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Job Description The Onsite Medical Coder is responsible for reviewing clinical documentation and assigning accurate diagnosis and procedure codes for inpatient and outpatient services in compliance with coding guidelines and regulatory requirements. This role also supports coding workflow management, coordination with outsourced coding partners, revenue cycle teams, and clinical staff to ensure accurate and timely coding across all three facilities. Qualifications Certified Coding Specialist (CCS), RHIT, RHIA, CPC, or equivalent preferred. Experience coding inpatient and outpatient hospital records. Strong knowledge of ICD-10-CM, ICD-10-PCS, and CPT coding guidelines. Experience working with electronic medical records and coding workflows. Strong attention to detail, analytical skills, and ability to communicate with clinical and administrative teams. Key Responsibilities Medical Coding: Code inpatient, outpatient, physical therapy, and same-day surgery records according to coding guidelines. Documentation Review: Ensure required documentation (e.g., pathology reports, H&P, discharge details) is complete before accounts are sent for coding. Account Management: Manage SDS and inpatient accounts, place holds when documentation is missing, and transfer accounts to coding once complete. Revenue Cycle Support: Review coding-related payor denials, identify missed procedures, and assist the Business Office with coding issues affecting reimbursement. Coordination with Coders: Support outsourced coding teams by answering questions, clarifying diagnoses, and maintaining tracking logs. Query Resolution: Review and resolve coding queries or escalate to physicians when documentation clarification is needed. Quality & Compliance: Monitor coding accuracy, track errors, and ensure compliance with regulations and facility policies. Education & Collaboration: Educate clinical staff on documentation requirements and collaborate with HIM, Case Management, and Revenue Cycle teams. Work Environment Onsite position at College Medical Center. Provides coding and workflow support for all three affiliated facilities. Pay Rate: $30.46-$38.07 per hour

Job DescriptionDescription: Inpatient Facility Coder – Future Opportunities (Talent Pool) Remote GeBBS Healthcare Solutions, an industry leader in Health Information Management (HIM) and Revenue Cycle Management (RCM) solutions, is building a talent pool of highly motivated Inpatient Facility Coders for future, upcoming opportunities. This posting is to connect with experienced coding professionals who have a passion for excellence and collaboration and would like to be considered as new projects and roles become available. These future roles are anticipated to be full and part-time, remote W-2 positions with flexible schedules. In upcoming opportunities, coders may be responsible for medical coding for one of our facility clients, including reviewing charts, assigning appropriate diagnosis and procedure codes, and ensuring high-quality standards are consistently met. The Inpatient Coder typically assigns diagnostic and procedural codes to patient charts using ICD-10-CM, ICD-10-PCS, or other designated coding classification systems in accordance with coding rules and regulations, and abstracts required clinical information. Requirements: Typical Requirements for Future Roles • RHIA, RHIT, or CCS certification through AHIMA required, • Minimum of 3 years of recent inpatient facility coding experience, • Ability to maintain standard industry productivity rates for inpatient coding, • Demonstrated ability to maintain high quality standards of 95% or greater, • Proficient with technology (computer, VPN, MS Office, coding software), • Strong verbal and written communication skills, • Must have ICD-10 coding experience and have completed an ICD-10 course, • Experience with trauma and highly complex cases preferred Why Join Our Talent Pool? By applying, you’ll be considered for future inpatient coding opportunities with GeBBS as new client needs and projects arise. Our recruiting team may reach out to discuss upcoming roles that align with your background and interests.

Job Description Are you in search of a fulfilling and meaningful position? Do you want to work for an organization that promotes growth and development? Here at Men's Health Foundation we envision a world where inequity and stigma do not separate people from healthcare. "Reimagining Healthcare" is our commitment to affirming the unique experience of every patient. We prioritize our patients’ evolving needs and strive to help each patient feel comfortable, understood, and respected. Why Men's Health Foundation? Men's Health Foundation is seeking compassionate, mission-driven individuals. We believe that by reimagining how healthcare is delivered, we can help create greater health equity for those most at risk, breaking down barriers to care. We welcome all backgrounds, gender identities, and expressions. We recognize our staff as the heart of our organization and seek to provide a generous and competitive benefits package to support our employee's well-being. We offer the following: • Medical, Dental, Vision, Life and LTD insurance (may be eligible on the 1st of the month following date of hire), • 12 Paid Holidays (including 1 mental health day), • 401(k) Retirement plan (may be eligible for employer matching up to 4% following completion of 90th day of employment), • Flexible Spending Account (FSA), • 40 hours of sick pay (following completion of 90th day of employment), • 120 hours of PTO accrued within the 1st year of employment We seek team members who embrace and champion diversity, as our work within the LGBTQ+ community promotes positive sexuality and inclusivity. Candidates should be comfortable with exposure to imagery, events, and materials that reflect our culture of acceptance and expression, ensuring alignment with our values. Organization Background Men’s Health Foundation connects men at risk to comprehensive healthcare and wellness through education, collaboration and advocacy, inspiring and empowering all men to live longer, healthier and happier lives. We see a world where inequity and stigma do not separate men from healthcare. At Men’s Health Foundation we are reimagining men’s healthcare. Job DescriptionOverview We are seeking a detail-oriented and experienced Certified Medical Coder & Biller to join our team. The ideal candidate will have 2–4 years of hands-on medical coding and billing experience, with a strong understanding of CPT and ICD-10 coding guidelines. This individual must be a self-starter who can work independently with minimal supervision while maintaining accuracy and compliance with all regulatory requirements, including government payer guidelines. Essential Functions and Responsibilities • Review and accurately assign CPT, ICD-10, and HCPCS codes to medical procedures and diagnoses., • Ensure coding accuracy and compliance with federal, state, and payer-specific regulations, including Medicare and Medi-Cal guidelines., • Submit claims to insurance carriers, including government payers, in a timely and accurate manner., • Apply proper coding rules specific to Medicare and Medi-Cal claims, including NCCI edits and medical necessity requirements., • Review and resolve claim edits, rejections, and denials, with a strong focus on government payer denials., • Perform corrections and rebill claims as necessary., • Verify documentation supports billed services and coding selections., • Work closely with providers and clinical staff to clarify diagnoses and procedures., • Maintain detailed and compliant documentation within the billing system., • Monitor accounts receivable and follow up on outstanding claims as needed., • Stay up to date with coding updates, payer policies, including CMS and Medi-Cal regulations. Qualifications Required Certification • Certified Professional Coder (CPC) through AAPC, • OR equivalent certification (e.g., CCS, CCA), • Candidates with an expired certification number, but with a minimum of three years of relevant coding experience may be considered. Experience • 2–4 years of medical coding and billing experience required., • Proven experience with CPT, ICD-10, and HCPCS coding., • Hands-on experience billing and coding for Medicare and Medi-Cal claims, including understanding of payer-specific rules and reimbursement structures., • Experience working claim edits, denials, and payer follow-up. Technical Skills • Experience with EHR/EMR systems; familiarity with Allscripts is a plus., • Strong knowledge of billing workflows and revenue cycle processes., • Proficient in Microsoft Office, especially Excel. Skills and Abilities • Strong attention to detail and accuracy., • Ability to work independently with minimal supervision., • Excellent problem-solving and analytical skills., • Strong organizational and time management abilities., • Effective communication skills, both written and verbal., • Ability to manage productivity and meet daily/weekly coding and billing targets., • Maintain compliance with HIPAA and company policies., • Collaborate with cross-functional teams while maintaining accountability for individual workload. Company Requirements • Must be able to pass a pre-employment drug test, physical, and a background check to include a 7-year criminal, 10-year SSN & employer history reference check., • Must be able to provide proof of COVID-19 vaccination on the first day of work., • Excellent interpersonal skills., • Attention to detail., • Must be able to work flexible schedules., • Must take yearly flu shot or wear flu mask during flu season for patient-facing positions and test for tuberculosis as required by the Centers for Disease Control and Prevention.

Job DescriptionDescription: GeBBS Healthcare Solutions is a leader in Health Information Management (HIM) and Revenue Cycle Management (RCM). We are committed to fostering a culture of excellence, integrity, and collaboration within the healthcare industry. We are building a talent pool of credentialed Outpatient Facility Coding Specialists for upcoming and future opportunities. While we may not have an immediate opening, we regularly partner with large health systems and Level I Trauma facilities and anticipate continued growth in this space. If you have strong outpatient facility coding experience and are interested in being considered for future roles, we encourage you to apply. Position Overview As an Outpatient Facility Coding Specialist, you would be responsible for coding diseases, operations, and procedures for outpatient encounters in accordance with ICD-10-CM, UHDDS, and AMA CPT-4 standards. Opportunities may support large, complex health systems, including Level I Trauma facilities. Potential Responsibilities • Code outpatient procedures according to client-specific guidelines, • Abstract patient data with accuracy and compliance, • Stay current on coding policies and regulatory updates, • Utilize healthcare abstracting software and ICD-10 data sets, • Initiate physician queries per client protocols, • Communicate regulatory or compliance changes to leadershipRequirements: Preferred Qualifications • Credentialed medical coder with 3+ years of experience, • AHIMA credential preferred; AAPC credentials considered, • Experience in facility OP & ED coding within large Level I Trauma facilities (SDS, OBS, ED; IR/Cath preferred), • Strong attention to detail and commitment to accuracy, • US-based candidates Additional Information By applying to this talent pool, you will be considered as upcoming opportunities become available that align with your skills and experience. We look forward to connecting with experienced outpatient facility coders who are interested in growing with GeBBS Healthcare Solutions.

Job Description On-Site/In-Person | Woodland Hills, CA | Full-Time | M-F 8:00 a.m. - 5:00 p.m. The Pre‑Billing Specialist II is responsible for advanced pre-claim review, validation, and issue resolution to ensure accurate, compliant, and clean claim submission for laboratory services. This role requires strong knowledge of laboratory billing workflows, payer policies, and medical necessity requirements. The position plays a key role in denial prevention by proactively identifying and resolving complex issues related to coding, eligibility, and documentation prior to claim submission. Key Responsibilities Advanced Pre-Billing Review & Claim Preparation • Perform comprehensive pre-bill review of laboratory claims to ensure accuracy, completeness, and compliance prior to submission, • Validate complex patient demographics, insurance coverage, and ordering provider information, • Identify trends and recurring issues impacting claim quality and first-pass acceptance Medical Necessity & Coding Validation • Evaluate diagnosis-to-procedure code alignment using payer-specific guidelines, including Medicare LCD/NCD policies, • Review and validate CPT/HCPCS coding for laboratory services, including specialty and high-complexity testing, • Identify potential medical necessity denials and ensure appropriate documentation or ABN workflows are applied Pre-Bill Edits & Issue Resolution • Independently resolve complex claim edits and exceptions within billing systems and clearinghouse tools, • Research and troubleshoot discrepancies related to eligibility, authorizations, coding, or charge capture, • Escalate systemic issues and recommend process improvements Charge Integrity & Revenue Accuracy • Review charge capture processes to ensure alignment between performed tests and billed services, • Support revenue integrity by identifying underbilling, overbilling, or missed charges, • Partner with coding and compliance teams on billing accuracy and audit readiness Workflow Optimization & Quality Assurance • Monitor and prioritize work queues to meet turnaround time and productivity standards, • Conduct quality checks and provide feedback to entry-level staff, • Assist in developing and refining standard operating procedures (SOPs) Collaboration & Cross-Functional Support • Work closely with accessioning, coding, billing, and client services teams to resolve pre-bill issues, • Serve as a subject matter expert (SME) for pre-billing processes and payer requirements, • Support training and onboarding of new team members Required Qualifications • High school diploma or equivalent (Associate or Bachelor’s degree preferred), • 2–5+ years of experience in medical billing, revenue cycle, or laboratory billing, • Strong understanding of:, • CPT/HCPCS and ICD-10 coding, • Insurance eligibility and coverage rules, • Medical necessity requirements (especially lab-specific), • Experience working with billing systems, LIS, EMR, or clearinghouse tools, • Ability to analyze and resolve complex billing issues independently Preferred Qualifications • Laboratory billing or diagnostic services experience (e.g., pathology, genetic testing, reference labs), • Experience with Medicare/Medicaid billing rules and payer-specific policies, • Familiarity with Epic (Beaker), Cerner, or comparable systems, • Certification (preferred but not required):, • CPC (Certified Professional Coder), • CPB (Certified Professional Biller) Core Competencies • Advanced analytical and problem-solving skills, • Deep attention to detail and accuracy, • Strong understanding of revenue cycle workflows, • Ability to prioritize in a high-volume environment, • Leadership mindset with mentoring capability

