Medical coder jobs in San Bernardino, 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 ******************.

Job DescriptionDescriptionWe 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 surrounding areas 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 Must possess and maintain AAPC or AHIMA certification - Certified Risk Adjustment Coder (CRC) & Certified Coding Specialist (CCS-P), CCS, CPC 3-5+ years of experience in risk adjustment coding and/or billing experience required 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: 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 Strong experience with Excel - pivot tables, VLOOKUP, etc. 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 in Central Georgia. 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.

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!

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

Brault is a practice management, billing and coding company exclusively serving acute care independent physician practices. Due to recent growth and expansion, we are seeking a strong and skilled coding professional with pro-fee and/or facility coding experience for Emergency Medicine, Hospitalist, and Urgent Care, to provide accurate coding to our physician and healthcare system clients. Requirements Qualifications: Certified Professional coder (AAPC or AHIMA) 5 years' experience required 5-7 years in Professional Fee or Facility Coding Cerner and Epic (preferred) Emergency Medicine experience (preferred) Meet quality and production requirements Salary Description $22 - $27

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: *************************************************************

R&D Partners is seeking to hire an Analyst for a growing Medical Affairs team with our medical device client in Irvine. is on-site from Monday to Friday. Your main responsibilities as an Analyst, Medical Affairs : Support the management and execution of contracts, budget and payments of educational and research grants, HCPs, educators, vendors, contractors, and consultants. Support contract lifecycle including negotiation, initiation, approval, payments, and documentation Track expenditure versus budget, support forecasting and generate metrics for reporting Partner with Legal, Compliance, Finance, and other cross-functional groups to ensure appropriate business practices What we are looking for in an Analyst, Medical Affairs : Bachelor's Degree with 2+ years of professional experience managing healthcare-related contracts, budgets and payments Proven expertise in Microsoft Office Suite (Worl, Excel, and PowerPoint) Why choose R&D Partners? As an employee, you have access to a comprehensive benefits package including: Medical insurance PPO, HMO & HSA Dental & Vision insurance 401k plan Employee Assistance Program Long-term disability Weekly payroll Expense reimbursement Online timecard approval Salary: $84,500 to $89,500 (Dependent on Experience) R&D Partners is a global functional service provider and strategic staffing resource specializing in scientific, clinical research & engineering. We provide job opportunities within major pharmaceutical, biopharmaceutical, biotechnology, and medical device companies. R&D Partners is an equal-opportunity employer.

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.

Looking to take the next step in your safety career? We have exciting opportunities for safety professionals with various experience levels and certifications to work on various, projects, throughout California and the US. Essel Environmental is the go-to resource for responsive, high-quality environmental, engineering and emergency response services. Responsibilities: Collaborate with project managers in the preparation of site-specific safety documentation JHA's, H&S plans, reports, and permits Conduct continuous worksite safety inspections, audits, and risk assessments to identify non-compliance issues and implement the necessary preventive or mitigating measures Maintain current knowledge on safety rules, regulations, and laws to ensure all projects comply with company safety policies, client requirements, and adherence to regulatory safety laws Communicate with various safety representatives and other governing bodies as it relates to project-specific health and safety. Identify metrics that can be used to support safety, safe practices, and employee engagement Record and investigate near-misses to determine root causes Ensure personnel have appropriate Personal Protective Equipment and that the equipment is used correctly Share information, suggestions, and observations with the project manager to create consistency in safety procedures throughout the project Conduct daily safety meetings and the necessary site-specific safety orientations Assess subcontractor safety plans and JHA's Attend project planning meetings and collaborate with project managers Monitor safety-related documents, reports, and issues to keep them updated Requirements At least 3 years recent and relevant experience in a similar role. OSHA 10, 30 - Construction Industry Certified. Strong knowledge of OSHA standards Computer literate Preferred cortications: Health and Safety Technician (CHST) Additional safety certifications desired (CSST, ASP to CSP) 40 - Hour HAZWOPER Training Bilingual, English and Spanish, preferred

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: *************************************************************

