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Coding specialist • orange ca

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Compliance Coding Auditor for the Auditing, Tracking, and Monitoring

Compliance Coding Auditor for the Auditing, Tracking, and Monitoring

Advanced Medical Management, Inc.Anaheim, CA, US
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As a member of AMM's Compliance and Ethics team, the Compliance Coding Auditor is an important driver of our mission.They are responsible for supporting the Company's Compliance & Ethics Progra...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
ORANGE, CA | Substitute Teacher, Teacher, Coding Robotics

ORANGE, CA | Substitute Teacher, Teacher, Coding Robotics

PARENT EDUCATION BRIDGE FOR STUDENT ACHIEVEMENT FOUNDATION LLCSANTA ANA, CA, US
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Areas : Santa Ana, Fullerton, Anaheim, Irvine, Orange County .We are seeking an energetic and experienced.As an Instructor, you will teach classes using the curriculum provided by our organization....serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Training Specialist

Training Specialist

ProvidenceBrea, CA, United States
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You will be required to work 20% onsite in Brea, CA and 80% remote!.Working under the direction of the Core Leader, this position is responsible for determining the educational and learning needs o...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Medical Billing and Insurance Coding Instructor (56961)

Medical Billing and Insurance Coding Instructor (56961)

International Education CorporationGarden Grove, CA, United States
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Job Details Job Location : California Garden Grove UEI - Garden Grove, CA Salary Range : $24.Hourly Job Category : Instructors & Education Description We're Looking For : Someone with tenacity, pa...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Housing Specialist

Housing Specialist

Volunteers of America Los AngelesGarden Grove, CA, United States
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Helping Our Most Vulnerable Change Their Life Stories.Volunteers of America is a non-profit human services organization committed to serving people in need, strengthening families, and building com...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Account Specialist

Account Specialist

TradeJobsWorkforce92703 Santa Ana, CA, US
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Account Specialist Job Duties : Prepares work to be processed by gathering, sorting, organizing, and recording data, information, and documents. Completes enrollments by analyzing and auditing docume...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Certified Coding Specialist

Certified Coding Specialist

VirtualVocationsFullerton, California, United States
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A company is looking for a RCM Coding Specialist.Key Responsibilities Perform designated abstracting and coding functions in a multi-specialty organization Assign diagnostic and procedure codes ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Coding Manager (Medical)- Santa Ana, CA Direct Hire

Coding Manager (Medical)- Santa Ana, CA Direct Hire

StaffingSanta Ana, CA, US
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The Coding Manager has overall responsibility for assigned hospitals for the management of the Coding Department which includes recruiting, hiring, training, mentoring and performance management of...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Registered Nurse - Diagnosis Related Group (DRG) Coding Auditor Principal - Carelon Payment Integrity

Registered Nurse - Diagnosis Related Group (DRG) Coding Auditor Principal - Carelon Payment Integrity

Elevance HealthCosta Mesa, CA, United States
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Registered Nurse - Diagnosis Related Group (DRG) Coding Auditor Principal - Carelon Payment Integrity.Registered Nurse - Diagnosis Related Group Coding Auditor Principal - Carelon Payment Integrity...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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PPC Specialist

PPC Specialist

TradeJobsWorkForce92704 Santa Ana, CA, US
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PPC Specialist Job Duties : Meet client goals through end-to-end paid media initiatives Pla...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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System Specialist

System Specialist

Hassan & Sons, Inc.Orange, CA, United States
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The System Specialist plays a crucial role in the maintenance, optimization, and support of retail and operational systems across all company locations. This includes overseeing POS systems, kiosks,...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
HCC Coding Analyst

HCC Coding Analyst

Alignment HealthcareOrange, California US
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Job Number6689Workplace Type : Hybrid RemoteOrange,California.By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart cul...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Payroll Specialist

Payroll Specialist

Macro-Z-Technology CompanyGarden Grove, CA, US
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Macro-Z Technology (MZT) is a leading construction company known for building exceptional projects through an unwavering commitment to its people. With a strong reputation in the Federal and Municip...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Medical Billing and Coding - Entry Level Training Program

Medical Billing and Coding - Entry Level Training Program

Dreambound Inc.Anaheim, California
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This is an educational program, not a job offer.Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market.Looking to s...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Payroll Specialist

Payroll Specialist

Century GroupTustin, CA, United States
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Fantastic opportunity with our client in Orange County! Fast paced and growing food / retail company looking for their next. This role is onsite in Tustin, CA.Exact pay based on experience, $58,000 to...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Financial Specialist

Financial Specialist

HigginbothamIrvine, CA, US
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Financial Documentation Specialist.The Paradigm Gilbert Group, A Higginbotham Partner, has an immediate opening for a Financial Documentation Specialist in their Irvine, CA office.Paradigm Gilbert ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Payroll Specialist

Payroll Specialist

Vaco by HighspringOrange, California, United States
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Our client in Santa Ana is seeking a detail-oriented and reliable Payroll Specialist to manage full-cycle payroll and support HR / finance operations. This role requires strong accuracy, excellent com...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Billing Specialist

Billing Specialist

Insight GlobalIrvine, CA, United States
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An employer in the Orange County area is seeking a Billing / Intake Specialist.The role requires onsite training in Ontario for the first 3 days of their assignment, moving to a hybrid role post trai...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Parts Specialist