Job Description FQHC Billing Account Manager - Santa Fe Springs, CA Compensation: $28 - $30 per hour Nexus HR is seeking an experienced RCM Billing Account Manager. The ideal candidate will have a strong background in FQHC medical billing, revenue cycle management, and coding compliance. This role requires deep knowledge of payer regulations and reimbursement models, as well as leadership experience managing billing teams. Strong communication, analytical, and organizational skills are essential for success in this position. About the Job The RCM Billing Account Manager is responsible for overseeing all aspects of Revenue Cycle Management (RCM), including billing operations, coding compliance, claims submission, denial management, and reimbursement optimization for FQHC clients. The role involves managing assigned accounts, supervising billing teams, and reporting directly to the RCM Division Manager. The schedule is Monday through Friday, 8:30 AM to 4:30 PM Pacific Standard Time and will work on-site at the client's office as a representative. Duties and Responsibilities: Oversee end-to-end billing and RCM operations for assigned FQHC accounts Communicate with clients and respond to inquiries within one business day Serve as a trusted advisor on FQHC billing rules, UDS reporting, wraparound payments, PPS/APM reimbursement models, sliding fee schedules, and Medicaid/Medicare billing Monitor key RCM metrics such as clean claim rate, days in A/R, denial trends, and collection performance Conduct monthly or quarterly business reviews (QBRs) with clients Collaborate with internal billing teams and clearinghouses to ensure accurate claims submission, payment posting, and denial resolution Ensure compliance with HRSA, CMS, and payer-specific billing guidelines Maintain knowledge of state Medicaid programs and managed care plans Create dashboards and KPI reports to track AR aging, charge lag, clean claim rate, and payment trends Lead and manage billing staff, set goals, delegate tasks,monitor performance and training Ensure accurate and compliant coding practices following CPT, ICD-10, and HCPCS guidelines Develop transition plans for team changes and support onboarding of new clients/projects Qualifications: Minimum of 3 years of FQHC medical billing experience and 3 years of management experience Associate’s or Bachelor’s degree preferred (or equivalent experience) CPC (Certified Professional Coder) required Strong leadership, client communication, KPI reporting, and RCM process optimization skills Extensive knowledge of FQHC billing regulations, Medicaid/Medicare billing, PPS/APM reimbursement models, HRSA, and CMS guidelines English proficiency required Must be authorized to work in the United States Benefits: 401(k) Medical Insurance Dental Insurance Vision Insurance Paid Time Off (PTO)

Job Description MAJOR RESPONSIBILITIES/ESSENTIAL FUNCTIONS The Revenue Integrity Analyst is responsible for supporting the hospital’s revenue cycle by ensuring accurate charge capture, compliant billing practices, and optimal reimbursement. This role analyzes clinical and financial data to identify revenue leakage, resolve billing discrepancies, and ensure adherence to regulatory and payer requirements within an acute care hospital environment. The analyst collaborates with clinical departments, coding, patient financial services, and compliance teams to maintain revenue integrity across all service lines. Key Responsibilities: • Monitor and analyze charge capture processes to identify missing, incorrect, or duplicate charges., • Conduct revenue integrity audits across hospital departments including inpatient, outpatient, and ancillary services., • Collaborate with coding, HIM, and patient financial services teams to ensure accurate coding and billing compliance., • Analyze payer policies and regulatory requirements to ensure compliance with federal and state guidelines., • Participate in process improvement initiatives to enhance revenue cycle efficiency and reduce revenue leakage, • Provide education and guidance to clinical and operational staff regarding proper charge capture and documentation., • CDM maintenance and governance, including adding, revising, and retiring charge codes, • Charge capture review and reconciliation to ensure services are billed appropriately, • Compliance monitoring related to CPT/HCPCS coding, payer guidelines, and regulatory requirements, • Pricing validation and updates within the Charge Description Master, • Coordination with departments to ensure accurate charge mapping and revenue capture, • Charge audits and variance analysis to identify revenue leakage or compliance risks, • Strong knowledge of medical terminology, coding guidelines, NCCI edits, and billing regulations., • Strong communication and interpersonal skills, with the ability to work collaboratively with clinical and administrative staff., • Ability to prioritize tasks and manage time effectively in a fast-paced environment., • Performs other job related duties as assigned. JOB QUALIFICATIONS Minimum Education (Indicate minimum education or degree required.) • Bachelor’s Degree in Healthcare Administration, Health Information Management, Finance, Business Administration, or a related field Preferred Education (Indicate preferred education or degree required.) • Master’s degree in Healthcare Administration, Business Administration, or related field Required work Experience and Qualification (Indicate minimum years of job experience, skills or abilities required for the job.) • Strong understanding of hospital revenue cycle operations including charge capture, coding, billing, and reimbursement., • Knowledge of Medicare, Medicaid, and commercial payer regulations, • Experience with electronic health records (EHR) and hospital billing systems, • Advanced analytical and problem-solving skills, • Strong proficiency in Microsoft Excel and data analysis tools, • Ability to interpret financial, clinical, and operational dataPossess excellent written/verbal communication skills in addition to the ability to work with minimal supervision Preferred Work Experience and Qualifications (Indicate preferred years of job experience, skills or abilities required for the job.) • Proven experience in charge capture, medical billing, or a similar role within a hospital setting 3-5 years' experience.Certified Revenue Integrity Professional (CRIP), • Certified Coding Specialist (CCS), • Certified Professional Coder (CPC), • Certified Healthcare Financial Professional (CHFP) Required Licensure, Certification, Registration or Designation (List any licensure or certification required and specify name of agency.) • Current Los Angeles County Fire Card (or must be obtained within 30 days of employment), • Assault Response Competency (ARC) required (within 30 days of hire) Shift: Days Hours: 8 Weekly Hours: 40 Type: Exempt FTE: 1.0

Job Description JOB DESCRIPTION JOB TITLE: Sr. Manager, Risk Adjustment FLSA STATUS: Exempt DEPARTMENT: Quality Improvement and Risk Adjustment REPORTS TO: Sr. Director, Quality Improvement, Risk Adjustment, and Health Analytics AUTHORITY: JOB SUMMARY: The Sr. Risk Adjustment Manager is responsible for leading and optimizing risk adjustment operations across all lines of business and entities, including Medicare Advantage, Marketplace, and other affiliated health plans, medical groups, and MSO functions. This role serves as a subject matter expert on federal risk adjustment regulations, policies, and methodologies. The position involves close collaboration with internal teams, providers, and external partners to improve risk score accuracy, provider engagement, and regulatory compliance. The Sr. Manager will also lead the development and operationalization of reporting tools, analytics, and workflows to support risk adjustment performance and data integrity across programs. This role plays a key part in aligning cross-functional teams, driving RADV audit readiness, and informing enterprise-level decisions related to financial forecasting, coding accuracy, and population health. ESSENTIAL JOB FUNCTIONS: • Lead Risk Adjustment Strategy & Operations: Oversee the development, implementation, and continuous improvement of risk adjustment programs across all lines of business, including Medicare Advantage (CMS-HCC), Marketplace (HHS-HCC), and RxHCC models, ensuring regulatory compliance, coding accuracy, and risk score optimization., • Stay Current on Model Versions & Methodologies: Maintain deep expertise in CMS-HCC model updates (e.g., V24 vs. V28), RxHCC methodology for Medicare Part D, and HHS-HCC annual model recalibrations, including normalization factors, coding intensity adjustments, and future model transitions as released in CMS Advance Notices and Final Rate Announcements., • Manage Department Staff & Cross-Functional Teams: Provide strategic direction and oversight for Risk Adjustment and coding department staff. Assemble and lead cross-functional and ad hoc teams for specific initiatives such as RADV audit readiness, encounter accuracy improvement, and provider education., • Build and Manage Risk Adjustment Reporting & BI Tools: Design, implement, and maintain dashboards and reporting tools to monitor performance metrics such as risk score trends, gap closure rates, encounter completeness, RxHCC attribution, and audit readiness benchmarks., • Conduct Data Gap Analysis & Targeted Program Design: Perform thorough analyses to identify documentation, coding, and encounter data gaps. Use findings to develop targeted retrospective and prospective strategies to improve risk capture and data completeness, especially in hard-to-reach or low-utilization populations., • Provider and Vendor Collaboration: Partner with provider groups, ACOs, MSOs, and vendors to ensure alignment with risk adjustment documentation and coding guidelines. Design and monitor clinical documentation improvement (CDI) initiatives to capture accurate and complete conditions, including RxHCC-relevant conditions., • Manage Vendor Relationships & Contractual Performance: Oversee vendor selection, contracting, performance monitoring, and ensure vendors are compliant with CMS, HHS, and HIPAA regulations. Evaluate results of chart review, in-home assessment, and coding audit programs to ensure ROI and coding accuracy., • Regulatory Monitoring & Policy Implementation: Translate CMS and HHS guidance (e.g., Final Rule, Advance Notice, DIY Instructions) into actionable operational processes. Ensure that all risk adjustment activities are aligned with evolving federal and state policy, including rules around telemedicine, audio-only visits, data submission, and model-specific filtering logic., • RADV & Audit Preparedness: Lead internal readiness for RADV (Risk Adjustment Data Validation) audits, including targeted coding audits, sampling validation, and documentation retrieval strategies. Ensure processes are in place to support both CMS RADV and HHS IVA audit requirements., • Analytics, Benchmarking & Forecasting: Utilize predictive analytics, industry benchmarks, and statistical modeling to assess financial and coding performance, forecast risk scores, and evaluate the impact of coding pattern adjustments (CPA), dual status, and symmetric caps., • Integrate HCC, RxHCC, and HEDIS Data Across Systems: Collaborate with internal data, quality, and clinical teams to align risk adjustment with HEDIS initiatives, STAR measure improvement, and RxHCC data submission processes. Ensure accurate crosswalks between claims, EHR, and supplemental data sources., • Provider & Staff Education: Develop and lead training programs for internal staff and network providers on CMS-HCC, HHS-HCC, and RxHCC requirements, documentation best practices, model changes, and audit implications. Use CMS and industry educational resources such as the MLN, EDGE DIY instructions, and model release notes., • Data Quality Oversight: Ensure ongoing monitoring and quality assurance of encounter data, HCC coding, supplemental data submissions, and RxHCC files. Validate data submitted to CMS (e.g., RAPS, EDPS, PDE files) and HHS (e.g., EDGE server)., • Audit & Regulatory Compliance: Maintain compliance with HIPAA, CMS and HHS regulations, ensuring all operational, coding, and documentation standards align with federal and contractual obligations., • Operational Oversight & Performance Management: Maintain regular operational reviews, enforce adherence to submission timelines (e.g., initial/mid-year/final sweeps), and ensure alignment with organizational goals for revenue accuracy and regulatory performance. MARGINAL JOB FUNCTIONS: • Leads or supports special projects and initiatives as assigned to meet organizational goals., • Performs additional duties as required to support department and company objectives. BEHAVIORAL EXPECTATIONS: 1. Continuous Learning & Professional Development • Actively participates in staff meetings, departmental updates, and organizational briefings., • Attends required trainings, conferences, and workshops to maintain knowledge of current regulatory standards, risk adjustment methodologies, and industry best practices, • Pursues ongoing professional development to enhance leadership, technical, and compliance-related competencies 1. Customer Focus & Professional Conduct • Maintains the confidentiality and privacy of member and organizational data in accordance with HIPAA regulations and company policies, • Demonstrates respect, professionalism, and courtesy in all interactions with members, providers, colleagues, vendors, and regulatory partners, • Communicates clearly and effectively with team members and leadership to support collaborative problem-solving and high-quality service delivery, • Quality, Compliance & Process Improvement, • Proactively identifies and reports any concerns related to safety, compliance, data security, or operations to the appropriate leadership., • Adheres to all internal policies and procedures, as well as applicable federal, state, and contractual requirements, • Supports and participates in continuous quality improvement initiatives, including process redesign, system enhancement, and performance optimization, • Promotes a culture of safety, accountability, and compliance throughout daily operations and team activities, • Ethics, Integrity & Accountability, • Acts with integrity in all professional activities, upholding the organization’s mission, values, and code of conduct, • Takes ownership of responsibilities, follows through on commitments, and holds self and others accountable for results, • Maintains transparency and ethical decision-making in alignment with regulatory standards and organizational expectations POSITION REQUIREMENTS: EDUCATION/EXPERIENCE: • Bachelor’s degree required; equivalent combination of education and relevant experience may be considered in lieu of a degree, • Minimum 5–7 years of progressive experience in Risk Adjustment, with hands-on expertise in CMS-HCC and HHS-HCC program operations, coding, analytics, and regulatory compliance, • At least 3 years of supervisory or managerial experience, preferably leading cross-functional teams and/or vendor management in a health plan or provider organization, • Strong working knowledge of Medicare Advantage (CMS-HCC) and Marketplace (HHS-HCC) risk adjustment regulations, encounter data submission requirements, and model methodologies, • Experience with RxHCC risk models and PDE submission processes preferred, • Familiarity with RADV audits, HHS IVA audits, and CMS data submission protocols (e.g., RAPS, EDPS, EDGE), • Prior experience collaborating with providers, vendors, and internal data/clinical teams to improve risk score accuracy and documentation quality SKILLS/KNOWLEDGE/ABILITY: • Strong knowledge of the U.S. healthcare system, including Medicare Advantage and ACA Marketplace programs, with working familiarity of claims data, encounters, eligibility, and risk adjustment methodologies, • Proficient in Microsoft Office Suite (Excel, Word, Access) and SQL for data analysis, reporting, and ad hoc queries, • Demonstrated experience leading and implementing process improvements and system enhancements in a healthcare or risk adjustment setting, • Excellent verbal and written communication skills in English, with the ability to convey technical and regulatory information clearly to both internal teams and external partners, • Proven ability to interact professionally and collaboratively with members, providers, vendors, and cross-functional teams, • Strong organizational and time management skills, with the ability to prioritize multiple tasks, manage shifting priorities, and meet deadlines in a dynamic environment, • Sound judgment and decision-making skills, with the ability to solve problems independently and escalate appropriately, • Committed to maintaining confidentiality, privacy, and regulatory compliance, including adherence to Federal, State, and HIPAA regulations, • Adaptable, team-oriented, and able to work both independently and as part of a collaborative team PREFERRED LICENSURE/CERTIFICATIONS/TRAININGS (NOT REQUIRED): • Certified Risk Adjustment Coder (CRC) — AAPC, • Certified Professional Coder (CPC) or Certified Coding Specialist (CCS), • Certified Clinical Research Auditor (CCRA), • Project Management Professional (PMP) or Agile certification, • Certified in Healthcare Compliance (CHC) or similar compliance certifications, • Completion of CMS MLN risk adjustment training and EDGE server/HHS Marketplace risk adjustment modules, • Experience or certification in data analytics and business intelligence tools (e.g., SQL, Tableau, Power BI, SAS), • RADV audit preparation, • Healthcare data privacy/security training, • Leadership and change management program completion