Overview (pay range: 15-23 HR) At PGA TOUR Superstore, we are always looking for enthusiastic, self-motivated, flexible individuals who will share a passion for helping transform our business. As one of the fastest growing specialty retailers, we are dedicated to hiring selfless team players from different backgrounds to influence the growth of our organization. Part of the Arthur M. Blank Family of Businesses, PGA TOUR Superstore continuously strives to create a family culture for our Associates - driven by our vision to inspire people through golf and tennis. Position Summary Reporting to the Sales and Service Manager, the STUDIO Performance Specialist delivers world-class service through expert instruction and precision fitting. This hybrid role blends the responsibilities of a Golf Instructor and a Fitting Specialist, ensuring every customer receives a tailored experience that improves their game and drives lasting relationships. The STUDIO Performance Specialist is responsible for achieving KPIs across both fittings and lessons, proactively growing their client base, and maintaining a fully booked schedule. The role also supports the visual and operational excellence of the STUDIO, leveraging advanced technology and product knowledge to deliver measurable performance results. Key Responsibilities: Customer Experience & Engagement * Engage every customer with world-class service by demonstrating PGA TOUR Superstore's Service Behaviors. * Build lasting relationships that encourage repeat business and client referrals. * Educate and inspire customers by connecting instruction and equipment performance to game improvement. Instruction & Coaching * Conduct one-on-one lessons, clinics, and group events tailored to player needs, goals, and skill levels. * Utilize technology such as TrackMan, SAM PuttLab, and USchedule to deliver data-driven instruction. * Develop personalized lesson plans and track student progress, providing constructive feedback and measurable improvement. * Proactively organize clinics and performance events to build customer engagement and community participation. Fitting & Equipment Performance * Execute professional club fittings using PGA TOUR Superstore's certified fitting techniques and technology. * Maintain a brand-agnostic approach to ensure customers are fit for the best equipment based on their unique swing data and goals. * Educate customers on product features, benefits, and performance differences across brands. * Accurately enter and manage custom orders, ensuring all specifications are documented precisely. Operational & Visual Excellence * Maintain all STUDIO areas (simulators, components drawers, putting green) to the highest visual and operational standards. * Ensure equipment, software, and technology remain functional and calibrated. * Support front-end operations, including returns, lesson redemptions, loyalty programs, and promotions. * Stay current on marketing campaigns and merchandising events, executing promotional setups and maintaining accurate displays. Performance & Business Growth * Achieve key performance indicators (KPIs) such as: * Lessons and fittings completed * Sales per hour and booking percentage * Clinic participation and conversion to sales * Proactively grow the STUDIO business through client outreach, networking, and relationship management. * Provide consistent feedback to the Sales and Service Manager to improve operations, merchandising, and customer experience. Qualifications and Skills Required * Certification: Only PGA Members and Apprentices in good standing with the PGA of America are eligible for this role. The candidate must maintain good standing with the PGA for the duration of employment. The candidate may be asked to provide proof of PGA membership in the form of a current membership card or proof of membership dues payment. * Communication: Strong interpersonal, listening, and verbal/written communication skills with the ability to engage and educate customers. * Technical Proficiency: Working knowledge of Microsoft Office Suite and fitting/instruction technology (TrackMan, SAM PuttLab, USchedule). * Organization: Ability to manage multiple priorities, maintain schedules, and meet deadlines. * Education: High school diploma or equivalent required; PGA certification or equivalent instruction credentials preferred. * Experience: * 2+ years of golf instruction and club fitting experience preferred. * Experience with swing analysis tools and custom club building highly valued. * Physical Demands: Must be able to stand for extended periods, move throughout the store, lift up to 30 lbs overhead, and work in simulator environments. * Availability: Must maintain flexible availability, including nights, weekends, and holidays. * Accountability: Demonstrates strong self-accountability, professionalism, and a proactive drive for results. Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. PGA TOUR Superstores is an Equal Opportunity Employer, committed to a diverse and inclusive work environment. We comply with all laws that prohibit discrimination based on race, color, religion, sex/gender, age (40 and over), national origin, ancestry, citizenship status, physical or mental disability, veteran status, marital status, genetic information, and any other legally protected status. Employment discrimination isn't just unlawful, it violates our policies and is not who we are. Every associate at every level in the organization is prohibited from engaging in any form of discrimination. An associate who believes s/he is being discriminated against should report it immediately to the Human Resources department. The law and our policies prohibit retaliation against anyone for making such a report.

