Qualifications
Required Certification/Licensure: Must possess and maintain AAPC or AHIMA certification - Certified Coding Specialist (CCS-P), CCS, or CPC.
3-5+ years of experience in risk adjustment coding and/or billing experience required
Strong billing knowledge and/or Certified Professional Biller (CPB) through APPC
Reliable transportation/Valid Driver's License/Must be able to travel up to 75% of work time, if applicable.
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:
Bilingual in Chinese (Cantonese/Mandarin)
Certified Risk Adjustment Coder (CRC) and/or Risk Adjustment coding experience
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 total pay range for this role is $75,000 - $85,000 per year. This salary range represents our national target range for this role.
This role follows a hybrid work structure where the expectation is to work on the field and at home on a weekly basis. This position requires up to 75% travel to provider offices in the surrounding areas. The home office is located at 1600 Corporate Center Dr., Monterey Park, CA 91754.
The work hours are Monday through Friday, standard business hours.
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 ************************************ 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.
Coder FT Days
Medical coder job in Monterey Park, CA
JOB SUMMARY: Under the direction of the Director of Health Information Management, Identifies and codes Newborns, Obstetrics, ER's and outpatient records for the purpose of reimbursement, research, and compliance with Federal Regulations using the ICD-10-CM/CPT coding classification systems.
EDUCATION, EXPERIENCE, TRAINING
Current coding certification-RHIA, RHIT, or CCS
1-2 years of coding experience in acute hospital setting
Knowledge and application of ICD10 classifications, CPT-4 and HCPCS with an accuracy level of 95%
Must be able to work in a very challenging environment.
Exceptional written and verbal communication skills
Excellent computer skills, including Microsoft Office, EHRs, Encoders
Analytical/critical thinking and problem solving
Knowledge of information privacy laws and high ethical standards
Auto-ApplyProfee Coder (temp)
Medical coder job in Culver City, CA
Temporary (3-4 month project with the possibility to become Permanent)
Accurate Coding: Assign E/M, modifiers, and ICD-10 codes from documentation ensuring proper medical necessity and preventing unbundling.
Charge Review WQ's: this entails reviewing the providers submitted coding in EPIC against the documentation and working any EPIC edits and then recommending coding changes back to the departments to make the corrections.
Claim Edit WQ's: this entails reviewing the providers submitted coding in EPIC against the documentation and working Clearing House rejections/edits and then recommending coding changes back to the departments to make the corrections.
Follow-Up WQ's: this entails reviewing the providers submitted coding in EPIC against post bill denials/edits and then recommending coding changes back to the departments to make the corrections.
Keep assigned EPIC WQ's within
Maintain 95% quality
CPH Expectation = 8 submissions per hour
Requirements
Current CPC or equivalent through the AAPC or AHIMA required
CEMC preferred, but not required
Must have at least three years of active E/M coding experience for multiple specialties. This experience must include coding POS 11, 21, 22, coding of in-office procedures across multiple specialties and must be able to code all types of E/M visits (ED, CC, home health, prolonged services, etc.)
Must have at least three years of active surgery coding experience
Experience with Medicaid of California guidelines strongly preferred
Must have recent experience in EPIC in Follow-Up WQ's (denials) and in either:
Charge Review WQ (coding)
Claim Edit WQ (edits)
Must have multi-specialty EM and procedure/Sx coding experience in ALL of the following specialties (this doesn't apply to each person, but the position as a whole):
Primary Care
Pediatrics
Colorectal
Gynecology (non-delivery OB)
Urology
Must have EM and procedure/Sx experience in at least 5 of the specialties below:
Cardiology
Cardiothoracic
Endocrinology
Gastro
Internal Medicine
Nephrology
Neurology
Orthopedics
Physical Therapy
Psychiatry
Rheumatology
Spine
Vascular
Coder
Medical coder job in Los Angeles, CA
Job DescriptionAI Coder
Our client is a leading force in advancing safer, smarter AI technology. Their work has been featured in Forbes, The New York Times, and other major outlets for pioneering high-quality, human-verified data that powers today's top AI systems.
They've built a global community of expert contributors and have already paid out more than $500 million to professionals worldwide who help train, test, and improve next-generation AI models.
Why Join This Team?
Earn up to $32/hr, paid weekly.
Payments via PayPal or AirTM.
No contracts, no 9-to-5. You control your schedule.
Most experts work 5-10 hours/week, with the option to work up to 40 hours from home.
Join a global community of experts contributing to advanced AI tools.
Free access to the Model Playground to interact with leading LLMs.
Requirements
Bachelor's degree or higher in Computer Science from a selective institution.
Proficiency in Python, Java, JavaScript, or C++.
Ability to explain complex programming concepts fluently in Spanish and English.
Strong Spanish and English grammar, punctuation, and technical writing skills.
Preferred: 1+ years of experience as a Software Engineer, Back End Developer, or Full Stack Developer.
What You'll Do
Teach AI to interpret and solve complex programming problems.
Create and answer computer-science questions to train AI models.