Job DescriptionDescriptionAstrana Health is currently seeking a highly motivated Medical Coder. This role will report to our Director - Revenue Cycle and enable us to continue to scale in the healthcare industry. Our Values: • Patients First, • Empowering the Independent Provider, • Be Innovative, • Operate with Integrity & Deliver Excellence, • Team of One What You'll Do • Extract diagnosis codes (specifically HCC codes) and CPT codes from hospital records., • Reviews medical records to determine if specific disease conditions were correctly reported based on documentation., • Follow the coding guidelines, • Ensures project activities are in compliance with applicable coding guidelines, government and federal regulations., • Regularly and consistently meet quality and productivity standards established by management, • Maintain ongoing communication with management regarding coding workload, turnaround time expectations and deliverables. • Additional duties as necessary to meet the obligations to our providers, • Maintains at least 95% accuracy in all coding projects by researching literature and attending professional seminars, workshops and conference as required by AAPC and/or AHIMA to maintain professional certification(s). Qualifications • Have a current coding certification (CPC, CRC, CCS) through AAPC and/or AHIMA, • At least 2 years of medical coding experience, • Experience coding cardiovascular/cardiothoracic surgical services (cardiac surgery, CVOR, inpatient surgical cases) strongly preferred, • Risk adjustment experience preferred, • Additional experience with HCC coding preferred Environmental Job Requirements and Working Conditions • Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The office is located at 1680 S Garfield Avenue, Alhambra, CA 91801, • The total compensation target pay rate for this role is: $22.00 - $26.00/hr. The pay range represents our national target range for this role. Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.

Job DescriptionJob Description Skilled Wound Care is looking for a Lead Medical Biller to join our rapidly growing company! We are a mobile surgical physician wound care group expanding into new markets of the United States. The Lead Medical Biller is a critical leader responsible for ensuring the financial health of our organization by overseeing the daily operations of the billing team. This role requires advanced expertise in the end-to-end claims lifecycle, ensuring maximum revenue capture through accurate, compliant, and timely submission of medical claims across all payer types (private, government, and third-party). You will be the primary subject matter expert, driving team performance, resolving complex billing issues, and upholding strict adherence to all federal, state, and FQHC-specific billing regulations. Position is hybrid at our office in Playa Vista, CA Responsibilities: • Supervise & Train: Lead the training and mentorship of new billing hires, ensuring rapid integration and consistent adherence to best practices.Quality Assurance: Assist management by conducting routine audits to ensure compliance with all regulatory and internal billing standards., • Workflow Management: Partner with management to efficiently re-distribute workloads, optimize team capacity, and maintain productivity., • Issue Resolution: Proactively identify, report, and collaborate on solutions for problematic issues impacting team duties, efficiency, or compliance., • Claim Submission: Review, prepare, and verify all claims for accuracy, completeness, and documentation, ensuring they meet specific payer requirements for "clean" submission., • Documentation & Verification: Verify all billing information, charges, patient documentation, and insurance coverage prior to claim submission., • Follow-Up & Denial Management: Perform timely and aggressive follow-up on outstanding claims, meticulously resolve denials by correcting errors, gathering necessary documentation, and resubmitting claims efficiently., • Payment Reconciliation: Analyze and interpret all Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs), confirm accurate payment posting, and manage all necessary claim appeals for underpaid or denied services., • Billing Compliance: Apply comprehensive working knowledge of governmental billing regulations, including Medicaid, Medicare, and Medi-Cal Managed Care. To learn more information contact us today at (310) 445-5999! Or visit us at www.skilledwoundcare.com Qualifications: • Good verbal and written communication, • 2+ years of Lead Medical Biller experience required, • Medical billing diploma or work experience Lytec or Medisoft experience a plus, • Certification as a Certified Professional Coder (CPC) preffered, • Knowledge of Microsoft Office, especially Excel, • High School diploma or equivalent is required. Pay: • $25-27/hr Depending on experience Benefits: • Health, Dental, Vision Insurance, • Generous 401 K plan, • Paid time off, • Life Insurance Great Place to Work® Certified! Skilled Wound Care is proud to be Certified™ by Great Place to Work® for the 3rd year in a row. The prestigious award is based entirely on what current employees say about their experience working at Skilled Wound Care. This year, 95% of employees said it's a great place to work – 39% higher than the average U.S. company. Skilled Wound Care will ask all candidates to perform pre-employment confidential DiSC testing and appropriate relevant skills testing prior to hiring. Skilled Wound Care is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age (40 or older), disability or genetic information. Compensation is DOE. "SWC1"

Job DescriptionDescriptionThe HEDIS Abstractor supports Quality Care Improvement initiatives by conducting comprehensive medical record reviews and abstraction activities to identify and close HEDIS measure care gaps. This role is responsible for ensuring accurate collection, validation, and submission of clinical data in accordance with NCQA HEDIS technical specifications and regulatory guidelines. The HEDIS Abstractor collaborates with internal quality teams, providers, and external audit vendors to improve measure performance, maintain compliance, and support successful HEDIS audits. What You'll Do • Perform medical record abstraction and chart review for HEDIS and quality improvement initiatives, • Identify and close HEDIS care gaps through accurate review and documentation of clinical records, • Interpret and apply HEDIS measure specifications, coding guidelines, and NCQA technical requirement, • Review and validate data for accuracy, completeness, and compliance with HEDIS standards, • Conduct quality assurance (QA) reviews of abstracted records and audit findings, • Collaborate with providers, clinics, health plans, and internal departments to obtain required medical documentation, • Partner with external audit vendors to support medical record retrieval, validation and audit readiness activities, • Analyze abstraction results and identify trends, discrepancies, or opportunities for process improvement, • Ensure compliance with HIPAA and all applicable privacy and confidentiality regulations, • Maintain productivity and accuracy standards while meeting project deadlines, • Support continuous quality improvement initiatives and assist with reporting activities as needed, • Other duties as assigned Qualifications • High school diploma or equivalent required; associate or bachelor’s degree in healthcare-related field, • Minimum of 2 years of HEDIS abstraction or medical record review experience, • Strong knowledge of NCQA HEDIS measure specifications and quality improvement processes, • Proficiency with ICD-10, CPT, HCPCS, and other clinical coding systems, • Experience performing QA reviews and supporting HEDIS audit activities, • Familiarity with EMR/EHR systems and healthcare documentation workflows, • Strong analytical, organizational, and problem-solving skills, • Excellent attention to detail and accuracy, • Ability to work independently and manage multiple priorities in a fast-paced environment, • Strong written and verbal communication skillsYou're great for the role if:, • Certified Professional Coder (CPC), RHIT, RHIA, LVN/LPN, RN, or other healthcare-related certification, • Experience working with health plans, managed care organizations, or quality improvement departments, • Knowledge of CMS Stars, risk adjustment, and population health initiatives strongly preferred Environmental Job Requirements and Working Conditions • Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The office is located at 1600 Corporate Center Dr, Monterey Park CA 91754., • This role will require travelling locally up to 35% of the time., • The annual total compensation target pay range for this role is: $27.00 - $32.00 per hour. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation. Additional Information: The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