Job DescriptionDescription: We are seeking a detail-oriented and knowledgeable Medical Biller to join our medical practice. The ideal candidate will be responsible for managing billing processes, ensuring accurate coding and submission of claims, and maintaining medical records. This role is crucial in facilitating the financial operations of our medical office while ensuring compliance with healthcare regulations. Requirements: Responsibilities Oversees the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management Plans and directs patient insurance documentation, workload coding, billing and collections, and data processing to ensure accurate billing and efficient account collection Analyze billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues Follow up on claims using various systems, such as practice management, EHR, and clearinghouse. Maintains contacts with other departments to obtain and analyze additional patient information to document and process billings Prepares and analyzes accounts receivable reports and weekly and monthly financial reports in concert with the Practice Administrator and Operations Manager. Collects and compiles accurate statistical reports Audits current procedures to monitor and improve the efficiency of billing and collections operations Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol and are in compliance with Federal, State, and payer regulations, guidelines, and requirements Participates in the development and implementation of operating policies and procedures Analyzes trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff and revise policies and procedures with the approval of the Director of Operations. Keep up to date with carrier rule changes and distribute the information within the practice Performs physician credentialing actions Required Skills Proficiency in medical coding (ICD-10, ICD-9) and familiarity with DRG systems. Strong understanding of medical records management and medical terminology. Experience in a medical office setting with knowledge of billing software and systems. Excellent attention to detail with strong organizational skills. Ability to communicate effectively with patients, healthcare providers, and insurance representatives. Problem-solving skills to address billing issues efficiently and effectively.

Yucaipa Hills Post Acute is hiring a full-time medical records coordinator for its 82-bed skilled nursing facility. We're looking for a motivated and knowledgeable person who can ensure our medical records are fully compliant while supporting our staff, residents, and clinical consultants on a daily basis. We're looking for someone that enjoys working in long-term care and is excited to make a difference in the lives of the residents we care for. What You Will Do in This Role We use electronic medical records and charting, requiring intermediate to advanced computer skills (Point Click Care, Microsoft Excel, and Outlook). Our medical records coordinator ensures medical records are properly completed, assembled, coded, signed, and indexed, etc. Inputs resident information into the computer and retrieves resident information as appropriate or as instructed. Audits and reports daily by reviewing electronic health records documentation for accuracy and completion. Maintains medical health records in a manner that is consistent with administrative, legal and regulatory requirements and best practices. Completes medical record and documentation competencies as directed. Participates in daily and weekly clinical meetings. Often asked to work beyond normal working hours and on weekends and holidays and on other shifts/positions as necessary. Qualifications Medical Records experience. Organized and detail oriented. Reliable and punctual. Flexibility and ability to work with other personnel. Understanding of medical terminology. Intermediate to advanced computer skills. Benefits Medical insurance. Dental insurance. Vision insurance. PM21

Requirements Minimum Knowledge, Skills, Experience Required High School Diploma (GED) required; degree preferred Prior experience with ROI fulfillment preferred Demonstrated attention to detail Demonstrated ability to prioritize, organize, and meet deadlines Demonstrated documentation and communication skills Demonstrated ability to maintain productivity and quality performance Basic knowledge of medical records and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) preferred Prior experience with EHR/EMR platforms preferred Prior experience with Windows environment and Microsoft Office products Displays strong interpersonal skills with team members, clients, and requestors Must have strong computer skills and Microsoft Office skills Prior experience with operations of equipment such as printers, computers, fax machines, scanners, and microfilm reader/printers, etc. preferred Must be detailed oriented, self-motivated and can stay focused on tasks for extended periods of time. Must be able to read, write, speak, and comprehend English. Bilingual skills are desirable.

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!

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.

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.

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: *************************************************************

Job Description Yucaipa Hills Post Acute is hiring a full-time medical records coordinator for its 82-bed skilled nursing facility. We're looking for a motivated and knowledgeable person who can ensure our medical records are fully compliant while supporting our staff, residents, and clinical consultants on a daily basis. We're looking for someone that enjoys working in long-term care and is excited to make a difference in the lives of the residents we care for. What You Will Do in This Role We use electronic medical records and charting, requiring intermediate to advanced computer skills (Point Click Care, Microsoft Excel, and Outlook). Our medical records coordinator ensures medical records are properly completed, assembled, coded, signed, and indexed, etc. Inputs resident information into the computer and retrieves resident information as appropriate or as instructed. Audits and reports daily by reviewing electronic health records documentation for accuracy and completion. Maintains medical health records in a manner that is consistent with administrative, legal and regulatory requirements and best practices. Completes medical record and documentation competencies as directed. Participates in daily and weekly clinical meetings. Often asked to work beyond normal working hours and on weekends and holidays and on other shifts/positions as necessary. Qualifications Medical Records experience. Organized and detail oriented. Reliable and punctual. Flexibility and ability to work with other personnel. Understanding of medical terminology. Intermediate to advanced computer skills. Benefits Medical insurance. Dental insurance. Vision insurance. PM21 Powered by JazzHR 3WEw0jbnEn