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Certified Coding Specialist Sr (HCC-Medicare and Medi-Cal) CalOptima CalOptima Health is seeking a highly motivated Certified Coding Specialist Sr (HCC-Medicare and Medi-Cal) to join our team. The Certified Coding Specialist Sr (HCC-Medicare and Medi-Cal) will be responsible for assisting with all Hierarchical Condition Categories (HCC) projects and Medi-Cal Annual Wellness Visit Initiative Program. The incumbent will handle risk adjustment-related activities to ensure the Centers for Medicare &amp; Medicaid Services (CMS) and Department of Health Care Services (DHCS) coding and documentation guidelines are met. The incumbent will assist in improving risk score performance through collaboration with CalOptima Health's health networks, contracted providers and Program of All-Inclusive Care for the Elderly (PACE) providers. The incumbent will substantiate and verify the member's medical records using International Classification of Diseases (ICD)-10 Clinical Modification (CM) official guidelines for coding and reporting during the review process. The incumbent will verify the accuracy, completeness and appropriateness of diagnosis codes based on the medical documentation provided. As part of the medical records review, travel may be required to physician offices or physician medical groups throughout Orange County. Position Information: 
<ul>
<li>Department: Financial Analysis </li>
<li>Salary Grade: 309 - $68,015 - $108,824 ($32.70 - $52.3192) </li>
<li>Work Arrangement: Full Telework **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>80% - Program Support
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Reviews and assesses the accuracy, completeness, specificity and appropriateness of diagnosis codes based on documentation and creates tools/tip sheets for audit staff to utilize for future audits based on findings.</li>
<li>Conducts in depth retrospective and prospective medical record audits to assess the accuracy of ICD-10 CM coding for chronic conditions as it pertains to HCC for CalOptima Health Community Network (CHCN), PACE providers and delegated health networks.</li>
<li>Tracks all network HCC activities, including training, audit results and evaluating future outcomes, which includes monitoring performance improvement of network providers by observing patterns and trends and recommending solutions to the manager.</li>
<li>Reviews medical record information to identify all appropriate coding CMS HCC categories and DHCS coding and monitors the DHCS and CMS websites for updates.</li>
<li>Reviews additional data identified from audits to ensure timely data entry for CMS sweeps.</li>
<li>Identifies providers for education and training opportunities following ICD-10-CM coding guidelines based on HCC audit results and Medi-Cal Annual Wellness Visit Initiative Program and reports findings to the Manager.</li>
<li>Assists with CMS Risk Adjustment Data Validation (RADV) and Office of Inspector General (OIG) audits, including workflow or data collection requirements and creating and maintaining HCC audit results when applicable.</li>
<li>Performs code abstraction on supported clinical documentation identified as opportunities through Natural Language Processing (NLP) software. </li>
</ul>
</li>
<li>15% - Administrative Support
<ul>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Assists manager in evaluating existing reports for PACE members provided by CMS and collaborates with Financial Analysis to create any custom report required to assist with audits. </li>
</ul>
</li>
<li>5% - Other-
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Minimum Qualifications: 
<ul>
<li>Bachelor's degree in public health, business administration or related field PLUS 5 years of risk adjustment coding and chart audit/quality experience in a managed care or health care environment required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying. </li>
<li>Have access to means of transportation for work away from the primary office approximately 20% of the time required.</li>
</ul>
 Preferred Qualifications: 
<ul>
<li>Registered Health Information Technician (RHIT) or Certified Risk Adjustment Coder (CRC). </li>
<li>Experience with conducting presentations and performing physician education.</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>Current Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) by the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) required. Certification is required to be current and maintained during employment.</li>
</ul>
 Knowledge &amp; Abilities: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6299515&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is June 26, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6299515" target="_blank">https://jobs.caloptima.org/jobs/certified-coding-specialist-sr-hcc-medicare-and-medi-cal-505-city-parkway-west-california-united-states</a> Copyright ©2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-d4deeaad9bc4a74cb61631e4900eb19a

Certified Coding Specialist Sr (HCC-Medicare and Medi-Cal)

