Payment Integrity Nurse Coder Rn Iii

LA Care Health Plan

Los Angeles, CA, US
Base: $102,183 - $163,492; bonus/equity: not speci...
On-site
Medical record review expertise
Payment integrity and utilization management
Clinical coding knowledge
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

  • 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.
  • The Payment Integrity Nurse Coder RN III serves as a subject matter expert performing medical records reviews, quality audits, and validation of coding accuracy for payment integrity initiatives.
  • L.A. Care offers a wide range of benefits including Paid Time Off (PTO), Tuition Reimbursement, Retirement Plans, Medical, Dental and Vision, Wellness Program, and Volunteer Time Off (VTO).

Matching Summary

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.

Salary

Base: $102,183 - $163,492; Bonus/Equity: Not specified; Benefits: Paid Time Off, Tuition Reimbursement, Retirement Plans, Medical, Dental, Vision, Wellness Program, Volunteer Time Off

Skills & Requirements

Must-have

  • Medical record review expertise
  • Payment integrity and utilization management
  • Clinical coding knowledge
  • Claims data analysis
  • Project leadership and management
  • Knowledge of healthcare reimbursement concepts
  • Collaboration across multiple functional areas

Nice-to-have

  • Mentoring and training staff
  • Analytical and problem-solving skills
  • Ability to thrive in fast-paced environment
  • Excellent communication skills
  • Cost avoidance strategy development

Key Requirements

  • Registered Nurse (RN) with active California license
  • Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)
  • At least 8 years clinical RN experience
  • At least 3 years utilization management or clinical coding experience
  • Investigation and auditing experience

Work Rights

Active, current and unrestricted California RN license required

Tailored Resume

Cover Letter