SUMMARY OF RESPONSIBILITIES The Client Manager is responsible for managing the revenue cycle processes for physician practices and ambulatory surgical centers. The Client Manager will analyze the financial health on a monthly basis to identify reimbursement trends, patterns of denials, and develop an intimate understanding of the factors that are contributing to the financial performance. ESSENTIAL FUNCTIONS • The Client Manager is responsible for the coordination of the Revenue Cycle Department, which includes billing and collection activities., • Responsible for overseeing eligibility, pre-authorization, time of service collections of co-pays and deductibles, coding of services, and reporting., • Reviews, revises, and/or implements policies and procedures within the department to ensure that best practices are followed in both the billing and collections functions, while remaining in compliance with federal/state laws, rules, and regulations as well as third party contracts., • Oversight of charge entry, claim submission, payment posting, denials management, bad debt and collections, appeals processing, credit balance resolution, and accounts receivable management. This includes being responsible for monitoring the productivity of all staff members- in person and those who work remotely., • Generates billing and collections data that supports finance and business operations and produces pricing and coding feedback that will optimize reimbursement., • Provides strategic guidance and analysis of the revenue cycle service line., • Reviews, designs, and implements processes surrounding third party payer relationships, collections, and other financial analyses to ensure clinical revenue cycle is effective and properly utilized., • Ensures all billing and collection practices are appropriate and align with payer policies and guidelines., • Identifies payer trends and reimbursement issues that can negatively impact the revenue cycle., • Utilizes data analysis, report writing and electronic data retrieval skills to extract, compile and present clear and concise information., • Maintains an understanding of coding rules and guidelines; utilizes coding and claims processing knowledge and resources to identify possible risks and revenue opportunities related to coding., • Collaborates with the Company’s external CPAs and Chief Legal Officer to ensure compliance with regulatory requirements., • Identify and correct workflow issues to help optimize revenue., • Works with Director of Practice Management and ASC Administrator regarding any front desk or clinical workflow issues that may impede revenue cycle., • Works with collection vendors on accounts that are deemed delinquent., • Monitors A/R to include oversight of days in A/R, gross billings, gross collections, net revenue, percent of collections to net revenue, monitoring and management of denial rates and denial categories related to activity., • Develop metrics and benchmarks for billing and accounts receivable., • Oversees and directs the creation and continual improvement of departmental procedures and best practice tools for billing, reimbursement, and collections., • Responsible for departmental specific training of employees; planning, assigning, and directing work; appraising performance; disciplining employees; addressing complaints and resolving problems., • Adheres to professional standards, company policies and procedures, and federal, state, and local laws and regulations., • Works to reduce charge holding, rejections, missing information, and denials reports., • Prepares billing reports summarizing billings, adjustments, and revenues received., • Evaluates clients billing needs., • Responsible for creating and educating clients on best practice workflow., • Responsible for data base setup content in the software to ensure best billing practices workflow., • Responsible for coordinating all practice billing activities with physician practice and RCM billing teams., • Works closely with the Implementation Team assigned to ensure proper system build and billing set up., • Responsible for processing clearing house enrollment and assisting the physician practice to set up EFTs as desired., • Ensures that the client’s system is set up correctly and trains staff on PrognoCIS software based on their workflow using billing best practices., • Responsible for daily tracking of operational elements of physician practice to include encounters (open/closed), timely claims processing, accurate payment posting, monitoring of un-posted payments, billing questions, clearinghouse reports, weekly go-live follow up., • Establishes and maintains working relationships with physician practice., • Makes workflow recommendations to both customer and internal RCM team to improve back-office operation., • Responsible for denial management process and reporting for assigned practices., • Responsible for accounts receivable process and reporting for assigned practices., • Creates Month End Reporting and submission to provider practices., • Responsible for researching, documenting, and training billing teams on specific insurance, coding, and documentation requirements., • Responsible for researching and sharing billing information pertinent to States and Insurances. Requirements CORE COMPETENCIES • Excellent oral, written, interpersonal, communication and presentation skills., • Ability to communicate effectively in a variety of settings and with a wide variety of people and different organization levels., • Highly organized with the desire and ability to effectively track projects from start to finish., • Must be able to manage multiple projects simultaneously., • Ability to work in a team environment as well as independently and with little to no supervision., • Demonstrate consistent reliability, integrity, and dependability., • Setting and achieving high goals and standards of performance., • Strong eye for detail, accurately inputting data., • Knowledge of Medicare, Medicaid, commercial paper and electronic claims processing., • Knowledge of ICD, CPT, HCPC coding, ability to read EOBs, familiarity with HIPAA rules. REQUIRED EDUCATION, EXPERIENCE, AND/OR CERTIFICATIONS • Minimum 3-5 years medical billing experience., • Certified Professional Coder., • Family Practice experience required., • Pain Management Experience is a plus., • ASC billing is a plus., • Experience in eligibility verification, ERA, familiarity with HIPAA rules., • Knowledge of billing workflow., • Ability to work in a fast-paced work environment., • Sound analytical and problem – solving skills., • Ability to make decisions and work independently., • Basic computer skills and familiarity with Microsoft Office Tools.

We are seeking a detail-oriented and experienced Medical Billing Specialist with a strong background in medical billing, coding, and insurance processes. The ideal candidate will be skilled in medical terminology, procedure coding, cost estimation, insurance appeals, and working within electronic health record systems. This role requires accuracy, excellent communication skills, and the ability to work with both patients and payers to ensure timely and correct reimbursement. This position may offer the opportunity to work from home, depending on experience and performance. Key Responsibilities: Accurately process and submit medical claims to insurance companies, government payers, and other third-party organizations. • Perform medical coding using ICD-10, CPT, and HCPCS standards for a variety of procedures and diagnoses., • Generate and communicate cost estimates for procedures based on insurance coverage and contract agreements., • Review and verify accuracy of billing data within EHR/EMR systems prior to claim submission., • Utilize EHR/EMR platforms (such as Epic, Meditech, PrognoCis) for documentation, coding, and billing workflows., • Research and resolve billing discrepancies or claim denials., • Prepare and submit insurance appeals, ensuring compliance with payer guidelines., • Communicate with patients regarding billing questions, payment responsibilities, and insurance coverage., • Maintain up-to-date knowledge of medical terminology, payer requirements, and compliance regulations (HIPAA, CMS, etc.)., • Collaborate with clinical staff and providers to ensure accurate coding and documentation within electronic systems., • Track accounts receivable and follow up on outstanding claims to maximize revenue. Requirements Qualifications: • High school diploma or equivalent required; Associate’s degree in Healthcare Administration, Billing & Coding, or related field preferred., • Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification strongly preferred., • Minimum of 2 years of experience in medical billing, coding, insurance follow-up, and working within EHR/EMR systems., • Strong knowledge of ICD-10, CPT, and HCPCS coding systems., • Hands-on experience with electronic health record (EHR) and electronic medical record (EMR) systems, including Epic, Meditech, and/or PrognoCis., • Familiarity with medical terminology, payer reimbursement guidelines, and healthcare regulations., • Experience creating cost estimates for medical procedures., • Skilled in preparing and submitting appeals for denied claims., • Proficiency with medical billing software and electronic health record (EHR) systems., • Strong attention to detail, problem-solving, and organizational skills., • Excellent written and verbal communication skills. Preferred Skills: • Experience with Medicare/Medicaid billing and commercial insurance., • Advanced knowledge of EHR/EMR workflows and system navigation., • Ability to work independently and manage multiple tasks in a fast-paced environment., • Customer service experience in a healthcare setting.

Date Posted: June 18, 2025 The _ seeks a part-time contract SAS Programmer to support the Research and Cost Trends (RCT) department in updating and maintaining the data infrastructure used to prepare the All-Payer Claims Database (APCD), advise on structural changes to case-mix and evaluate existing tools used in analytic file creation. This is an opportunity for a detail-oriented, skilled SAS coder with previous experience working with health insurance enrollment files, medical claims, and pharmacy claims, as well as datasets maintained by the Massachusetts Center for Health Information and Analysis (CHIA). The SAS Programmer will join the Research and Cost Trends (RCT) department and will report directly to the Manager of Research and Cost Trends. Duties of the position may include, but are not limited to: Updating programs to allow for changes in new releases of the All-Payer Claims Database (APCD); Advising and creating best practices to integrate CHIA’s Master Patient Index (MPI) that is updated on a quarterly basis and allows linking across APCD and case-mix; Integrating the 3M Core Grouping Software into the analytic pipeline; Integrating the HHS-HCC risk adjustment model into the analytic pipeline; Validating HPC’s methods for processing MassHealth ACO/MCO/FFS claims; Helping integrate MassHealth MCO processing into commercial processing such that both sets of claims can be processed simultaneously; Identify and eliminate outdated SAS code in programs to help reduce confusion for future processors; Advising HPC on processing Medicare Advantage claims and make changes to existing programs as needed to allow for Medicare Advantage analytic file creation; and Providing ongoing on-demand support for technical issues The HPC operates a hybrid work schedule, with employees splitting their time between the downtown Boston office and remote work. Desired Qualifications: Advanced Degree in Computer Science, Information Systems Management, or related field; At least 5 years of experience with SAS programming, data infrastructure maintenance, and analytic file creation; Previous experience working with claims data such as Center for Health Information Analysis All-Payer Claims Database preferred; Excellent oral, written, and interpersonal skills and the ability to work in groups; The ability to balance multiple and competing priorities in a fast-paced work environment; A commitment to fostering an inclusive workplace that promotes collaboration amongst diverse viewpoints, facilitates cooperation and teamwork, and supports constructive resolution of conflicts; A strong interest in public service and desire to advance a more transparent, accountable, and equitable health care system for all Massachusetts residents. Candidates must be eligible to work in the United States. Compensation and Benefits Compensation Range $140-$155 per hour worked, up to 20 hours of work a week. An initial maximum contract obligation of 120 hours. Compensation is commensurate with experience. The HPC may adjust title, responsibilities, and compensation depending on the experience and expertise of the individual selected. This is a contract position for up to one year of work. This position is not eligible for benefits other than limited sick leave. Our Commitment: The HPC is committed to a policy of non-discrimination and equal employment opportunity. We recognize that diversity in the workplace is a source of strength, vital to its ability to effectively advance its mission. The HPC is committed to: Actively promoting diversity in our workforce, including greater racial and ethnic diversity, at all levels of the organization; Fostering a work environment in which all employees are inspired to do their best, strengthened by their different perspectives, backgrounds, and experiences; Ensuring that no employee’s growth, achievement, or advancement is hindered because of race, ethnicity, sex, sexual orientation, religion, age, genetic information, gender identity, pregnancy, veteran status, or disability; Holding ourselves to a high standard of inclusion and opportunity that will serve as a model for other public and private employers throughout the Commonwealth; Promoting our core values of equal opportunity, equal justice, and inclusion in HPC actions and initiatives.