Review, analyze, and rank AI-generated code for accuracy and efficiency.
Provide clear and constructive feedback to improve AI responses.
Apply now to help train the next generation of programming-capable AI models!
Medical Coder
Medical coder job in Long Beach, CA
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Job Description
Serves as the primary resource for medical coding updates and information. Advises client on coding issues, provides in-depth research on new or unusual procedures, and makes recommendations when appropriate.
Qualifications
Coding Certification - Active CCS, or CPC credentialing
Coding guidelines knowledge
Claims experience
Additional Information
Advantages of this Opportunity:
Pay $17 - $19 per hour, negotiable based on experience
Weekly Pay
Healthcare Benefits
Work for a Fortune 500 company who pride themselves on partnership, integrity, teamwork, and accountability
Be a part of a team who serves the full spectrum of member needs
If you are interested, please call, Maro at 407-636-7030 ext. 204 and email your resume to Maro.
The greatest compliment to our business is a referral.
If you know of someone looking for a new opportunity, please pass along my contact information! We offer referral bonuses for each placement.
Health Info Coder II - Pro Fee Internal Medicine/Multi-Specialty
Medical coder job in Los Angeles, CA
General Information Press space or enter keys to toggle section visibility Onsite or Remote Flexible Hybrid Work Schedule Monday - Friday, 8:00am - 5:00pm PST Posted Date 12/02/2025 Salary Range: $40.04 - 52.83 Hourly Employment Type
2 - Staff: Career
Duration
Indefinite
Job #
27468
Primary Duties and Responsibilities
Press space or enter keys to toggle section visibility
Take on a significant role within a world-class health organization. Elevate the operational effectiveness of a complex health system. Take your professional expertise to the next level. You can do all this and more at UCLA Health.
As a Health Information Coder for our Medical Group, you will handle a variety of vital responsibilities, including:
* Reviewing physicians' notes to determine if documentation requirements are met
* Extrapolating and Applying surgical codes as applicable across anatomical subsections for general coding in work queues.
* Analyzing medical documentation to assess accuracy
* Entering charges in EPIC
* Identifying and reporting any potential compliance risks
Salary Range: $40.04 - $52.83 Hourly
Job Qualifications
Press space or enter keys to toggle section visibility
We're seeking a self-directed, detail-oriented professional with:
* Current Certified Professional Coder (CPC) certification, must have been certified a minimum of 2 years required
* Additional specialty certification a plus, multi-specialty group experience a plus
* Minimum of 2 years of pro fee coding experience is required
* 3 or more years surgical and/or evaluation and management experience preferred
* Experience as Medical Record Abstractor
* Detailed knowledge of Medical Terminology and its application
* Detailed knowledge and understanding of ICD-10, CPT, and HCPCS coding systems
* Working experience with 2021 E&M guidelines preferred
* Knowledge of CMS and local carrier regulations and guidelines for teaching hospital preferred
* Computer proficiency with MS Office
* Superior ability to research coding guidelines and payor policies a must
* Previous Epic or Cerner experience preferred
Note: Skills may be subject to test.
HIM Coder I - HIM Financial - Full Time 8 Hour Days (Non-Exempt) (Non-Union)
Medical coder job in Alhambra, CA
In accordance with federal coding compliance regulations and guidelines, use current ICD-10-CM, CPT-4, and HCPCS code sets/systems to accurately abstract, code, and electronically record into the 3M Coding & Reimburse System (3M-CRS) & the coding abstracting system (3M-ClinTrac), all diagnoses and minor invasive and non-invasive procedures, documented by any physician in outpatient medical records (i.e. OP Ancillary visits: Laboratory, Radiology etc.; Clinic Visits; Radiation Oncology; Recurring Visits, etc.). Address OCE/NCCI edits within 3M-CRS and those returned from the Business Office. Understands PFS coding/billing processes & systems such as PBAR and nThrive/MedAssets/XClaim in a manner to assure claims drop timely with appropriate codes. Performs other coding department related duties as assigned by HIM management staff.
Essential Duties:
Outpatient Ancillary/Clinic Visit/Emergency Department coding of all diagnostic and procedural information from the medical records using ICD-10-CM, ICD-10-PCS, and CPT/HCPCS, and Modifier classification systems and abstracting patient information as established and required by official coding laws, regulations, rules, guidelines, and conventions.
Reviews the entire medical record; accurately classify and sequence diagnoses and procedures; ensure the capture of all documented conditions that coexist at the time of the encounter/visit, all medical necessity diagnoses, complications, co-morbidities, historical condition or family history that has an impact on current care or influences treatment, and all external causes of morbidity.
Enter patient information into inpatient and outpatient medical record databases (ClinTrac/HDM). Ensures accuracy and integrity of medical record abstracted UB-04 & OSHPD data elements prior to billing interface and claims submission.
Works cooperatively with HIM Coding Support and/or Clinical Documentation Improvement Specialist in obtaining documentation to complete medical records and ensure optimal and accurate assignment of diagnosis & procedure codes.
Assists in the correction of regulatory reports, such as OSHPD data, as requested.