<h3>Job Description</h3>
Job Description
QualDerm Partners is seeking a dedicated Medical Assistant to join our dynamic team in Centerville, OH. At QualDerm Partners, we’re committed to being the nation’s premier source for comprehensive skin and aesthetics wellness. Our mission is to support patients’ lifetime wellness journeys with unmatched care across dermatology, skin cancer treatment, cosmetics, and plastic surgery. 
As a Medical Assistant, you will play a vital role in providing exceptional patient care, contributing to our commitment to excellence, and being a part of a talented team dedicated to creating a standout patient experience. If you are passionate about skin and aesthetics wellness and are eager to work in a supportive and collaborative environment, this is the opportunity for you. Your contributions will directly influence the lives of our patients, ensuring they receive the highest quality of care as they navigate their wellness journeys. Join us in making a difference in the lives of our patients as we continue to expand our footprint in the hospital and healthcare industry, elevating the standard of care in our communities.
Responsibilities
<ul>
<li>Prepare patients for examination by taking vital signs and recording medical history.</li>
<li>Assist the physician during examinations and procedures, ensuring all necessary instruments are available.</li>
<li>Perform basic laboratory tests and prepare specimens for laboratory analysis.</li>
<li>Maintain patient records, ensuring accuracy and confidentiality at all times.</li>
<li>Schedule patient appointments and manage office communications.</li>
<li>Educate patients on treatment plans, medications, and proper skincare practices.</li>
<li>Ensure the examination rooms are clean, organized, and fully stocked with supplies.</li>
</ul>
Requirements
<ul>
<li>High school diploma or equivalent; certification as a Medical Assistant preferred.</li>
<li>Proven experience as a Medical Assistant or similar role in a clinical setting.</li>
<li>Knowledge of medical terminology and practices relevant to dermatology.</li>
<li>Strong communication skills, both verbal and written, to interact with patients and staff effectively.</li>
<li>Ability to handle sensitive information with discretion and maintain patient confidentiality.</li>
<li>Excellent organizational skills with attention to detail in a fast-paced environment.</li>
<li>Basic proficiency in using electronic health records (EHR) systems and general office software.</li>
</ul>
Benefits
Benefits of joining Qualderm Partners:
<ul>
<li>Competitive Pay – Attractive compensation to reward your hard work</li>
<li>Comprehensive Health Coverage – Includes Medical, Dental, and Vision plans to keep you covered</li>
<li>Generous 401(k) Plan – Company matches 100% of the first 3%, plus 50% of the next 2%, with immediate vesting</li>
<li>Paid Time Off (PTO) – Accrue PTO from day one, plus enjoy 6 paid holidays and 2 floating holidays each year</li>
<li>Company-Paid Life Insurance – Peace of mind with basic life coverage, with the option for additional plans</li>
<li>Disability Protection – Short-term and long-term disability coverage to protect you in unexpected circumstances</li>
<li>Additional Wellness Plans – Accident, critical illness, and identity theft protection plans for extra security</li>
<li>Employee Assistance Program (EAP) – Access confidential support for personal or work-related challenges</li>
<li>Exclusive Employee Discounts – Save on products and services with special discounts just for you</li>
<li>Referral Bonus Program – Earn bonuses by referring qualified candidates to join the team</li>
</ul>
QualDerm Partners is proud to be an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Applicants must be currently authorized to work in the United States in a full-time basis.