About SpotOn We’re not just building restaurant tech, we’re giving independent restaurants the tools to compete and win. From our award-winning point-of-sale to AI-powered profit tools, everything we do helps operators boost profit, work smarter, and keep their best people. And every solution is backed by real humans who actually give a sh*t about helping restaurants succeed. Named the #1 Restaurant POS by G2 (Fall 2025), based on ratings from real users Rated the top-rated point-of-sale (POS) for restaurants, bars, retail, and small businesses by Capterra users Awarded Great Places to Work and Built In’s Best Workplaces for multiple years running We move fast, care hard, and fight for independent restaurant operators to do what they love, and love doing it. If you’re looking to make an impact with heart and hustle, SpotOn is the place for you. The Accelerate team is a new 5-person engineering team with a singular mission: prove that AI-native engineering practices can fundamentally change how a fintech engineering org builds software - then make that the new standard. The team has direct VP sponsorship, mission & charter, and three defined projects with hard deadlines. We're hiring a Staff/Principal IC who has already demonstrated AI-assisted engineering at scale. This is not an "AI-curious" role. You write code with AI every day. You've built agents that do real work. You have strong, experience-backed opinions on which models to use for what, where agents fail, and how to build guardrails that actually hold. You've seen what works in production and you're impatient to do it at scale. You will be the most technically senior AI practitioner on this team - the person everyone looks to for "how do we actually build this." You don't manage the team. You drive the architecture, build the hardest parts, and set the technical standard. This isn't a "set up some CI/CD and plug in Copilot" role. You are the person who architects the systems that change how SpotOn engineers build software. You will: Be the AI engineering technical authority. You set the technical standard for how AI is used in code generation, review, testing, and task automation. You don't just implement tools - you design the systems, workflows, and guardrails that make AI-assisted development safe, measurable, and scalable in a PCI-regulated payments environment. The team lead sets priorities; you set the technical direction. Drive the architecture and implementation of three concurrent projects: Automated PR Review - A risk-tiered AI review pipeline where AI handles first-pass review on every PR, with an escalation framework you design that determines when human review is mandatory (payment logic, PCI-scoped code, compliance paths) versus when AI approval is sufficient. You define the criteria. You tune the thresholds. You prove it works. Android and API Test Automation - A fully automated test harness for our Android-native POS and KDS products: virtual device provisioning, test execution, teardown, AI-assisted failure analysis - replacing multi-day manual QA cycles with sub-30-minute automated runs. AI Agent Swarms - A multi-agent pipeline that takes a PRD and produces a tested, reviewed pull request for tier 1-3 engineering work (nits, bugs, small features). You design the agent orchestration - planner, coder, tester, reviewer - and the blast-radius controls that keep it safe in fintech. Evangelize by shipping, not by presenting. Your most persuasive argument is a working system, not a slide deck. You demo to engineering leads every two weeks with real metrics. You turn skeptics into adopters by showing them their own time savings. Measure everything. You define the metrics framework: developer hours recovered, cycle time compression, quality ratios, cost per deployment. You report to the CTO monthly with quantified value delivered. If something isn't working, the data tells you before anyone else. This is a high bar intentionally. We need someone who has already done this, not someone who wants to learn. Required experience: 5+ years building developer tools, infrastructure, or platform engineering systems - you understand how engineering orgs actually work at scale, not just how AI demos work 2+ years working deeply with LLMs and AI agents in production - not side projects, not hackathons. Production systems handling real code, real reviews, or real task automation. You can speak to failure modes, cost optimization, prompt engineering patterns, and model selection trade-offs from experience. Designed and operated AI-assisted code generation or review systems serving 50+ engineers or 30+ repositories. You know the difference between "cool demo" and "trusted by the team." Built multi-agent or agentic workflows - task decomposition, agent specialization, orchestration, error recovery. You've worked with Claude Code, OpenAI Assistants, LangGraph, CrewAI, AutoGen, or custom agent frameworks at a level where you can articulate why you chose one approach over another. Hands-on with AI coding tools daily - Claude Code, Cursor, GitHub Copilot, Windsurf, Codeium - you don't just use them, you push their limits. You know where they excel and where they hallucinate. You have a personal workflow that makes you measurably faster and you can teach it. Required domain expertise (at least two of three): Fintech / payments / regulated industry - you understand what PCI-DSS, SOX, or HIPAA compliance means for code review and deployment. You know why "just let the AI merge it" isn't an option for payment logic. Mobile / Android testing automation - Espresso, UI Automator, or AI-native tools (Drizz, mabl, testRigor). Experience with emulator farms, device provisioning, and CI-integrated test pipelines. Multi-agent system architecture - you've built systems where multiple AI agents collaborate on decomposed tasks with coordination protocols, fallback strategies, and human-in-the-loop checkpoints. You are not "AI-interested." You are AI-obsessed in the productive sense: You already write 50%+ of your code with AI assistance and you've measured the impact on your own velocity. You have opinions on which models are best for which tasks and you update those opinions monthly as the landscape shifts. You've built things with agents that most engineers think aren't possible yet. You're 6-12 months ahead of the mainstream in your personal practice and you have the shipped systems to prove it. You prototype in hours, not days. You can go from "I have an idea for how to automate X" to a working POC before end of day. You refine ruthlessly after. You context-switch across backend, mobile tooling, and AI/ML systems without losing depth. You don't need to be an Android expert, but you need to be dangerous enough to architect the test harness and evaluate the output. You communicate technical progress in business terms. You know that "we reduced median PR review time by 47%" lands better with a CTO than "we fine-tuned our prompt chain." You build dashboards, not just systems. You're an evangelist, not a gatekeeper. You get energy from showing other engineers how to work with AI. You don't hoard knowledge - you build systems that make the whole org better. You have a healthy skepticism forged by real experience. You've seen AI fail in production. You've dealt with hallucinated code, flaky agent workflows, and false-positive reviews. That experience makes your guardrails better, not your enthusiasm less. Building product features for restaurants (that's the rest of the org) Pure ML/AI research without production deployment Maintaining legacy systems or writing JIRA tickets all day People management - you're a pure IC on a small, senior, fast-moving squad. You write more code than anyone on the team. Languages: Kotlin (Android), Go, TypeScript, Python Mobile: Android-native POS applications on dedicated hardware Infrastructure: AWS, GitHub, CI/CD (GitHub Actions) AI Stack: You'll have significant influence on tool selection - bring your opinions Team tooling: Jira, Slack, Figma, standard SpotOn eng stack Why Join Us? At SpotOn, you’ll be part of a team that values diversity, creativity, and a shared mission to help small businesses succeed. Join us to build technology that makes a difference, work with talented peers, and contribute to a culture where your ideas and impact matter. Compensation: Our base pay range is $210,000 -$290,000+ for this role Please note the salary range listed is just one component of a competitive compensation package which includes a company stock plan Offers will be reflective of the candidate’s location and experience. Benefits: At SpotOn, we put people above everything else. We’re known for our innovative software and technology solutions, but we stand out because of the hard-working humans behind the tech. We can’t take care of our clients without taking care of our employees first, and that’s why we invest in you with a competitive benefits package which includes: Medical, Dental and Vision Insurance 401k with company match RSUs Paid vacation, 10 company holidays, sick time, and volunteer time off Employee Resource Groups to build community and inclusion at work Monthly cell phone and internet stipend Tuition reimbursement for up to $2,000 per calendar year to assist with your professional development We will never ask candidates to pay fees, purchase equipment, or share sensitive personal or financial information during the hiring process. All legitimate communication from our recruiting team will come from an official company email address (@). If something seems suspicious, please contact us at . SpotOn is an equal employment opportunity employer. Qualified candidates are considered for employment without regard to race, religion, gender, gender identity, sexual orientation, national origin, age, military or veteran status, disability, or any other characteristic protected by applicable law. Work authorization in the U.S. is required. Visa sponsorship is not available for this role. SpotOn is an E-Verify company.

Salary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Clinical Policy Clinical Coder RN II is responsible for analyzing, interpreting, and operationalizing medical and utilization management policies to ensure accurate coding, appropriate authorization requirements, compliant claims processing, and effective utilization oversight. This position serves as a key clinical and coding resource, translating medical policy requirements into diagnosis, procedure, and service code logic, including determining which codes require prior authorization. Conducts in-depth research and analysis of legislation and regulatory requirements, clinical outcomes, utilization, claims, and financial data to identify utilization trends, fiscal risk, and opportunities for policy enhancement and cost containment. This position works cross-functionally with internal teams to ensure policies are codified, consistently applied, and monitored through reporting and data analysis. This position collaborates closely with internal stakeholders and external entities to support standardized benefit administration, effective program implementation, and organizational compliance with state, federal, and accreditation requirements. Duties Translate approved clinical policies and utilization management criteria into clear, codified claims rules and system logic to support accurate claims adjudication. Develop, revise, and recommend clinical policies and internal utilization management criteria when standard clinical guidelines are insufficient to support appropriate decision-making based on codified claim rules. Assess the downstream claims impact of new or revised clinical policies prior to implementation and recommend configuration updates to mitigate operational or financial risk. Participate in validation of claims configuration changes to ensure policies are applied correctly and consistently across all lines of business. Monitor post-implementation claims activity to identify configuration issues, unintended denials, or payment discrepancies related to clinical policy application. Support remediation of claims configuration defects by identifying root causes and coordinating corrective actions with internal teams. Participate in and lead specialty and cross-functional workgroups and committees focused on healthcare services clinical policies, utilization management processes, strategic initiatives, policy governance, operational alignment, and continuous improvement efforts. Ensure timely dissemination of accurate and consistent policies and procedures across departments. Promote collaboration, engagement, and a positive work environment while supporting departmental initiatives and team-based activities. Manage assigned projects from concept through implementation, ensuring timelines, quality standards, and deliverables are met. Analyze and interpret medical and utilization management policies to identify applicable diagnosis, procedure, and service codes and determine authorization, pre-payment, or post-payment review requirements. Define and maintain code lists that require prior authorization or other utilization management controls based on clinical evidence, regulatory guidance, utilization trends, and financial risk. Duties Continued Collaborate with internal teams to ensure authorization requirements and coding logic are accurately configured in authorization and claims systems based on authorization matrix requirements. Support accurate claims processing by validating codified authorization and policy requirements are correctly applied and aligned with approved medical policies. Provide clinical and coding recommendations to support the development, revision, and implementation of new or updated medical and utilization management policies. Investigate and resolve coding and authorization related issues, including claim denials, coding edits, authorization discrepancies, and policy interpretation questions. Review and assess claims edits, authorization matrixes, and coding rules to identify root causes of errors or inconsistencies and recommend corrective actions. Ensure coding, authorization requirements, and claims-related guidance align with medical necessity criteria, benefit structures, and applicable state, federal, and regulatory requirements. Develop, review, and maintain reporting related to authorization required codes, approval and denial rates, utilization patterns, claims payment outcomes, and policy effectiveness. Prepare reports, summaries, and presentations and communicate findings, recommendations, and action plans to internal and external stakeholders. Analyze claims, authorization, and utilization data to identify trends, measure policy impact, and recommend opportunities for policy refinement, cost containment, or reduction of administrative burden. Monitor post-implementation performance of authorization-required codes and recommend additions, removals, or modifications to authorization requirements based on regulatory thresholds and utilization outcomes. Perform other duties as assigned. Education Required Associate's Degree in Nursing Education Preferred Bachelor's Degree in Nursing Experience Required: At least 8 years of experience in Clinical Nursing. At least 3 years of experience with Medi-Cal and Medicare in a managed care environment. Experience in performing and creating clinical documentation. Experience in regulatory compliance for a health plan. Experience with medical coding systems. Preferred: At least 1 year of experience in editing and writing clinical health services policies within a managed care health plan. Skills Required: Proficient with clinical policy through skills in literature searching and clinical research analysis based on the best available evidence. Working knowledge of clinical policies. Working knowledge of CPT/HCPC codes and claims. Ability to translate regulatory requirements into auditable tools. Ability to perform independent research on complex medical topics. Excellent verbal and written communication skills. Strong analytical, problem solving, and team building skills. Ability to work independently with strong self-direction. Advanced proficiency in Microsoft Word, Excel, and PDF documentation tools. Ability to work effectively with diverse teams in cross-functional work groups. Ability to multitask, re-prioritize tasking, and streamline day-to-day operations. Ability to identify discrepancies, assess risk, and recommend actionable solutions. Knowledge of medical coding systems, including ICD-10-CM, CPT, and HCPCS, and their application in authorization and claims environments. Strong organizational and time-management skills. Preferred: Advanced skills in assessing clinical policy deficiencies through literature searching and clinical research analysis based on the best available evidence. Proficient in claims configuration, including claims adjudication workflows, configuration of claims edits and rules, and the translation of clinical and utilization management policies into system-based claims logic to support accurate, compliant payment outcomes. Understanding of the managed care industry and market conditions. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California License Licenses/Certifications Preferred Certified Professional Coder (CPC) Required Training Physical Requirements Light Additional Information Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including • Paid Time Off (PTO), • Tuition Reimbursement, • Retirement Plans, • Medical, Dental and Vision, • Wellness Program, • Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Nursing, Medical Research, Clinical Research, Medical Coding, Claims, Healthcare, Insurance