Parts Specialist

O'Reilly AutomotiveIrvine, CA, US
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The Parts Specialist will provide all retail and installer customers with a high level of service.This position will also support store management in the accomplishment of assigned tasks.Bilingual ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Compliance Coding Auditor for the Auditing, Tracking, and Monitoring

Compliance Coding Auditor for the Auditing, Tracking, and Monitoring

Advanced Medical Management, Inc.Anaheim, CA, US
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THE ROLE

As a member of AMM's Compliance and Ethics team, the Compliance Coding Auditor is an important driver of our mission. They are responsible for supporting the Company's Compliance & Ethics Program (the Program) auditing, tracking, and monitoring initiatives. Robust auditing, testing, and monitoring capabilities are essential to fulfilling the expectations of AMM's key stakeholders, including patients and their families and government agencies, and AMM is committed to exceeding those expectations. The Program is led by AMM's CCEO, who reports to AMM's Chief Executive Officer and the AMM Board, and who oversees and manages the AMM Compliance Committee, consistent with industry best practices.

The Compliance Coding Auditor for the Auditing, Tracking, and Monitoring team is expected to exemplify the Company's culture and core values. This is a role that requires sound and risk-aware judgment, productive collaboration across the Company, and demonstrated success in performing audits to determine organizational integrity of billing and risk adjustment metrics, including : appropriate documentation, accurate coding and billing, and / or medical necessity of services billed.

ESSENTIAL DUTIES & RESPONSIBILITIES

The following description provides an overview of primary responsibilities for this position; it should not be interpreted as all-encompassing.

General Responsibilities

  • Ensures that the Manager is timely informed of all key findings of internal compliance tests and assessments, audits, and monitoring initiatives.
  • Undertakes to remain informed of relevant developments and trends in healthcare compliance and ethics by, among other things, attending seminars, reviewing professional journals, and actively participating in professional organizations, and leverages that insight and knowledge to enhance the Program.

Auditing, Testing, and Monitoring-Specific Responsibilities

  • Performs internal compliance department audits based on departmental planning to determine accuracy and adequacy of documentation and coding related to physician billed services based on supporting record documentation and ensures documentation by providers conforms to legal and procedural requirements.
  • Prepares written reports of audit findings, with recommendations, and presents to the Manager for review and presentation to appropriate stakeholders; maintains audit records.
  • Performs focused audits as needed in response to reported compliance and ethics concerns, with direction from the Manager of Auditing, Testing, and Monitoring.
  • Ensures that written evaluative reports of findings are developed for all initiatives undertaken.
  • In collaboration with the appropriate business unit leader, supports corrective action plans to address systemic issues or pervasive practices that could give rise to potential violations of applicable laws, regulations, or AMM's Code of Conduct and / or policies and procedures.
  • Other duties as assigned
  • EDUCATION & EXPERIENCE

  • Required five to ten years of relevant professional experience in healthcare, including coding and / or auditing roles. Experience auditing healthcare claims in a professional services firm and / or in-house at a large healthcare provider organization, health system, and / or payer.
  • An undergraduate degree; preference for Health Business or related field.
  • In lieu of an undergraduate degree, HS Diploma / GED and five (5) additional years of relevant experience will be considered
  • Required coding certification, preferred Certified Professional Coder (CPC) or Certified Risk Adjustment Coder (CRC), from the American Academy of Professional Coders (AAPC)
  • Required top-tier healthcare audit certification, preferred Certified Professional Medical Auditor (CPMA) from the American Academy of Professional Coders (AAPC) along with a fundamental understanding of regulatory framework and coding practices.
  • Fundamental understanding of government healthcare programs (i.e., Medicare and Medicaid).
  • Demonstrated ability to work effectively with key internal and external stakeholders.
  • PROFESSIONAL PROFILE

    Key Professional Skills

  • A demonstrated ability to cultivate working relationships with representatives from government agencies.
  • An ability to operate successfully in a flat culture, with the courage and competence to engage on multiple fronts and tackle challenges head-on.
  • An ability to prioritize effectively, and exercise sound judgment, in a fast-paced, physician-driven environment.
  • A demonstrated ability to accurately apply the necessary methodologies, professional standards, and government agency expectations for conducting healthcare auditing, testing, and monitoring activities.
  • Personal Characteristics

  • Exemplary integrity with courage and an unwavering ethical compass.
  • Pragmatic, risk-aware professional judgment.
  • Demonstrated tact, trustworthiness, and diplomacy skills needed to manage sensitive and confidential information such as protected health information.
  • An adept listener with a sense of humility.
  • Capable of earning the respect and confidence of colleagues through demonstrated professional excellence and expertise.
  • Prompt and efficient ability to manage shifting priorities, demands and timelines.
  • Ability to effectively prioritize and execute tasks in a fast-paced, dynamic environment.
  • AMM BENEFITS

    When you join AMM, you're not just getting a job—you're getting a benefits package that puts YOU first :

  • Health Coverage You Can Count On
  • Full employer-paid

    HMO and the option for a flexible PPO plan

  • Wellness Made Affordable
  • Discounted

    vision and dental premiums to help keep you healthy from head to toe.

  • Smart Spending FSAs to manage healthcare and dependent care costs, plus a 401(k) to secure your future.
  • Work-Life Balance
  • Generous

    PTO 40 hours of sick pay , and 13 paid holidays to enjoy life outside of work.

  • Career Development Tuition reimbursement to support your education and growth.
  • Team Fun Paid company outings and lunches because we work hard, but we also know how to have fun!