- LA Care Health Plan (Los Angeles, CA)
- Medical Review Nurse Coder RN III (Payment Integrity Nurse ) Job Category: Clinical Department: Managed Care Services Location: Los Angeles, CA, US, ... to achieve that purpose. Job Summary The Payment Integrity Nurse Coder RN III is responsible for...and reimbursement policies within the claim adjudication process through medical record review for Payment Integrity and… more
- Molina Healthcare (Long Beach, CA)
- …**Preferred License, Certification, Association** + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialists (CMAS) + Certified ... **JOB DESCRIPTION** **Job Summary** The **Delegation Oversight Nurse ** is responsible for ensuring that Molina Healthcare's UM delegates are compliant with all… more
- Elevance Health (Costa Mesa, CA)
- …Related Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs ... billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How...an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in… more