Attendance, punctuality, and professionalism in all HIM Coding and work related activities.
Consistently assumes responsibility and displays reliability for completion of tasks, duties, communications and actions. Completes tasks accurately, legibly, and in a timely fashion.
Performs other duties as requested/assigned by Director, Manager, Supervisor, or designee.
Ability to achieve a minimum of 95% coding accuracy rate as determined by any internal or external review of coding and/or department quality review(s).
Ability to achieve a minimum of 95% abstracting accuracy rate of UB-04 and OSHPD data elements as determined by any internal or external review of coding and/or department quality review(s).
Assist in ensuring that all medical records contain information necessary for optimal and accurate coding and abstracting.
Recognizes education needs of based on monthly reviews and conducts self-improvement activities.
Ability to act as a resource to coding and hospital staff on coding issues and questions.
Ability to improve MS-DRG assignments specific to the documentation & coding of PDx, SecDx, CC/MCC, PPx, and SecPx in accordance with official coding laws, regulations, rules, guidelines, and conventions.
Ability to improve APR-DRG, SOI, and ROM assignments specific to the documentation & coding of PDx, SecDx, CC/MCC, PPx, and SecPx in accordance with official coding laws, regulations, rules, guidelines, and conventions.
Ability to improve APC/HCC assignments specific to medical necessity documentation & coding of PDx, SecDx, and CPT/HCPCS in accordance with official coding laws, regulations, rules, guidelines, and conventions.
Maintains at minimum, expected productivity standards (See HIM Practice Guidelines) and strives to maintain a steady level of productivity and provides consistent effort.
Works coding queues/task lists to ensure 95% of patient bills are dropped within 5 days after patient discharge/date of service.
Works coding queues/task lists to ensures the remaining 5% of patient bills are dropped within 2 weeks of discharge/date of service.
Assist other coders in performance of duties including answering questions and providing guidance, as necessary.
Assists Patient Financial Services (PFS), Patient Access, and other departments in addressing coding issues/questions and/or providing information so that an interim bill can be generated. Assists with physicians, physician office staff and hospital ancillary department staff with diagnostic or procedural coding issues/questions, as needed.
Assists in the monitoring unbilled accounts to ensure that the oldest records are coded and/or given priority.
Maintains AHIMA and or AAPC coding credential(s) specified in the job description.
Attend coding & CDI seminars, webinars, and in-services to maintain the required annual continued education units (CEU).
Keep up-to-date and reviews ICD-10 Official Guidelines for Coding & Reporting, AHA Coding Clinic, and CPT Assistant to maintain knowledge of the principles of coding.
Keep up-to-date and reviews other professional journals and newsletters in a timely fashion to maintain knowledge of the principles of coding.
Consistently attend and actively participate in the daily huddles.
Consistently adhere to HIM policies and procedures as directed by HIM management.
Demonstrates an understanding of policies and procedures and priorities, seeking clarification as needed.
Participates in continuously assessing and improving departmental performance.
Ability to communicate changes to improve processes to the director, as needed.
Assists in department and section quality improvement activities and processes (i.e. Performance Improvement).
Works and communicates in a positive manner with management and supervisory staff, medical staff, co-workers and other healthcare personnel.
Ability to communicate effectively intra-departmentally and inter-departmentally.
Ability to communicate effectively with external customers.
Provides timely follow-up with both written and verbal requests for information, including voice mail and email.
Working knowledge and efficient navigation of the Electronic Health Record (EHR): Cerner/Powerchart & Coding mPage.
Working knowledge, efficient navigation, & full use of 3M-CRS Encoder system; utilize to expedite coding process; utilize all references.
Knowledge & understanding of PFS system (PBAR) functionality and any interface with the coding abstracting system: ClinTrac.
Working knowledge, efficient navigation, & full use of ‘HDM/HRM/ARMS Core' coding & abstracting software.
Working knowledge, efficient navigation, & full use of ‘3M 360 Encompass/CAC'
Performs other duties as assigned.
Required Qualifications:
Req High school or equivalent
Req Specialized/technical training Successful completion of college courses in Medical Terminology, Anatomy & Physiology and a certified coding course. Successful completion of the hospital specific coding test - with a passing score of ≥70. The coding test may be waived for 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 Experience in using a computerized coding & abstracting database software and an encoding/codefinder systems are required.
Preferred Qualifications:
Pref Prior experience in ICD-9 & ICD-10 (combined) and CPT/HCPCS coding of Outpatient Ancillary/ED medical records in hospital and/or outpatient clinic preferred.
