Medical Billing and Coding

• Performs coding audits of patient care billing documentation to ensure adherence with CPT and ICD coding guidelines
• Ensure adherence with federal, state, and commercial payor billing and payment policy for all services provided
• Work under direction of the Coding Supervisor and Coding Manager

Coder

• Supports assigned inpatient and/or outpatient coding operations through day-to-day workflow leadership.
• Provides oversight of coding quality, coding edits, auditing, and staff education.
• Monitors coder productivity and quality and provides timely feedback.
• Ensures encounters processed by the coding team include an appropriate documented claim-hold reason before final billing.
• Develops, implements, and monitors coding policies and procedures that support accurate coding and compliance.
• Tracks and trends post-discharge coding queries and provides education.

Senior Outpatient Coder

• Abstract data from the anesthesia record into the MD Cloud Practice Solutions platform
• Work with charge capture platforms, including Medaxion, PC7, and multiple facility EMR's
• Reviews anesthesia documentation for appropriate required elements, such as attestations, signatures, dates, etc.
• Abstract and code surgical procedures from all sections of CPT and cross walk surgical codes to ASA
• Comprehensive understanding of applicable modifiers
• Abstracts anesthesia times and events
• Identify and assign care team providers
• Review for medical direction
• Meet team KPIs including daily production and quarterly coding audit score requirements
• Perform other duties as assigned
• Adhere to all company policies and procedures – especially HIPAA and confidentiality.

Production Coding Specialist I

• Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company
• Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC)
• Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines
• Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
• Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing
• Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements.
• Provides recommendations to management related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives.
• Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work.
• Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager.
• May assist or lead projects and/or higher work volume than Risk Adjustment Coding Specialist I
• Other duties as assigned.

Risk Adjustment Coding Specialist II

• Manage, mentor, and grow a team of individual contributors, fostering a culture of innovation and continuous improvement.
• Develop and organize our overall strategy for Onboard Behavior ML Models for generating driving plans for our autonomous vehicle. You will interface with multiple partner teams to identify opportunities for model improvements within their problem area.
• Provide technical guidance and leadership in the design and development of training models at large scale and work with partner teams on ensuring their efficient inference.
• Establish and monitor key performance indicators (KPIs) to measure the effectiveness of work packages and drive continuous improvement.
• Manage the allocation of resources within the team, ensuring that projects are staffed appropriately and that team members have the necessary tools and support to succeed.

Manager, Onboard Behavior Encoder

• Evaluates medical records, provides clinical and surgical abstraction and assigns appropriate clinical diagnosis and procedure codes.
• Analyzes medical information from medical records
• Accurately codes diagnostic and procedural information in accordance with national coding guidelines
• Consults with medical providers to clarify missing or inadequate record information and to determine appropriate codes.
• Provides thorough, timely and accurate coding in accordance to department specific productivity and quality standards.

Profee Coder – Primary Care

• Assigned codes to patient symptoms, diagnosis, operations, and treatments to process reimbursements
• Knowledge and expertise in reviewing and adjudicating coding services, procedures, and diagnoses on medical claims
• Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes, and CPT codes into the NextGen system.

Certified Professional Coder

• Coordinate with DCOQR to design, monitor, implement, and evaluate coding and quality assurance processes and programs
• Support local clinical leaders at agencies located throughout the United States
• Meet regulatory and accreditation requirements
• Achieve the highest standard of care delivery system
• Commit to providing superior service levels

Home Health Coding and OASIS Accuracy Specialist

• Review and validate medical codes assigned to diagnoses, procedures, and services to ensure accuracy and compliance with ICD-10, CPT, HCPCS, and other coding systems.
• Provide expert coding guidance and support to clinicians, and other departments, serving as a resource for complex coding questions.
• Conduct coding audits and quality reviews to identify discrepancies and ensure adherence to regulatory guidelines.
• Generate and analyze coding productivity reports.
• Collaborate with IT and billing teams to resolve system issues impacting coding workflows.
• Participate in organizational initiatives, training and continuous improvement to better support the coding process.

Coding Specialist

• The Certified Coder and Billing Compliance Specialist is responsible for reviewing and coding medical records to ensure accurate, compliant billing in accordance with Medicare, Medicaid, and private insurance requirements.
• This role evaluates clinical documentation, assigns ICD-10, CPT, HCPCS, E/M, CCM, and TCM codes, identifies missed or incorrect charges, and resolves coding and claim discrepancies prior to submission.
• The position works closely with providers and the billing team to support documentation integrity, denial prevention and resolution, audit readiness, and regulatory compliance, while providing education and reporting to strengthen revenue integrity.
• Through these efforts, the role helps ensure timely reimbursement and supports the financial sustainability of Snowline Health’s mission-driven care programs.

Certified Coding and Billing Compliance Specialist

• Lead a Team: Manage, mentor, and grow a team of individual contributors, fostering a culture of innovation and continuous improvement.
• Develop Strategy: Develop and organize our overall strategy for Onboard Behavior ML Models for generating driving plans for our autonomous vehicle. You will interface with multiple partner teams to identify opportunities for model improvements within their problem area. You’ll be setting the short and long term technical direction for the team and collaborate on broader company-wide directions.
• Provide technical guidance and leadership in the design and development of training models at large scale and work with partner teams on ensuring their efficient inference.
• Monitor Performance: Establish and monitor key performance indicators (KPIs) to measure the effectiveness of work packages and drive continuous improvement.
• Manage Resources: Manage the allocation of resources within the team, ensuring that projects are staffed appropriately and that team members have the necessary tools and support to succeed.

