- Astrix Technology (Los Angeles, CA)
- ** Clinical Compliance Auditor ** Clinical Los Angeles, CA, US + Added - 04/04/2025 Apply for Job Pay Rate Low: 100000 | Pay Rate High: 150000 We're ... in the biotechnology industry, and they're on the lookout for a talented ** Clinical Compliance Auditor ** to join their dynamic team! If you're passionate… more
- Sharp HealthCare (San Diego, CA)
- …employer business practices. *This is a remote position* **What You Will Do** The Compliance Coding Auditor is responsible for the administration of the Sharp ... timeframe. **Essential Functions** + Coding ComplianceCompliance Coding and Billing AuditsThe Compliance Coding Auditor has the primary responsibility of… more
- LA Care Health Plan (Los Angeles, CA)
- …net required to achieve that purpose. Job Summary The Risk Adjustment Coding Auditor II position is responsible for auditing clinical documentation and coding ... Risk Adjustment Coding Auditor II Job Category: Accounting/Finance Department: Risk Adjustment...and compliance of coding assignments per the clinical documentation for the various risk adjustment models (Health… more
- Sharp HealthCare (San Diego, CA)
- …To support and facilitate the implementation of correct coding standards by clinical providers as established by SHC Corporate Compliance in accordance ... healthcare environment related to auditing of medical records and CMS compliance . - Required **Essential Functions** + AuditingParticipates in audit risk assessment… more
- Cedars-Sinai (Los Angeles, CA)
- …America's Best Hospitals. **What will I be doing in this role?** The Coding Auditor works under the general direction of the Coding Supervisor. A Coding Auditor ... opportunities, and other related encounter data collection points. Auditors evaluate compliance with all coding guidelines including but not limited to: Internal… more
- Spread Your Wings, LLC. (Garden Grove, CA)
- …assigned region. Primary functions will include assessing service delivery, documentation compliance , monitoring of client records, and serving as the representative ... regulations and familiarity with developmental disabilities services is a plus. Compliance & Enforcement: Responsible for conducting monthly and quarterly audit… more
- UCLA Health (Los Angeles, CA)
- …next level. You can do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned to the ... auditor . You will review claims (paid, pending, and denied)...services, contract interpretation, Division of Financial Responsibility (DOFR), and application/ compliance with policies and procedures. You will: + Research… more
- Molina Healthcare (San Diego, CA)
- JOB DESCRIPTION Job Summary The Non- Clinical Auditor is responsible for conducting detailed audits of member service interactions, including call recordings and ... documentation, to assess accuracy, completeness, and compliance . This role ensures adherence to regulatory and organizational standards by monitoring for … more
- Providence (Torrance, CA)
- **Description** The Revenue Cycle Auditor is responsible for providing patient focused, standardized, compliant revenue cycle support that will assist Providence St ... objectives. - Conduct audits (individual chart/bill audits, focus audits, compliance audits, payer defense audits, patient requests for audit...Or + Bachelor's Degree Nursing. Or + 5 years Clinical experience in an acute care setting. + 3… more
- Molina Healthcare (Long Beach, CA)
- JOB DESCRIPTION Job SummaryProvides support for non- clinical healthcare services auditing activities. Responsible for performing audits for non- clinical ... functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide… more
- University of Southern California (Alhambra, CA)
- …Specialist also coordinates with Keck Medical Center of USC Administration, IS, Compliance , Clinical Informatics and Integration personnel on technology projects ... As the center of clinical charge capture, the Revenue Integrity (RI) Specialist...As a subject matter expert in the area of compliance and pricing of services, the Senior RI Specialist… more
- Merck (Sacramento, CA)
- …line to ensure appropriate quality oversight of assigned studies. + Assesses compliance of clinical investigator sites, vendors, study activities, clinical ... of individuals. EligibleforERP **Required Skills:** Accountability, Accountability, Adaptability, Audits Compliance , Business Processes, Clinical Documentation, Clinical… more
- CVS Health (Sacramento, CA)
- …to Eastern and Central time zones._ **Job Summary:** The NCQA Accreditation Auditor is responsible for evaluating healthcare organizations' compliance with NCQA ... well as external customers to ensure readiness for NCQA accreditation reviews. The auditor plays a critical role in maintaining quality standards and regulatory … more
- Cardinal Health (Sacramento, CA)
- …customized solutions for hospitals, healthcare systems, pharmacies, ambulatory surgery centers, clinical laboratories, physician offices and patients in the home. We ... as well as completes risk assessments. The **IT Governance and Compliance ** function within the organization develops, enhances, and maintains security policies… more
- The County of Los Angeles (Los Angeles, CA)
- …in nearly every medical specialty and subspecialty. In addition to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the ... responsible for implementing these policies and procedures to ensure compliance . Discusses accounting systems studies and findings with departmental personnel.… more
- Stanford Health Care (Palo Alto, CA)
- …within the Controller's Office, responsible for overseeing the organization's compliance reporting and non-patient services reimbursement activities. This role ... the organization's responses to government audits and inquiries, ensuring full compliance and clear communication with regulatory agencies. The role also ensures… more
- Datavant (Sacramento, CA)
- …addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, ... you to help shape the future of healthcare from your own workspace! Inpatient auditor with 3-5 years of experience at a Trauma Level 1 facility. SMART software… more
- Gilead Sciences, Inc. (Foster City, CA)
- …interface extensively with internal stakeholders to address and resolve quality and compliance issues related to drug-device combination products. + Identify gaps in ... comply with FDA QSR/QMSR, ISO 13485, and other applicable standards. + Maintain compliance with global Risk Management processes in accordance with ISO 14971 and… more
- University of Southern California (Los Angeles, CA)
- …preparation and audits. The analyst works collaboratively with finance, revenue cycle, compliance , and clinical teams to maintain proper reimbursement under ... reporting and reimbursement, focusing on tasks such as preparing and ensuring compliance with the Medicare Cost Report (MCR) and related Medicaid Cost Reports.… more
- Humana (Sacramento, CA)
- …the QSI Data Quality/Integrity Lead will leverage their expertise in clinical /healthcare data, data exploration, collaboration, and leadership to guide the daily ... the data procured digitally and manually. + Support STARs Clinical Team to gather data for pilots and Humana...and functionality. + Partner with internal HEDIS operations and compliance teams on the maintenance of policies, processes, and… more