Required Licenses/Certifications:
Req Certified Coding Specialist - CCS (AHIMA) OR AHIMA Certified Coding Specialist - Physician (CCS-P); OR AAPC Certified Professional Coder (CPC); OR AAPC Certified Outpatient Coding (COC) If there is the absence of a national coding certificate and the coder possesses any one of the following national certifications, the coder will be required to pass any of the national coding examinations Re: the aforementioned coding certificates within six (6) months of employment: 1. AHIMA Registered Health Information Technician (RHIT) 2. AHIMA Registered Health Information Administrator (RHIA)
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 hourly rate range for this position is $33.00 - $54.02. 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 **************, or by email at *************. 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
If you are a current USC employee, please apply to this USC job posting in Workday by copying and pasting this link into your browser:
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Auto-ApplyMedical Records Clerk
Medical coder job in Los Angeles, CA
JOB TITLE: Medical Records Clerk * Under direct supervision, assembles and maintains complete medical records according to established procedures. * Files and retrieves patient records; prepares new files; may open and distribute mail.
* Organizes and evaluates patient medical records.
* Reviews medical records for accuracy and completeness.
* Responsible for filing and retrieving medical records.
REQUIREMENTS:
* 6 months experience directly related to the duties and responsibilities specified preferred.
Benefits:
* Comprehensive health, dental, and vision insurance
* Health Savings Account with an employer contribution
* Life Insurance
* PTO
* 401(k) retirement plan with a company match
* And more!
Equal Employment Opportunity & Work Force Diversity
Our organization is an equal opportunity employer and will not discriminate against any employee or applicant for employment based on race, color, creed, sex, religion, marital status, age, national origin or ancestry, physical or mental disability, medical condition, parental status, sexual orientation, veteran status, genetic testing results or any other consideration made unlawful by federal, state or local laws. This practice relates to all personnel matters such as compensation, benefits, training, promotions, transfers, layoffs, etc. Furthermore, our organization is committed to going beyond the legal requirements of equal employment opportunity to take positive actions which ensure diversity in the workplace and result in a multi-cultural organization.
Coder 3-HIM
Medical coder job in San Bernardino, CA
Job Summary: The Coder 3-HIM performs International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) coding and abstracts data the legal medical record for facilities, licensed under LLUMC and contracted other LLUH facilities. Assigns diagnosis and procedure codes in compliance with the American Hospital Association Official Coding Guidelines. Ensures the quality and accuracy of coding and abstracted information are in compliance with federal and state regulations, government and contract payers, and grant funding. Quality of data collected impacts the facility in multiple ways, including finance, legal, research, teaching, quality assurance, etc. Coder 3-HIM performs coding in all areas including, Inpatient, Outpatient, Emergency, Interventional Radiology etc. Performs secondary coding reviews as needed. Works with students and coding interns as requested. Performs other duties as needed.
Education and Experience: Completion of Coding Certificate program or Associate's Degree in Health Information Management required. Minimum five years of experience coding in an acute care facility required. Experience may be considered in lieu of formal education.
Knowledge and Skills: Extensive knowledge of ICD and CPT coding systems is required. Medical terminology required. Knowledge of the standards of Coding as set forth by the American Health Information Management Association. Able to read; write legibly; speak in English with professional quality; use computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint). Operate/troubleshoot basic office equipment required for the position; Able to relate and communicate positively, effectively, and professionally with others; work calmly and respond courteously when under pressure; collaborate and accept direction. Able to communicate effectively in English in person, in writing, and on the telephone; think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position.
Licensures and Certifications: Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) credentials through AHIMA required.
Auto-ApplyPA UCC Certified Code Specialist
Medical coder job in Lancaster, CA
Barry Isett & Associates (Isett) is an employee-owned multi-discipline engineering/consulting firm headquartered in Allentown, PA, with additional offices throughout eastern and central PA. Isett associates get the opportunity to perform meaningful work that helps enrich our community each and every day. Our company is a values-based organization which has been recognized for its award-winning culture through several regional and statewide programs:
Best Places to Work in PA (annually since 2019)
The Morning Call's Top Workplaces (annually, since 2013)
Empowering Women Award by Central Penn Business Journal and Lehigh Valley Business (2023)
Philadelphia Inquirer's Top Workplaces (2023)
Corporate Citizen of the Year (by the Lehigh Valley Business Journal)
The Societas Award for Responsible Corporate Conduct (for Ethics).
Barry Isett & Associates is looking for ICC/PA UCC Certified Code Specialists to perform inspections and plan reviews for commercial (and residential) properties for clients throughout eastern PA. We are looking for additional associates to work for our municipal clients in the Lancaster area on a full-time or part-time basis.
Through performing these inspections, we are beautifying our community and upholding safety standards.
Benefits
Career advancement and continuing education opportunities
Employee engagement events and parties
Work-life balance & flexible working schedules
Paid vacation/holiday/sick time
Employee Stock Ownership Plan (ESOP)
Medical, dental, vision, life, and disability insurances
Discounted and/or free Isett wear
Parental leave
401k/Roth match
In additional to standard company benefits, our code professionals also receive:
Company supplied cell phone, or opt out credit
Company vehicle
Requirements
Multiple ICC/PA UCC Commercial certifications and a willingness to continue training. (Commercial certifications preferred but the right candidate with all residential certifications, including residential electric inspector will be considered.)
Valid driver's license and the ability to travel to client sites.
Ability to establish and maintain professional working relationships with our clients and other Isett associates.
Demonstrated skills in organizing resources and establishing priorities.