Manager, RL Algorithms – Decoder

• Manage incoming and outgoing payments for medical treatment.
• Communicate with clients about their outstanding balance and handle the administrative responsibilities of billing insurance and processing payments.
• Checking clients’ eligibility and coverage on a daily basis. (Online & through call if necessary)
• Review and resolve the to-do list daily.
• Accept inbound calls.
• Always document the conversation to Billing Comments of Therapy Notes.
• Calling clients to collect aging balances.
• Resolve claims denial.
• Contracting and credentialing knowledge.
• Other billing-related work.

Medical Billing Assistant

• Prepare, review, and submit clean medical claims to commercial payers.
• Verify claim accuracy, including coding, modifiers, eligibility, EAP authorizations, and provider details
• Monitor claim rejections and take timely corrective actions
• Manage denial resolution: research root cause, correct and resubmit, or prepare appeals
• Conduct proactive follow-up on outstanding A/R and aging claims
• Support patient billing activities and inquiries when needed
• Document all billing activities clearly and accurately in internal systems
• Ensure compliance with HIPAA, payer regulations, and state/federal billing guidelines
• Collaborate with credentialing, eligibility/benefits, clinical operations, and internal RCM teammates
• Identify trends and recommend process improvements to reduce denials and rework

Medical Billing Specialist

• Execute tasks focused on revenue generation through account resolution for any company client.
• Review documentation to support or contest payer coding decisions for multiple facilities.
• Prepare clear, concise, and well-supported appeals where applicable, using all available documentation, coding guidelines, and regulatory references to defend billed claims and secure reimbursement on insurance accounts receivable.
• Investigate the root causes of denials and downgrades, as needed.
• Provide targeted training on coding practices to Currance team members, promoting accuracy, compliance, and efficiency in resolving coding-related issues.
• Participate in daily shift briefings and contribute actively.
• Resubmit corrected claims according to Federal, State, and payer-mandated guidelines.
• Research, analyze, and correct claim errors and rejections to ensure accurate resubmission and to avoid payer denials due to preventable errors.
• Escalate problematic accounts, recurring issues, or trends to Supervisor and recommend education or denial prevention measures to the client.
• Stay current on payer updates, process changes, and coding guidelines to maintain compliance with Federal, State, and payer requirements.
• Meet productivity standards while maintaining quality output.
• Communicate payer-specific issues to the team and management for timely resolution.
• Engage in continuous learning to remain up to date on coding and payer policies.

Denial Resolution Specialist

• Accurately assigns diagnosis and procedure codes for inpatient facility and professional services.
• Performs necessary tasks within MHS GENESIS and other military coding systems.
• Accurately assign Evaluation and Management (E&M) codes, ICD-CM diagnoses, CPT and HCPCS, modifiers, and quantities derived from medical record documentation.
• Reviews encounter and/or record documentation to identify and resolve inconsistencies, ambiguities, or discrepancies.
• Assigns accurate codes based on provider responses to coding queries.
• Supports DHA coding compliance by performing due diligence in ethically and appropriately researching and/or interpreting existing guidance.
• Utilizes MHS computer systems to remotely access patient records and assign codes for patient encounters in support of other MTFs.
• Achieve and maintain DHA coding productivity and accuracy standards for the position.
• Educates and provides feedback to providers and clinical staff to resolve documentation issues to support coding compliance.
• Acts as a source of reference to medical staff having questions, issues, or concerns related to coding.
• Responds to provider questions and provides examples of appropriate coding and documentation reference(s).

Medical Coder II

• Review clinical documentation to assign and sequence diagnostic and procedural codes
• Validate APC calculations
• Perform documentation review and assessment for accurate abstracting of clinical data
• Maintain strict patient and provider confidentiality in compliance with all HIPAA Guidelines
• Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials

Profee Coder – Neurology/Neurosurgery

• Process and submit medical claims accurately and on time
• Assign appropriate ICD-10, CPT, and HCPCS codes
• Review documentation for coding compliance
• Follow up on denied or unpaid claims as needed
• Communicate with providers, payers, or clients when necessary
• Maintain HIPAA compliance and data security standards

Medical Biller, Coder

• Codes and abstracts diagnoses and patient information from outpatient ancillary encounters and enters data into the hospital information system
• Verifies abstracted hospital information fields for accuracy and completeness
• Monitors daily data printout to assure completion of all outpatient records requiring coding and abstracting
• Communicates with physicians or physician office staff when documentation is unclear or insufficient to complete the coding process
• Maintains coding proficiency through self-directed continuing education

HIM Coding Specialist I

• Accurately translating medical procedures and diagnoses into ICD 10, CPT and HCPCS codes
• Abstracting demographic and physician data to meet both internal and regulatory requirements for reporting utilizing the hospital’s abstracting system
• Collaborating with providers via email, phone call, or in person to educate or discuss coding requirements
• Ensuring compliance with AAPC/AMA CPT Guidelines, AAPC/AMA Coding Clinic, ICD 10-CM CMS, HCAI, and NorthBay Health coding guidelines
• Working in an environment focused on delivering high-quality patient care

ED Professional Fee Coder

• Code medical records to validate ICD-10-CM codes for PACE Risk Adjustment
• Meet department production and quality standards
• Research regulatory guidelines for supporting documentation
• Prepare coding reports using excel
• Prepare oral and/or written reports of work activity to Supervisor
• Be responsible and accountable for maintaining the confidentiality, integrity, and availability of protected health information.
• Follow HIPAA security policies and procedures affecting your job, and report any suspected or actual violation or breach
• Other duties as assigned

Medical Billing and Coding jobs in California

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