Align yourself with an organization that has a reputation for excellence! Cedars-Sinai was awarded the National Research Corporation's Consumer Choice Award 19 times for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company's Workplace of the Year. This recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. We offer an outstanding benefits package that includes healthcare, a 403(b) and paid vacation. Join us! Discover why U.S. News & World Report has named us one of America's Best Hospitals. What will you be doing in this role? Under general direction of the RCSC Audit Manager, provides oversight for management of coding policy and procedures throughout Cedars-Sinai Medical Center. This position may serve as an additional liaison for Enterprise Information Systems (EIS) as it relates to data collection, data management and reporting requirements as well as integration of data collected at the Medical Center. Approved Remote States: Arizona, California, Colorado, Florida, Georgia, Minnesota, Nevada, Oregon, Texas Responsibilities include: • Supervision, allocation and management of audit resources in accordance with established Department and Medical Center guidelines., • Working with Manager, develops goals and objectives related compliance, data quality, productivity, team development, inter and intra-departmental relationships and financial performance., • Manages and develops audit schedule and plan from year to year with input from management on key projects and indicators to be monitored. Works with Resource and Outcome Management, Business Development and Patient Financial Services to provide timely and complete coded/audited data elements. Requirements: High school diploma or GED required. Associate of Science in Health Information Science, or completion of courses in ICD-10-CM and CPT-4 coding from an accredited coding program or comparable level of education preferred. Certified Coder Specialist (CCS), Certified Procedural Coder (CPC), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA) required. A minimum of 2 years of Supervisory experience required. A minimum of 2 years of experience with outpatient/ambulatory care coding or inpatient acute care coding required, with familiarity with ICD-10-CM, CPT-4 coding and APC payment methodologies required. A minimum of 2 years of familiarity with Revenue Cycle/Revenue Management Improvement methodologies preferred. Why work here? We take pride in hiring the best employees. Our accomplished and compassionate staff reflects the culturally and ethnically diverse community we serve. They are proof of our dedication to creating a dynamic, inclusive environment that fuels innovation

Provides senior level support for coding activities. Responsible for monitoring adherence to Molina's compliance program, minimizing risks related to coding and billing practices, and protecting the business from liability related to fraudulent/abusive practices. Performs chart reviews, facilitates physician education, and maintains comprehensive knowledge of coding rules and regulations. Essential Job Duties • Provides senior level coding expertise and administrative technical oversight to ensure successful integration of departmental initiatives., • Performs ongoing chart reviews and abstracts diagnoses codes in alignment with the Hierarchical Condition Categories (HCC) model., • Leverages understanding of current billing practices in provider offices to ensure that diagnoses codes are submitted appropriately., • Documents results/findings from chart reviews, and provides feedback to leadership, providers, and office staff., • Creates necessary tools (educational materials, newsletters, etc.) for providers to support risk adjustment., • Provides training and education to network of providers on risk adjustment best practices and provides coding updates related to risk adjustment., • Monitors progress of providers to ensure guidelines set forth by Centers for Medicare and Medicaid Services (CMS) are adhered to., • Builds positive relationships between providers, and provides coding assistance as needed., • Responsible for administrative duties such as planning, scheduling of chart reviews, obtaining of medical records, and provider training and education., • Collaborates with cross-functional teams to support a variety of projects such as implementation of risk adjustment applications, development of reports, etc., • Coordinates related activities with departments including finance, revenue analytics, claims, encounters, and medical directors., • Coordinates CMS data validation activities, including record selection, tracking and submission, in conjunction with coding leadership., • Maintains professional and technical coding-related knowledge. Job Requirements • At least 4 years of medical coding, auditing, and/or compliance experience, or equivalent combination of relevant education and experience., • Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)., • Detail-oriented; skilled in medical/clinical documentation review., • Ability to collaborate in a cross-functional highly matrixed organization., • Proven experience partnering with business leaders on training design and execution, instructional design, adult learning theory and deploying training through innovative solutions, and ability to strategically approach development and implementation of clinical education across the enterprise., • Effective verbal and written communication skills, including ability to present to medical professionals., • Microsoft Office suite and applicable software program(s) proficiency. Preferred Qualifications • Familiar with the Hierarchical Condition Categories (HCC) risk adjustment model., • Background in supporting risk adjustment management activities and clinical informatics.

Complexity of Work: Requires critical thinking skills, effective communication skills, decisive judgment, and the ability to work independently with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Proficient in basic computer skills. Ability to perform job duties using an electronic medical record system. Strong knowledge of anatomy, physiology and medical terminology. Knowledge of coding classification systems and procedures. Required Work Experience: For HIM coder, one (1) year hospital-based outpatient coding experience. For Physician Billing Coder, one (1) year diagnostic/procedural office coding experience with surgical coding experience or six (6) months working within the Memorial Health System. For HIM, Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS) or Certified Coding Associate (CCA). For Physician Billing, Certified Professional Coder (CPC) or Certified Risk Adjustment Coder (CRC) by AAPC. For Hospital Billing, Certified Coding Specialist (CCS), Certified Coding Associate (CCA) or Certified Professional Coder (CPC) Memorial Healthcare System is a community of caregivers dedicated to delivering quality patient- and family-centered care. This passion for caring extends to our teammates, who support one another and create heartfelt connections that last a lifetime. We are one family at the heart of exceptional care. Join us as we elevate the well-being of everyone we touch. #teamMHSflorida

Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Salary Range: $102,183.00 (Min.) - $163,492.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Clinical Policy Clinical Coder RN II is responsible for analyzing, interpreting, and operationalizing medical and utilization management policies to ensure accurate coding, appropriate authorization requirements, compliant claims processing, and effective utilization oversight. This position serves as a key clinical and coding resource, translating medical policy requirements into diagnosis, procedure, and service code logic, including determining which codes require prior authorization. Conducts in-depth research and analysis of legislation and regulatory requirements, clinical outcomes, utilization, claims, and financial data to identify utilization trends, fiscal risk, and opportunities for policy enhancement and cost containment. This position works cross-functionally with internal teams to ensure policies are codified, consistently applied, and monitored through reporting and data analysis. This position collaborates closely with internal stakeholders and external entities to support standardized benefit administration, effective program implementation, and organizational compliance with state, federal, and accreditation requirements. Duties Translate approved clinical policies and utilization management criteria into clear, codified claims rules and system logic to support accurate claims adjudication. Develop, revise, and recommend clinical policies and internal utilization management criteria when standard clinical guidelines are insufficient to support appropriate decision-making based on codified claim rules. Assess the downstream claims impact of new or revised clinical policies prior to implementation and recommend configuration updates to mitigate operational or financial risk. Participate in validation of claims configuration changes to ensure policies are applied correctly and consistently across all lines of business. Monitor post-implementation claims activity to identify configuration issues, unintended denials, or payment discrepancies related to clinical policy application. Support remediation of claims configuration defects by identifying root causes and coordinating corrective actions with internal teams. Participate in and lead specialty and cross-functional workgroups and committees focused on healthcare services clinical policies, utilization management processes, strategic initiatives, policy governance, operational alignment, and continuous improvement efforts. Ensure timely dissemination of accurate and consistent policies and procedures across departments. Promote collaboration, engagement, and a positive work environment while supporting departmental initiatives and team-based activities. Manage assigned projects from concept through implementation, ensuring timelines, quality standards, and deliverables are met. Analyze and interpret medical and utilization management policies to identify applicable diagnosis, procedure, and service codes and determine authorization, pre-payment, or post-payment review requirements. Define and maintain code lists that require prior authorization or other utilization management controls based on clinical evidence, regulatory guidance, utilization trends, and financial risk. Collaborate with internal teams to ensure authorization requirements and coding logic are accurately configured in authorization and claims systems based on authorization matrix requirements. Support accurate claims processing by validating codified authorization and policy requirements are correctly applied and aligned with approved medical policies. Provide clinical and coding recommendations to support the development, revision, and implementation of new or updated medical and utilization management policies. Investigate and resolve coding and authorization related issues, including claim denials, coding edits, authorization discrepancies, and policy interpretation questions. Review and assess claims edits, authorization matrixes, and coding rules to identify root causes of errors or inconsistencies and recommend corrective actions. Ensure coding, authorization requirements, and claims-related guidance align with medical necessity criteria, benefit structures, and applicable state, federal, and regulatory requirements. Develop, review, and maintain reporting related to authorization required codes, approval and denial rates, utilization patterns, claims payment outcomes, and policy effectiveness. Prepare reports, summaries, and presentations and communicate findings, recommendations, and action plans to internal and external stakeholders. Analyze claims, authorization, and utilization data to identify trends, measure policy impact, and recommend opportunities for policy refinement, cost containment, or reduction of administrative burden. Monitor post-implementation performance of authorization-required codes and recommend additions, removals, or modifications to authorization requirements based on regulatory thresholds and utilization outcomes. Perform other duties as assigned. Education Required Associate's Degree in Nursing Education Preferred Bachelor's Degree in Nursing Experience Required: At least 8 years of experience in Clinical Nursing. At least 3 years of experience with Medi-Cal and Medicare in a managed care environment. Experience in performing and creating clinical documentation. Experience in regulatory compliance for a health plan. Experience with medical coding systems. Skills Required: Proficient with clinical policy through skills in literature searching and clinical research analysis based on the best available evidence. Working knowledge of clinical policies. Working knowledge of CPT/HCPC codes and claims. Ability to translate regulatory requirements into auditable tools. Ability to perform independent research on complex medical topics. Excellent verbal and written communication skills. Strong analytical, problem solving, and team building skills. Ability to work independently with strong self-direction. Advanced proficiency in Microsoft Word, Excel, and PDF documentation tools. Ability to work effectively with diverse teams in cross-functional work groups. Ability to multitask, re-prioritize tasking, and streamline day-to-day operations. Ability to identify discrepancies, assess risk, and recommend actionable solutions. Knowledge of medical coding systems, including ICD-10-CM, CPT, and HCPCS, and their application in authorization and claims environments. Strong organizational and time-management skills. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California License Licenses/Certifications Preferred Certified Professional Coder (CPC) Required Training Physical Requirements Light