Plan review certification/experience a plus.
Candidates will be encouraged (and supported) to obtain additional certifications.
Ability to work independently/remotely.
Ability to obtain Act 34, 151 and 114 clearances as needed for residential inspections.
We are an equal opportunity employer and welcome applications from all qualified candidates. We are committed to a diverse and inclusive workplace and do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation or gender identity), nation origin, age (40 or older), disability or genetic information (including family medical history).
Please, no third-party recruiters.
Inpatient Facility Coder (P)
Medical coder job in Culver City, CA
Job DescriptionDescription:
GeBBS Healthcare Solutions, an industry leader in Health Information Management (HIM) and Revenue Cycle Management (RCM) solutions, is seeking highly motivated individuals with a passion for excellence & collaboration, for careers in the healthcare industry. We are looking for a full-time Inpatient Facility Coder. This is a remote W-2 position with flexible work schedules.
This position will be responsible for medical coding for one of facility clients. Coder will be responsible for reviewing charts, coding appropriate charges and ensuring high quality standards are achieved.
The Inpatient Coder is responsible for assigning diagnostic and procedural codes to patient charts using ICD-10-CM, ICD-10-PCS or any other designated coding classification system in accordance with coding rules and regulations. The coder will abstract required clinical information. This position requires a thorough knowledge of medical terminology, disease processes, pharmacology, Medicare's Inpatient Prospective Payment System (IPPS), Official Coding Guidelines for ICD-10-CM and ICD-10-PCS codes, and documentation requirements for correct and accurate coding.
Experience with trauma and highly complex cases, orthopedic, and cardiology preferred
Requirements:
RHIA, RHIT, CCS certification through AHIMA required
Minimum 3 years inpatient coding experience in facility setting (recent)
Maintain standard industry productivity rates for Inpatient coding (3 charts/hour)
Demonstrated ability to maintain high quality standards of 95% or greater
Proficient in utilizing technology (computer, VPN, MS Office, coding software) to perform responsibilities
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, orthopedic, and cardiology preferred
Hours must to be worked between 6a-6:30p Pacific time Mon-Fri only. Hours can flex between those times daily to reach 40 hrs/week.
Coder
Medical coder job in Riverside, CA
Our client is a leading force in advancing safer, smarter AI technology. Their work has been featured in Forbes, The New York Times, and other major outlets for pioneering high-quality, human-verified data that powers today's top AI systems.
They've built a global community of expert contributors and have already paid out more than $500 million to professionals worldwide who help train, test, and improve next-generation AI models.
Why Join This Team?
Earn up to $32/hr, paid weekly.
Payments via PayPal or AirTM.
No contracts, no 9-to-5. You control your schedule.
Most experts work 5-10 hours/week, with the option to work up to 40 hours from home.
Join a global community of experts contributing to advanced AI tools.
Free access to the Model Playground to interact with leading LLMs.
Requirements
Bachelor's degree or higher in Computer Science from a selective institution.
Proficiency in Python, Java, JavaScript, or C++.
Ability to explain complex programming concepts fluently in Spanish and English.
Strong Spanish and English grammar, punctuation, and technical writing skills.
Preferred: 1+ years of experience as a Software Engineer, Back End Developer, or Full Stack Developer.
What You'll Do
Teach AI to interpret and solve complex programming problems.
Create and answer computer-science questions to train AI models.
Review, analyze, and rank AI-generated code for accuracy and efficiency.
Provide clear and constructive feedback to improve AI responses.
to help train the next generation of programming-capable AI models!
Health Info Coder II - Pro Fee Internal Medicine/Multi-Specialty
Medical coder job in Los Angeles, CA
Take on a significant role within a world-class health organization. Elevate the operational effectiveness of a complex health system. Take your professional expertise to the next level. You can do all this and more at UCLA Health. As a Health Information Coder for our Medical Group, you will handle a variety of vital responsibilities, including:
+ Reviewing physicians' notes to determine if documentation requirements are met
+ Extrapolating and Applying surgical codes as applicable across anatomical subsections for general coding in work queues.
+ Analyzing medical documentation to assess accuracy
+ Entering charges in EPIC
+ Identifying and reporting any potential compliance risks
Salary Range: $40.04 - $52.83 Hourly
Qualifications
We're seeking a self-directed, detail-oriented professional with:
+ Current Certified Professional Coder (CPC) certification, must have been certified a minimum of 2 years required
+ Additional specialty certification a plus, multi-specialty group experience a plus
+ Minimum of 2 years of pro fee coding experience is required
+ 3 or more years surgical and/or evaluation and management experience preferred
+ Experience as Medical Record Abstractor
+ Detailed knowledge of Medical Terminology and its application
+ Detailed knowledge and understanding of ICD-10, CPT, and HCPCS coding systems
+ Working experience with 2021 E&M guidelines preferred
+ Knowledge of CMS and local carrier regulations and guidelines for teaching hospital preferred
+ Computer proficiency with MS Office
+ Superior ability to research coding guidelines and payor policies a must
+ Previous Epic or Cerner experience preferred
Note: Skills may be subject to test.
UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person's unique achievements and experiences to further set us apart.
Senior Coding Denials Management Specialist (HIM Inpatient) - HIM Financial - Full Time 8 Hour Days (Non-Exempt) (Non-Union)
Medical coder job in Alhambra, CA
In accordance with current federal & state coding compliance regulations and guidelines, the HIM Coding Denials Management Specialist" analyze, investigate, mitigate, and resolve all coding-related 'claims denials' and 'claims rejections,' specific to ICD-10-CM, ICD-10-PCS, CPT/HCPCS, DRGs, APCs, and Modifiers-from Medicare, Medi-Cal, MAC, RAC, and commercial insurance companies -when there is refusal or rejection to honor Keck Medicine of USC request for payment for both IP & OP healthcare services provided to covered patients. Manages the denial management process for coding-related denials, triage denied claims to distinguish coding-related denials versus clinical-related denials, evaluating claims deemed inappropriately paid by the payer/external auditors, and determining the need for appeal. Performs all 1st and 2nd level coding-related denial appeals. All tasks & duties to be perform in compliance with federal & state coding laws, rules, regulations, Official Coding Guidelines, AHA Coding Clinic, AMA CPT Assistance, NCCI, NCD, LCDs, etc. Analyze, investigate, and resolve coding-related pre-bill edits from the Patient Financial Services (PFS) Dept. Researches, responds, and documents findings, correspondence, and notes regarding coding-related 'claims denials' and 'claims rejections' on patient accounts in both the Coding & Billing systems. Responsible for reviewing reports/work queues to identify and to correct the root cause for claim rejections and denials which might prevent or delay payment of a particular claim or group of claims. Prepares appeals and rebuttals letters/packages in responses to payer's reason for coding-related 'claims denials' and 'claims rejections'-including documentation and an argument and follow up with the PFS about possible reimbursement. Identifies, analyzes, and researches frequent root causes of denials and develops corrective action plans for resolution of denials. Develop reporting tools that effectively measure and monitor processes throughout the denials management process in order to support process improvement. Initiates appropriate CDI query engagements with Coders & CDI Specialists in order to acquire or clarify the necessary clinical documentation needed to facilitate accurate and complete coding, abstracting, and DRG assignments. Participate in responses to inquiries regarding coding and clinical documentation from Coders, CDI Specialists, and all other internal & external customers. Performs other HIM Coding Department duties as assigned by the HIM leadership team. Excellent written and oral communication skills are required, as well as effective human relations and leadership skills for building and maintaining a working relationship with all levels of staff, physicians, and other contacts. Must possess the ability to: interact professionally and ethically with third parties including stakeholders, co-workers, and management; handle multiple tasks simultaneously. Provide clear, concise oral and written directives/communications; quickly assess situations and respond appropriately; handle special requests in a sensitive, professional manner. Demonstrates the ability to perform in-depth clinical & regulatory research Re: NCD, LCD, NCCI, Official Coding Guidelines, AHA Coding Clinic, CPT Assistant, etc. Ability to problem solve, prioritize and organize, follow directives with accuracy and precision. In addition, this position will provide guidance and training to other HIM Coding Denials Management Specialist, and will assist with escalated issues.
Essential Duties:
CODING AUDITING • Performs monthly internal coding audits to evaluate accuracy of coding staff to ensure a 95% coding accuracy rate. • Develops monitoring/education plans for coding staff who do not meet the 95% accuracy rate. • Recognizes education needs of staff based on monthly reviews and conducts related in-services, as needed. • Ability to act as a resource to coding and hospital staff on coding issues and questions. • Ability to achieve a 95% accuracy rate as determined by an annual external review of coding.
ABSTRACTING AUDITING • Performs monthly internal abstracting audits to evaluate accuracy of coding staff to ensure a 95% abstracting accuracy rate. • Develops monitoring/education plans for coding staff who do not meet the 95% accuracy rate. • Recognizes education needs of staff based on monthly reviews and conducts related in-services, as needed. • Ability to act as a resource to coding staff on difficult coding issues.
UNDER GENERAL SUPERVISION, RESPONSIBLE FOR • Provide guidance and training to other HIM Coding Denials Management Specialists. • Performs all 1st and 2nd level coding-related denial appeals. • Inpatient coding of all diagnostic and procedural information from the medical records using ICD-10-CM, ICD-10-PCS, and CPT/HCPCS, and Modifier classification systems and abstracting patient information as established and required by official coding laws, regulations, rules, guidelines, and conventions. • Reviews the entire medical record; accurately classify and sequence diagnoses and procedures; ensure the capture of all documented conditions that coexist at the time of the encounter/visit, all medical necessity diagnoses, complications, co-morbidities, historical condition or family history that has an impact on current care or influences treatment, and all external causes of morbidity. • Enter patient information into inpatient and outpatient medical record databases (ClinTrac/HDM). Ensures accuracy and integrity of medical record abstracted UB-04 & OSHPD data elements prior to billing interface and claims submission. • Works cooperatively with HIM Coding Support and/or Clinical Documentation Improvement Specialist in obtaining documentation to complete medical records and ensure optimal and accurate assignment of diagnosis & procedure codes. • Assists in the correction of regulatory reports, such as OSHPD, as requested. • Attendance, punctuality, and professionalism in all HIM Coding and work related activities. • Consistently assumes responsibility and displays reliability for completion of tasks, duties, communications and actions. Completes tasks accurately, legibly, and in a timely fashion. • Performs other duties as requested/assigned by Director, Manager, Supervisor, or designee.