Medical Assistant

<h3>Job Description</h3>
Job Description
Position Type:Full-time, exempt
Compensation: Up to $165,000 annually 
Job Location: In person
Job Highlights
<ul>
<li>6-Hour Shifts Daily: Short, balanced workdays.</li>
<li>Flexible Schedules: Work around your life.</li>
<li>No On-Call: Free weekends</li>
<li>No Overnight Requirements</li>
<li>Supportive Community: Access to physician/provider network.</li>
<li>Effortless documentation: Conversational and Dragon dictation.</li>
<li>Meaningful Connections: Establish lasting relationships with patients and staff.</li>
<li>Paid Time Off! No holidays!</li>
<li>Culture of Appreciation: Your work is valued and rewarded.</li>
<li>$1,500 CME and Conference Allowance: Invest in your growth.</li>
<li>Full Gear: iPad with LTE, Apple Pen, AirPods provided.</li>
<li>Licensure Reimbursed: We cover your medical licensure costs.</li>
<li>Malpractice &amp; Tail Covered: Full insurance peace of mind.</li>
<li>Benefits: 401k match, Medical/Dental/Vision, Disability, Employer-paid Life Insurance.</li>
<li>Relocation Help: Assistance for a smooth move.</li>
<li>Referral Bonus: Earn more by expanding our team.</li>
<li>Travel Reimbursed: Gas and mileage for work travel.</li>
<li>Career Advancement: Leadership opportunities promoted.</li>
<li>UpToDate Subscription: Latest medical info at your fingertips.</li>
</ul>
Essential Functions &amp; Responsibilities
<ul>
<li>Provider is responsible for rounding and managing the clinical care of the population at the assigned SNF. </li>
<li>The provider is responsible for rounding daily and prescribing medications and treatments for residents residing at SNFs. </li>
<li>Provider will provide high quality, patient-centered, comprehensive primary care services to patients residing in SNFs. </li>
<li>Provider is responsible for timely documentation of all patient care/encounters </li>
<li>The provider will be available for phone/secure messaging consultations with facility nursing staff.</li>
<li>Provider documentation is completed in Theoria's proprietary electronic health record (EHR) system, ChartEasy™. </li>
<li>PointClickCare, MatrixCare, and American HealthTech are the most commonly used facility EHR systems. </li>
<li>Provider is expected to be on-site on and on time for their in-person scheduled shifts. </li>
<li>Timely attendance is imperative.</li>
<li>Reliable transportation required.</li>
</ul>
Company Overview
Leading the charge in healthcare innovation, Theoria Medical offers a unique blend of medical excellence and technological advancement, primarily serving the post-acute and primary care sectors. Our extensive network includes multispecialty physician services and RPM, covering skilled nursing facilities across the country. In our national push for expansion, we're scouting for the brightest nurse practitioners and physicians eager to drive change and deliver superior care. Join us for a rewarding career that promises professional growth, flexibility, and the chance to shape the future of healthcare.
Shift Structure
<ul>
<li>Rounding time is 7AM-1PM local time, during which the provider must be available to nursing staff and address acute/emergent issues that arise. </li>
<li>Shifts begin around 7AM local time with flexibility within reason.</li>
<li>Shifts are daily Monday-Friday </li>
<li>Charting/documentation can be completed off-site. </li>
<li>This is an in-person position.</li>
</ul>
Compensation and Benefits
<ul>
<li>Salary based with monthly productivity bonuses. </li>
<li>Paid Time Off.</li>
<li>401k with employer matching and participation</li>
<li>Medical, vision, and dental insurance</li>
<li>Short term and Long term disability insurance.</li>
<li>$1,500 CME allowance.</li>
<li>Malpractice insurance covered by employer.</li>
<li>Medical licensure expenses reimbursed by employer.</li>
<li>Opportunities for training</li>
<li>All equipment and practice expenses covered.</li>
<li>Employer Paid - Life Insurance Policy</li>
</ul>
Employee must be able to perform the essential functions of this position satisfactorily, with or without a reasonable accommodation. Employer retains the right to change or assign other duties to this position. All benefits and job highlights are subject to and contingent upon availability. 
#LI-JT1 #LI-Onsite #IND-REFRESH-MULTI

Physician Assistant

<h3>Job Description</h3>
Job Description
We are seeking a Laboratory Assistant to join our team! You will be responsible for performing medical tests for the diagnosis, treatment, and prevention of diseases.
Responsibilities:
<ul>
<li>Prepare samples for routine testing and analysis</li>
<li>Properly record results for further analysis and easy reference</li>
<li>Monitor inventory samples and supplies</li>
<li>Maintain a clean work environment</li>
</ul>
Qualifications:
<ul>
<li>Strong organizational skills</li>
</ul>
Company DescriptionBROWARD MEDICAL LAB IS AN ANATOMIC PATHOLOGY LAB LOCATED NEAR THE FORT LAUDERDALE AREA. 
<h3>Company Description</h3>
BROWARD MEDICAL LAB \r\n IS AN ANATOMIC PATHOLOGY LAB LOCATED NEAR THE FORT LAUDERDALE AREA.