Location: Open to candidates across the US RSM's Healthcare Margin Improvement practice is searching for a Healthcare Revenue Integrity Consulting Manager to join our team. We are an integrated healthcare consulting team that provides regulatory, strategy, and operations focused services to healthcare organizations throughout the country. The Consulting Manager will understand the consulting cycle process within the healthcare industry. More specifically, qualified candidates must have experience with revenue integrity process management and optimization, including experience with Charge Data Master, Pricing, Coding, and CDI including the identification, qualification and quantification of opportunities. Responsibilities: • Work with clients to design processes that align with healthcare business and management processes, regulatory requirements, and other business needs, • Assess current state workflow and work with implementation team to validate proposed future state fits with overall project objectives, all in conjunction with the functional, clinical, and operational teams., • Identify, assess, and solve complex business integration challenges where analysis of situations or data requires an in-depth evaluation of variable factors., • Evaluate client compliance with state and federal regulations applying to patient consumer rights, privacy requirements, and transparency under the affordable care act and no surprise act., • Evaluate client revenue cycle org structure and staffing levels based on breadth of organization, strategic growth plans, and annual volume of patient activity., • Identify opportunities to improve technical adoption across the continuum of EMR, billing platform, and bolt-on applications., • Work interactively with clients and client team members to create deliverables., • Assist in the development of training materials for client personnel related to any new processes/systems, • Assist in creating, managing, and executing project work plans to provide high-quality client service delivery., • Assist in preparing and maintaining internal and external project status reports, • Assist in leading and directing support staff on projects to prioritize work tasks, ensuring project milestones and deadlines are met, and ensuring work products meet quality standards, • Mentor junior team members in industry best practices for implementation and project management, • Support sales activity with new and existing clients by participating in meaningful conversations regarding current challenges while representing RSM's capabilities. Basic Qualifications: • Bachelor's degree, • 5+ years of revenue integrity leadership experience with Hospitals or large Physician groups, ideally in a consulting capacity, • Certified Professional Coder (CPC) or American Academy of Professional Coders (AAPC) certification preferred, • Experience designing best practices and managing teams responsible for Revenue Integrity processes preferred., • Proven experience leading and/or supervising client service teams, • Ability and willingness to travel nationwide up to 60% At RSM, we offer a competitive benefits and compensation package for all our people.?We offer flexibility in your schedule, empowering you to balance life's demands, while also maintaining your ability to serve clients.?Learn more about our total rewards. All applicants will receive consideration for employment as RSM does not tolerate discrimination and/or harassment based on race; color; creed; sincerely held religious beliefs, practices or observances; sex (including pregnancy or disabilities related to nursing); gender; sexual orientation; HIV Status; national origin; ancestry; familial or marital status; age; physical or mental disability; citizenship; political affiliation; medical condition (including family and medical leave); domestic violence victim status; past, current or prospective service in the US uniformed service; US Military/Veteran status; pre-disposing genetic characteristics or any other characteristic protected under applicable federal, state or local law. Accommodation for applicants with disabilities is available upon request in connection with the recruitment process and/or employment/partnership.?RSM is committed to providing equal opportunity and reasonable accommodation for people with disabilities. If you require a reasonable accommodation to complete an application, interview, or otherwise participate in the recruiting process, please call us at 800-274-3978 or send us an email at careers@rsmus.com. RSM does not intend to hire entry level candidates who will require sponsorship now OR in the future (i.e. F-1 visa holders). If you are a recent U.S. college / university graduate possessing 1-2 years of progressive and relevant work experience in a same or similar role to the one for which you are applying, excluding internships, you may be eligible for hire as an experienced associate. RSM will consider for employment qualified applicants with arrest or conviction records. For those living in California or applying to a position in California, please click here for additional information. At RSM, an employee's pay at any point in their career is intended to reflect their experiences, performance, and skills for their current role. The salary range (or starting rate for interns and associates) for this role represents numerous factors considered in the hiring decisions including, but not limited to, education, skills, work experience, certifications, location, etc. As such, pay for the successful candidate(s) could fall anywhere within the stated range. Compensation Range: $112,100 - $225,500 Individuals selected for this role will be eligible for a discretionary bonus based on firm and individual performance.

Job Category: Management/Executive Department: Office of CSC Excellence Location: Los Angeles, CA, US, 90017 Position Type: Full Time Salary Range: $117,509.00 (Min.) - $188,015.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Senior Manager, Payment Integrity (PI) Operations, manages and leads critical components of L.A. Care's enterprise Payment Integrity program, overseeing the design, execution, and continuous refinement of pre-payment and post-payment accuracy activities. This position integrates operational management with analytic, regulatory, and contract-driven development to prevent inappropriate payments, strengthen upstream controls, and ensure accurate financial outcomes across all lines of business. The Senior Manager manages multi-functional teams responsible for prospective edit development, clinical and non-clinical pre-payment reviews, retrospective audits, overpayment/underpayment identification, recovery operations, and pipeline management. This position ensures PI programs are executed consistently, documented clearly, and aligned with regulatory, contractual, and financial expectations. The Senior Manager works closely with cross-functional stakeholders to translate insights into actionable system changes and preventive modifications. The Senior Manager serves as the operational driver for Payment Integrity interventions, ensuring programs scale effectively, are audit-ready, and deliver measurable reductions in inaccurate or wasteful spend. Manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports. Responsible for driving performance to ensure that the team can lead high-level decisions that impact on the success of L.A. Care. Oversees the development, implementation, administration, and maintenance of the department's programs, policies, and procedures. Responsible for driving management and performance to ensure that the team can lead high-level decisions that impact on the success of L.A. Care. Collaborate closely with executive/ senior management to establish goals that align with the company's mission and vision. Duties Leads daily operations of pre-pay and post-pay PI activities, ensuring accuracy, timeliness, and effective case management. Oversees prospective review programs including clinical editing, code auditing, algorithm-driven controls, and provider contract/benefit interpretation. Ensures post-pay functions, including data mining, recovery validation, provider outreach, and reconciliation, are accurate, transparent, and compliant. Establishes standardized workflows, documentation, and quality review expectations across all PI teams. Ensures Payment Integrity operates as a disciplined, analytically driven, and preventive control function. Strengthens the reliability of claims processing, increases automation and cost avoidance, manages complex PI workflows, and translates regulatory and contract-driven requirements into systematic, sustainable accuracy improvements. Oversees development, refinement, and implementation of new edits, rules, and clinical/non-clinical logic that reduce future payment errors. Translates regulatory updates, provider contract terms, benefit changes, and emerging industry standards into edit or algorithm recommendations. Manages the PI pipeline of prospective initiatives, ensuring strong prioritization, impact modeling, and timely deployment. Partners with key stakeholders to implement upstream corrections and reduce recurring defects. Ensures prospective controls improve auto-adjudication, accuracy, and reduction of rework. Oversees identification and validation of overpayments and underpayments from solicited/unsolicited sources, analytics, and vendor partners. Ensures recoveries follow compliant workflows, including provider notification, appeal support, repayment management, and financial reconciliation. Ensures post-pay insights translate into upstream corrective actions, edit changes, or preventive improvements. Oversees development of operational processes that strengthen coordination between internal recovery teams and external vendors. Directs analytic and data mining efforts to detect billing anomalies, emerging risk patterns, and high-impact cost avoidance opportunities. Partners with enterprise analytics to refine predictive modeling, trending dashboards, and reporting frameworks. Ensures analytical findings convert into operational interventions, policy updates, or system changes. Identifies high-risk providers, services, or claims behaviors requiring new controls or deeper review. Duties Continued Ensures PI programs align with federal, state, and contractual requirements for all lines of business. Interprets regulatory updates and directs teams to integrate changes into rules, workflows, and edit development. Ensures that benefit structures, contract terms, and pricing methodologies are correctly reflected in both pre- and post-pay activities. Partners with Compliance and SIU on cases requiring heightened review or escalated investigation. Oversees operational execution of vendor-driven PI programs, ensuring strong Service level agreement (SLA) performance, validated results, and accurate financial reporting. Supports vendor onboarding, implementation, testing, and algorithm or rule customizations. Ensures internal teams coordinate effectively with external partners across pre-pay and post-pay programs. Partners with cross-functional key stakeholders to resolve system issues and strengthen upstream accuracy. Serves as an advisor to internal partners on PI trends, risk areas, provider behavior insights, and recommended control changes. Ensures PI findings are shared proactively and used to influence broader operational and configuration improvements. Manages staff and the day-to-day activities in the department. Participates in the department budgeting process. Responsible for scheduling, training, performance, corrective actions, mentoring, developing of the team(s). Foster and promote a culture of transparency, continuous improvement, accountability, and shared ownership of enterprise goals. Mentors and develops staff, building technical and problem-solving skills across the team. Implements and provides guidance to the departmental and organizational processes and policies and works with senior and/ or executive management to define, prioritize, and develop projects and programs. Responsible for Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions. Responsible for overseeing and managing the budgets of their respective departments. Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval. Plans and implements systems and procedures to maximize operating efficiency and achieve strategic priorities. Perform other duties as assigned. Education Required Bachelor's Degree In lieu of degree, equivalent education and/or experience may be considered. Education Preferred Master's Degree in Business Administration or Related Field Experience Required: At least 6 years of Payment Integrity, Program Integrity, medical cost containment, Fraud Waste and Abuse (FWA), data mining, claim accuracy, or related experience. At least 5 years of experience in leading staff, Supervising and/or managing staff. Experience leading teams, projects, initiatives, and cross-functional groups. Experience in Medicaid, Medicare, and Commercial managed care lines of business. Experience in pre-pay and/or post-pay review, edit development, recovery operations, or claim logic development. Experience interpreting provider contracts, payment methodologies, and managed care benefit structures. Experience handling complex claim review, root-cause evaluation, and adhering to regulatory TAT requirements Experience working with COB and Third-Party Liability (TPL) claims in a managed care setting. Experience with vendor-managed PI programs. Preferred: Experience applying predictive analytics or algorithm-based PI solutions. Experience with SQL, BI tools, or data mining platforms. Skills Required: Strong understanding of adjudication, coding, and the application of Division of Financial Responsibility (DOFR) to claims processing. Extensive knowledge of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), International Classification of Diseases (ICD)-10, DRG/ Ambulatory Payment Classification (APC), and pricing methodologies. Understanding of benefit interpretation, contract terms, and payment rules. Strong analytical, investigative, financial, and operational skills. Exceptional written and verbal communication skills, including executive communication and the ability to translate technical findings into actionable recommendations. Advanced project leadership, workflow management, and prioritization skills. Ability to collaborate with internal and external stakeholders at all levels. Proven problem-solving skills and ability to translate knowledge to the department. Strong interpersonal skills for building relationships, fostering teamwork, and creating a positive work environment. Ability to guide and support team members. Excellent ability to set clear goals, develop strategic plans to achieve those goals, and inspire others to work towards a shared vision. Skilled in mediating disputes and resolving conflicts in a fair and constructive manner. Must have a deep understanding of financial principles. Ability and excellent knowledge in developing and managing budgets, forecasting future financial outcomes, and making informed decisions about resource allocation. Demonstrated ability to make informed decisions. Strong verbal, written communication and presentation skills. Deep understanding of the industry, market dynamics, and organizational operations to identify opportunities and navigate challenges. Strong ability and knowledge to analyze market trends, anticipate future changes, and develop long-term strategies that align with the company's goals. Preferred: Knowledge of SIU/FWA methodologies and risk indicators. Experience with SQL, BI tools, or data mining platforms. Licenses/Certifications Required Licenses/Certifications Preferred Certified Professional Coder (CPC) designation by the American Academy of Professional Coders Required Training Physical Requirements Light Additional Information Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including Paid Time Off (PTO) Tuition Reimbursement

Provides investigative support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates and resolves instances of health care fraud and abuse investigations of medical providers using informational tips from member benefits and medical records following review of post-payment claims. • Independently re-evaluates medical claims and associated records by applying knowledge of advanced coding, all relevant and applicable Federal and State regulatory requirements, and Molina policies., • Reviews post-pay claims against corresponding medical records to determine accuracy of claims payments., • Manages documents and prioritizes caseloads to ensure timely turnaround., • Ensures adherence to applicable state/federal/internal policies, Current Procedural Terminology (CPT) guidelines and provider contract requirements., • Devises clinical summary post-review., • Communicates and participates in meetings related to cases., • Completes medical review to facilitate referral to law enforcement or payment recovery., • Supports investigation work as necessary and required by the regulatory agency., • At least 2 years CPT coding experience in a surgical, hospital and/or clinic setting, or equivalent combination of relevant education and experience., • Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Professional Medical Auditor (CPMA), or American Academy of Professional Coders (AAPC) certified, • Critical-thinking, problem-solving and analytical skills., • Ability to prioritize and manage multiple tasks., • Ability to work in a team setting., • Strong verbal/written communication skills, and presentation skills., • Microsoft Office suite (including Excel), and applicable software program(s) proficiency., • In some states, 5 years of experience working in a fraud, waste and abuse (FWA)/special investigations unit (SIU)/fraud investigations role may be required (dependent on state/contractual requirements)., • Knowledge of investigative and law enforcement procedures with emphasis on fraud investigations., • Knowledge of Managed Care and the Medicaid, Medicare, and Marketplace programs., • Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems., • Ability to research and interpret regulatory requirements., • Certified Professional Compliance Officer (CPCO)., • Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI)., • Experience working in group health insurance, particularly within claims processing or operations., • Working knowledge of local, state and federal laws and regulations pertaining to health insurance, investigations and legal processes (commercial insurance, Medicare, Medicare Advantage, Medicare Part D, Medicaid, Tricare, Pharmacy, etc.)., • Experience with claims processing systems., • Ability to use Microsoft Excel/Access platforms working with large quantities of data., • Ability to answer questions, identify trends and patterns, and present findings. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Under direct supervision of licensed personnel, the Patient Care Assistant is responsible for performing activities of daily living for patients and generally assist with the unit activities that support patient care in the Ortho/Neuro Unit at MemorialCare Long Beach Medical Center. MemorialCare is