CODING & ABSTRACTING ACCURACY • Ability to achieve a minimum of 95% coding accuracy rate as determined by any internal or external review of coding and/or department quality review(s). • Ability to achieve a minimum of 95% abstracting accuracy rate of UB-04 and OSHPD data elements as determined by any internal or external review of coding and/or department quality review(s). • Assist in ensuring that all medical records contain information necessary for optimal and accurate coding and abstracting. • Recognizes education needs of based on monthly reviews and conducts self-improvement activities. • Ability to act as a resource to coding and hospital staff on coding issues and questions.
CODING OPTIMIZATION • Ability to improve MS-DRG assignments related to the documentation & coding of PDx, SecDx, CC/MCC, PPx, and SecPx in accordance with official coding laws, regulations, rules, guidelines, and conventions. • Ability to improve APR-DRG, SOI, and ROM assignments related to the documentation & coding of PDx, SecDx, CC/MCC, PPx, and SecPx in accordance with official coding laws, regulations, rules, guidelines, and conventions. • Ability to improve APC/HCC assignments based on medical necessity documentation & coding of PDx, SecDx, and CPT/HCPCS in accordance with official coding laws, regulations, rules, guidelines, and conventions.
TIMELINESS OF AUDITING/CODING & PRODUCTIVITY • Maintains at minimum, expected productivity standards (See HIM Practice Guidelines) and strives to maintain a steady level of productivity and provides consistent effort. • Works coding queues/task lists to ensure 95% of patient bills are dropped within 5 days after patient discharge/date of service. • Works coding queues/task lists to ensures the remaining 5% of patient bills are dropped within 2 weeks of discharge/date of service. • Assist other coders in performance of duties including answering questions and providing guidance, as necessary. • Assists Patient Financial Services (PFS), Patient Access, and other departments in addressing coding issues/questions and/or providing information so that an interim bill can be generated. Assists with physicians, physician office staff and hospital ancillary department staff with diagnostic or procedural coding issues/questions, as needed. • Assists in the monitoring unbilled accounts to ensure that the oldest records are coded and/or given priority.
CONTINUING EDUCATION • Maintains AHIMA and or AAPC coding credential(s) specified in the job description. • Attend coding & CDI seminars, webinars, and in-services to maintain the required annual continued education units (CEU). • Keep up-to-date and reviews ICD-10 Official Guidelines for Coding & Reporting, AHA Coding Clinic, and CPT Assistant to maintain knowledge of the principles of coding. • Keep up-to-date and reviews other professional journals and newsletters in a timely fashion to maintain knowledge of the principles of coding. • Consistently attend and actively participate in the daily huddles.
POLICY & PROCEDURES; PERFORMANCE IMPROVEMENT • Consistently adhere to HIM policies and procedures as directed by HIM management. • Demonstrates an understanding of policies and procedures and priorities, seeking clarification as needed. • Participates in continuously assessing and improving departmental performance. • Ability to communicate changes to improve processes to the director, as needed. • Assists in department and section quality improvement activities and processes (i.e. Performance Improvement).
COMMUNICATION • Works and communicates in a positive manner with management and supervisory staff, medical staff, co-workers and other healthcare personnel. • Ability to communicate effectively intra-departmentally and inter-departmentally. • Ability to communicate effectively with external customers. • Provides timely follow-up with both written and verbal requests for information, including voice mail and email. • Performs other duties as assigned.
SYSTEMS • Working knowledge and efficient navigation of the Electronic Health Record (EHR): Cerner/Powerchart & Coding mPage. • Working knowledge, efficient navigation, & full use of 3M-CRS Encoder system; utilize to expedite coding process; utilize all references. • Knowledge & understanding of PFS system (PBAR) functionality and any interface with the coding abstracting system: ClinTrac. • Working knowledge, efficient navigation, & full use of ‘HDM/HRM/ARMS Core' coding & abstracting software. • Working knowledge, efficient navigation, & full use of ‘3M 360 Encompass/CAC'.
Required Qualifications:
Req High School or equivalent
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/DRG coding and/or CPT/HCPCS coding principles, and the recommended American Health Information Management Association (AHIMA) coding competencies.
Req 10 years Experience in ICD, CPT/HCPCS coding of inpatient & outpatient medical records in an acute care facility.
Req Experience in using a computerized coding & abstracting database software and encoding/code-finder systems [e.g., 3M 360 Encompass/CAC & 3M Coding & Reimbursement System (CRS)].