Laboratory Assistant

<h3>Job Description</h3>
Build your practice, your way
\n
Ready to grow your practice? Spring Health is hiring part-time, experienced therapists who:
\n
• Offer in-office care with the flexibility to take appointments virtually
\n
• Deliver high-quality, evidence-based care
\n
• Hold active licenses with 3+ years of experience
\n
Bring your expertise,
\n
we'll take care of the rest.
\n
Partner with a mental health company that prioritizes your experience so you can focus on what matters most—caring for your patients. Just like it should be.
\n
Flexible schedule
\n
Create a schedule that works for you. Decide how, when, and where you deliver care.
\n
Compatible patient matches
\n
Leave the marketing to us. We'll connect you with patients that match your skills and specialties.
\n
Performance incentives
\n
We value your expertise, offering pay based on your experience, specialties, and location—with incentives tied to care quality.
\n
Administrative ease
\n
Say goodbye to the hassle of billing and documentation—our streamlined systems make it easier to focus on patient care.
\n
Reliable support
\n
Get backed by a team of professionals who are ready to help you when challenges arise.
\n
A thriving community
\n
Join a collaborative network offering peer support, consultations, resources, and continuing education to enhance your practice. 
\n
Partner of choice for providers
\n
Experience the support and recognition that keeps our providers returning year after year.
\n
Nearly 20% of our top-performing therapists are rewarded based on outcomes they deliver.
\n
Nearly 95% of members stay with their provider.
\n
Providers onboard and start seeing patients in as little as 14 days.

Part Time - Mental Health Therapist - Spring Health

<h3>Job Description</h3>
Host Healthcare is seeking a local contract nurse RN CVOR for a local contract nursing job in Grosse Pointe Woods, Michigan.
Job Description &amp; Requirements
<ul>
<li>Specialty: CVOR</li>
<li>Discipline: RN</li>
<li>Start Date: 08/05/2025</li>
<li>Duration: 13 weeks</li>
<li>40 hours per week</li>
<li>Shift: 8 hours, days</li>
<li>Employment Type: Local Contract</li>
</ul>
Host Healthcare is an award-winning travel healthcare company with an immediate opening for this Registered Nurse - Operating Room in Grosse Pointe Woods, MI. If you are interested in this position, please contact your recruiter and reference Job #2080770\n \nWhy choose Host Healthcare?\n \nBecause a great Host provides a worry-free travel experience and always puts your needs first. Our passionate and transparent team members have made Host Healthcare the #1 ranked Travel Healthcare company in the U.S. Our recruiters act not only as your dedicated travel career mentor but also as your #1 advocate. When you work with us, you can trust that we will help you with everything from travel, to housing, and acting as a liaison between you and the facility. We’ve got your back!\n \nTravel Happy With Host Healthcare\n \n
<ul>\n
<li>We offer the best pay for our travelers</li>
\n
<li>Day one medical, dental, and vision insurance</li>
\n
<li>License, travel, tuition, and scrub reimbursement</li>
\n
<li>Matching 401k</li>
\n
<li>Deluxe private housing or generous housing stipend</li>
\n
<li>Discounts to your favorite activities, restaurants, health &amp; beauty brands, shopping and hotels</li>
\n</ul>
\n
Host Healthcare Job ID #La1fVJ000006OO7NYAW. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN -CVOR
About Host Healthcare
At Host Healthcare, we provide a truly comfortable experience as you explore your travel nursing, therapy, or allied career. We make your travel healthcare journey easy by taking care of all the details, so you don’t have to.
We are on a mission to help others live better and we do this by helping the healers of the world be as comfortable as possible. With access to tens of thousands of travel nursing, therapy, and allied jobs in all 50 states, our responsive and friendly recruiters find your dream position based on what’s important to you.
During your assignment, get access to premium benefits, including Day 1 medical that continues up to 30 days between assignments, 401K matching, travel reimbursements, dedicated housing support, and more. We also offer 24/7 support from our team and access to our on-staff clinicians so you can feel comfortable and confident throughout your entire assignment.
Travel comfortably with Host Healthcare.
Benefits
<ul>
<li>Referral bonus</li>
<li>School loan reimbursement</li>
<li>Vision benefits</li>
<li>Wellness and fitness programs</li>
<li>Company provided housing options</li>
<li>License and certification reimbursement</li>
<li>Life insurance</li>
<li>Medical benefits</li>
<li>Mileage reimbursement</li>
<li>Pet insurance</li>
<li>Discount program</li>
<li>Employee assistance programs</li>
<li>Guaranteed Hours</li>
<li>Health savings account</li>
<li>Holiday Pay</li>
<li>401k retirement plan</li>
<li>Continuing Education</li>
<li>Dental benefits</li>
</ul>

39,215 Healthcare Jobs in California