Job Description Drive the Future with Xos Xos (NASDAQ: XOS), is a technology company and electric truck manufacturer on a mission to decarbonize commercial transportation. We design and build state-of-the-art electric vehicles, develop advanced fleet management software, and create charging solutions that make fleet electrification seamless and cost-efficient. At Xos, we're problem-solvers, innovators, and go-getters, working together to drive a cleaner, more sustainable future. Join us and be part of the movement shaping the next generation of commercial transportation. The Role Xos is seeking a Senior Vehicle Controls Software Engineer to lead the development, integration, and validation of control systems across our electric vehicle platforms. In this role, you'll design and implement embedded control software that powers core vehicle systems including propulsion, energy management, thermal control, and safety. Success in this role requires strong expertise in embedded software and EV systems, couple with the ability to tackle complex engineering challenges with precision and creativity. You'll collaborate closely with cross-functional teams to deliver production-ready software that meets rigorous automotive standards and drive performance across our growing vehicle lineup. This is an on-site based role at our Los Angeles, CA HQ Responsibilities • Lead the design, development, and integration of vehicle control software across multiple electric vehicle platforms., • Define and maintain system and software architecture for propulsion, regenerative braking, energy management, and thermal control systems., • Oversee the validation and verification of control software, ensuring functionality, performance, and safety compliance., • Translate system level and stakeholder requirements into detailed technical specifications and software requirements., • Conduct system-level trade studies, simulations, and analyses to support design decisions and mitigate technical risks., • Collaborate with cross-functional engineering teams, including electrical, mechanical, and test, to ensure seamless system integration and traceability., • Support root cause analysis and resolution of complex technical issues using structured problem-solving methodologies (e.g. 8D, DMAIC)., • Participate in supplier assessment and integration of critical components and subsystems affecting vehicle control performance., • Ensure adherence to functional safety processes (ISO 26262) and contribute to the development of safety-related work products., • Contribute to continuous improvement of software development, verification, and validation practices within the vehicle systems engineering function., • Additional duties and special projects as assigned. Qualifications • Bachelor's or Master's degree in Electrical Engineering, Control Systems, Computer Engineering, Automotive Engineering, or a related field., • Minimum 5+ years of experience in embedded software development, with at least 3 years in vehicle control systems for electric or hybrid vehicles, • Proficiency in C/C++, MATLAB/Simulink/Stateflow, and experience with software-in-the-loop (SIL) and hardware-in-the-loop (HIL) environments., • Demonstrated understanding of EV systems, including propulsion, motor/inverter control, battery management systems (BMS), and vehicle-level energy management., • Experience with functional safety standards (ISO 26262) and automotive development lifecycles., • Familiarity with software requirements management tools such as JIRA, Jama, Polarion, and version control systems, • Strong analytical, diagnostic, and problem-solving skills with attention to technical detail., • Experience with model-based design workflows and code generation ( e.g. Embedded Coder), • Knowledge of communication protocols such as CAN, LIN, and Ethernet, • Ability to travel domestically up to 20% as required to support testing, validation, and launch activities., • A valid Driver's License and a clean driving record are required for this position, as driving is an essential function of the role The salary range for this role is specific to the locations listed below and is the range Xos Inc. reasonably and in good faith expects to pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but not limited to, job-related knowledge, skillset, relevant education, qualifications, certifications, geographic location, and other business or organizational factors. The total compensation package for this position may also include other elements dependent on the position offered. • California (Los Angeles Metropolitan): $120,000 - $160,000 annual base salary Benefits & Perks Xos is a people-focused company—we are committed to providing our employees with a comprehensive package of benefits and perks designed to support their well-being and professional growth. We continually evaluate and expand our offerings to best serve our team. • Comprehensive Medical, Dental, and Vision - Coverage for you and your family, with PPO and HMO (California) plans available. We offer plans with 100% covered employee premiums. Employees can also enroll in a variety of voluntary ancillary benefits to further support their needs., • HSA & FSA Plans - Set aside pre-tax dollars for qualified healthcare expenses., • PTO - Accrue vacation time over time, with additional days earned as your tenure grows, plus sick time and paid holidays!, • Generous Company Holidays - Enjoy a generous holiday calendar, including a winter holiday hiatus in December., • Basic Life & AD&D Insurance - 100% covered by Xos, with the option to purchase additional life insurance coverage for yourself and eligible dependents., • Betterment 401(k) - Save for retirement with our employer-sponsored plan through Betterment., • Pet Insurance - Coverage for your furry friends to keep them healthy and happy!, • Additional opportunities to learn, grow, and advance in your career, just to name a few! We are dedicated to fostering a workplace where employees can thrive. Our benefits continue to evolve to best support our team's well-being and success. Commitment to Equal Opportunity Xos is proud to be an Equal Opportunity Employer and will consider all qualified applicants for employment without regard to race, color, gender, pregnancy, sex, sexual orientation, gender identity, gender expression, national origin, age, genetic information, ancestry, protected veteran status, disability, or any other basis protected by local, state, or federal law. Xos provides equal access to services and employment to all qualified persons. For applicants with disabilities or limitations, such as those covered by the Americans with Disabilities Act, requiring accommodations to complete the application and/or interview process, please email us at support@xostrucks.com Candidate Data Privacy This notice describes how Xos (as used in this Notice, the terms "Company," "Xos," "we," "our," or "us" in this Notice refers to Xos, Inc., together with its subsidiaries and other corporate affiliates, who may handle your candidacy and application for employment) may collect, process, and use your personal data in connection with the recruitment process when you apply for a position. Xos may collect, use and disclose your personal information or personal data (within the meaning of the applicable data protection laws) when you apply for employment and/or participate in the recruitment process ("Candidate Personal Data"). This data includes contact, demographic, communications, educational, professional, employment, social media/website, network/device, recruiting system usage/interaction, security and preference information. Xos may use your Candidate Personal Data for the purposes of (i) tracking interactions with our recruiting system; (ii) carrying out, analyzing and improving our application and recruitment process, including assessing you and your application and conducting employment, background and reference checks; (iii) establishing an employment relationship or entering into an employment contract with you; (iv) complying with legal, regulatory and corporate governance obligations; (v) recordkeeping; (vi) ensuring network and information security and preventing fraud; and (vii) as otherwise required or permitted by applicable law. Xos may share your Candidate Personal Data with (i) internal personnel who have a need to know such information in order to perform duties, including individuals on our People Operations Team, Finance, Legal, and the team(s) with the position(s) for which you are applying; (ii) Xos affiliates; and (iii) Xos's service providers, including providers of background checks, staffing services, and cloud services. Where permitted by applicable law, Xos may transfer or store internationally your Candidate Profile Data, including to or in the United States, Canada, the United Kingdom, and the European Union and in the cloud, and this data may be subject to the laws and accessible to the courts, law enforcement and national security authorities of such jurisdictions. Notice to Recruitment Services Xos is not accepting applications from third-party recruitment services at this time. Unsolicited resumes or candidate profiles submitted in response to our job postings will not be subject to any referral or placement fees unless a written agreement is in place with Xos for the specific job opportunity.

Job DescriptionJob Summary: • This is an exciting role an innovative, high-growth defense technology company. The ideal candidate for the position is someone who has experience designing, verifying, and integrating state-of-the-art FPGA systems and embedded processing solutions for RF applications. As a Sr. FPGA Engineer, you will work closely with a talented, multi-disciplinary engineering team in a fast-paced environment to apply emerging technologies in innovative ways to rapidly produce new products. Job Duties:, • Design and verification of RTL modules for FPGA applications, • Ownership of entire FPGA designs from initial architecture trades through implementation, verification, and hardware bringup, including FPGA sizing estimation and IO planning., • Lead initial testing and bring-up of custom FPGA circuit cards, validating functionality of on-board peripherals including memory interfaces, Ethernet controllers, and integrated sensors., • Automating test environment (up to and including hardware-in-the-loop testing), lab equipment, and measurement devices, • Capturing design tradeoffs, state machine flow, system address maps, and block diagrams Required Qualifications:, • Bachelor’s degree in Electrical Engineering or a related field., • 5+ years of experience in FPGA design, implementation, and testing, • Extensive experience implementing FPGA designs and embedded processing designs on embedded hardware, • Experience working with latest generation state-of-the-art Xilinx/Intel Parts and associated tool sets (Vivado, Quartus), • Understanding of common digital communication protocols (SPI, I2C, UART), • Development Experience of Integrated Embedded Applications (ARM, GPU), • Experience with standard bus and streaming protocols, such as AXI and AXI-Stream, • Experience with Continuous Integration and Continuous Delivery processes, • Active Secret or Top Secret clearance, or ability to obtain one desired but not required. Desired Qualifications:, • Experience with design automation, scripting languages (TCL, Python, Perl, Matlab), • Knowledge of Advanced Firmware Verification Testbench Development (UVM, System Verilog), • Skilled with Advanced High-Speed Verilog/VHDL Designs including High Speed Memory Interfaces (DDR4, HBM) and High Speed SerDes IO and Protocols (100GE, JESD204B, Interlaken), • Experience implementing Complex DSP Algorithms on FPGAs using tools such as Matlab, Simulink, HDL Coder to implement advanced communications or other designs in FPGA, • Experience collaborating with software engineering team in an SoC environment to develop designs that incorporate HDL combined with embedded Linux, • Good written and oral communication skills, • Collaborative; capable of working across all levels of the organization, • Organized; comfortable working in a fast-paced, ever-changing environment Job Type & Location This is a Permanent position based out of Torrance, CA. Pay and Benefits The pay range for this position is $140000.00 - $176000.00/yr. o Up to 100% paid medical coverage, robust vision & dental, personalized flex accounts, and supplemental health plans. o Stock options with full vesting, 6% 401k match, Annual dependent care support, Monthly electronics stipend. o 19 paid holidays (including winter break), unlimited PTO, and generous parental leave to focus on what matters. o Free gyms, Calm app subscriptions, and unlimited mental health access – we've got you covered. o Fuel your day with catered lunches, stocked kitchens, flexible hours, and casual dress. o Pet insurance Workplace Type This is a fully onsite position in Torrance,CA. Application Deadline This position is anticipated to close on Jul 21, 2026. About Actalent Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options. San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records. Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.

A leading medical center in Los Angeles is looking for a Coder II to perform essential surgical coding tasks. The ideal candidate will have a minimum of 3 years of surgical coding experience and a Certified Procedural Coder (CPC) certification.

Salary Range: $65,800 - $130,800 /Annually Qualifications All items listed below are required: CPC (Certified Professional Coder - AAPC) Bachelor’s degree in Health Information Management, healthcare administration, or related field, or equivalent experience Five or more years of medical codin

Required Qualifications: Req High school or equivalent Req Specialized/technical training; Combined experience/education as substitute for minimum education Graduation from a formal coder training program or completion of academic class in medical coding Combined experience/education as substitute f

Working Nurse in Los Angeles is seeking a Clinical Policy Clinical Coder RN II to ensure accurate medical coding and compliance with regulations.