Req Working knowledge of CPT, HCPCs and ICD9 coding principles
Req Organization/time management skills.
Req Demonstrate excellent customer service behavior.
Req Demonstrates excellent verbal and written communication skills.
Req Able to function independently and as a member of a team.
Preferred Qualifications:
Pref 1 - 2 years Lead Experience.
Required Licenses/Certifications:
Req 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 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. (Required within LA City only)
The hourly rate range for this position is $46.00 - $76.07. 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 **************, or by email at *************. 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
If you are a current USC employee, please apply to this USC job posting in Workday by copying and pasting this link into your browser:
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Auto-ApplyCoder 1-HIM
Medical coder job in San Bernardino, CA
Job Summary: The Coder 1-HIM performs International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) coding and abstracts data the legal medical record for facilities, licensed under LLUMC and contracted other LLUH facilities. Assigns diagnosis and procedure codes in compliance with the American Hospital Association Official Coding Guidelines. Ensures the quality and accuracy of coding and abstract information are in compliance with federal and state regulations, government and contract payers, and grant funding. Quality of data collected impacts the facility in multiple ways, including finance, legal, research, teaching, quality assurance, etc. The Coder 1-HIM must be able to perform coding in Outpatient and/or Emergency area. Works with students and coding interns as requested. Performs other duties as needed.
Education and Experience: Completion of Coding Certificate program or Associate's Degree in Health Information Management required. Minimum one year of coding experience in an acute care facility preferred. Experience may be considered in lieu of formal education.
Knowledge and Skills: Knowledge of Medical Terminology preferred. Knowledge of the standards of Coding as set forth by the American Health Information Management Association. Able to read; write legibly; speak in English with professional quality; use computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint). Operate/troubleshoot basic office equipment required for the position; Able to relate and communicate positively, effectively, and professionally with others; work calmly and respond courteously when under pressure; collaborate and accept direction. Able to communicate effectively in English in person, in writing, and on the telephone; think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position.
Licensures and Certifications: Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) credentials through AHIMA required.
Auto-ApplyEmergency Department Facility Coder (P)
Medical coder job in Culver City, CA
Be Part of A Team That Believes in True Partnership, Continuous Improvement, and Collaboration to Deliver High-Quality Professional Solutions!
We are currently recruiting for a remote ED facility medical coding specialists with at least 3 years' experience in addition to any formal training. If you are a successful Emergency Department medical coding professional that will bring a wealth of experience to our team, apply today to take advantage of our flexible remote coding career opportunities. This is a W-2 employee, working from your home office that is temp full time for 4-5 months. The position could extend.
Responsible for coding all diseases, on ED according to ICD-10-CM, UHDDS, American Medical Association's CPT-4, according to client specifications. (No injection/infusion required)
Responsible for keeping current on all Aviacode and client coding policies and procedures while ensuring all procedure changes and additions are understood.
Responsible to discuss any unclear information needing clarification with supervisor and/or data quality specialist.
Works with 3M Encoder and EPIC EMR system
Mantains production of 12 CPH
Keeps abreast of regulatory changes and communicates these changes to Coding Supervisor
Requirements Requirements
AHIMA: RHIT, RHIA, CCS credentials required
Minimum of 3 years Emergency Department coding experience (recent)
Principals of ICD-10 Outpatient Coding
Maintains accuracy of diagnosis code assignment per client and GeBBS Healthcare Solutions policies.
Maintains productivity levels per client and GeBBS policies.
Maintains reports and their integrity by insuring that all data is entered and recorded as directed by supervisor and director.
Communicates in a responsible manner according to GeBBS policies
Working hours must be between 6a-6:30p Pacific time Mon-Fri only.
Coder
Medical coder job in Riverside, CA
Job DescriptionAI Coder
Our client is a leading force in advancing safer, smarter AI technology. Their work has been featured in Forbes, The New York Times, and other major outlets for pioneering high-quality, human-verified data that powers today's top AI systems.
They've built a global community of expert contributors and have already paid out more than $500 million to professionals worldwide who help train, test, and improve next-generation AI models.
Why Join This Team?
Earn up to $32/hr, paid weekly.
Payments via PayPal or AirTM.
No contracts, no 9-to-5. You control your schedule.
Most experts work 5-10 hours/week, with the option to work up to 40 hours from home.
Join a global community of experts contributing to advanced AI tools.
Free access to the Model Playground to interact with leading LLMs.
Requirements
Bachelor's degree or higher in Computer Science from a selective institution.
Proficiency in Python, Java, JavaScript, or C++.
Ability to explain complex programming concepts fluently in Spanish and English.
Strong Spanish and English grammar, punctuation, and technical writing skills.
Preferred: 1+ years of experience as a Software Engineer, Back End Developer, or Full Stack Developer.
What You'll Do
Teach AI to interpret and solve complex programming problems.
Create and answer computer-science questions to train AI models.
Review, analyze, and rank AI-generated code for accuracy and efficiency.
Provide clear and constructive feedback to improve AI responses.
Apply now to help train the next generation of programming-capable AI models!