Clinical Policy Clinical Coder RN II
$132K - $163K/yr
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 ...
$132K - $163K/yr
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 ...
$132K - $163K/yr
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 ...
Los Angeles, CA · On-site
$132K - $163K/yr
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 ...
Los Angeles, CA · On-site
$132K - $163K/yr
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 ...
Long Beach, CA · On-site
$30.46 - $38.07/hr
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 ...
Quick apply
Long Beach, CA · On-site
$30.46 - $38.07/hr
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 ...
Ontario, CA · On-site
$28 - $43.40/hr
... Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Inpatient Coder Auditor finalizes the coding and abstracting of the medical record upon ensuring the ...
New
Ontario, CA · On-site
$28 - $43.40/hr
... Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Inpatient Coder Auditor finalizes the coding and abstracting of the medical record upon ensuring the ...
New
Ontario, CA · On-site
$28 - $43.40/hr
... Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Inpatient Coder Auditor finalizes the coding and abstracting of the medical record upon ensuring the ...
New
Ontario, CA · On-site
$28 - $43.40/hr
... Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Inpatient Coder Auditor finalizes the coding and abstracting of the medical record upon ensuring the ...
New
Ontario, CA · On-site
$28 - $43.40/hr
... Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Inpatient Coder Auditor finalizes the coding and abstracting of the medical record upon ensuring the ...
New
Ontario, CA · On-site
$28 - $43.40/hr
... Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Inpatient Coder Auditor finalizes the coding and abstracting of the medical record upon ensuring the ...
New
Ontario, CA · On-site
$28 - $43.40/hr
... Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Inpatient Coder Auditor finalizes the coding and abstracting of the medical record upon ensuring the ...
New
Ontario, CA · On-site
$28 - $43.40/hr
... Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Inpatient Coder Auditor finalizes the coding and abstracting of the medical record upon ensuring the ...
New
$30.46 - $38.07/hr
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 ...
Quick apply
$30.46 - $38.07/hr
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 ...
$33 - $38/hr
Determine the appropriate MS-DRG or APR-DRG assignment based on coding and clinical documentation * Conduct coding validation and auditing to ensure compliance with payer and regulatory requirements
$33 - $38/hr
Determine the appropriate MS-DRG or APR-DRG assignment based on coding and clinical documentation * Conduct coding validation and auditing to ensure compliance with payer and regulatory requirements
Pomona, CA · On-site
$39.89 - $56.13/hr
Responsible for the review and evaluation of the medical record in order to assign accurate diagnosis and procedural codes ensuring optimal reimbursement while remaining compliant with all regulatory ...
Pomona, CA · On-site
$39.89 - $56.13/hr
Responsible for the review and evaluation of the medical record in order to assign accurate diagnosis and procedural codes ensuring optimal reimbursement while remaining compliant with all regulatory ...
Pomona, CA · On-site
$39.89 - $56.13/hr
Responsible for the review and evaluation of the medical record in order to assign accurate diagnosis and procedural codes ensuring optimal reimbursement while remaining compliant with all regulatory ...
Pomona, CA · On-site
$39.89 - $56.13/hr
Responsible for the review and evaluation of the medical record in order to assign accurate diagnosis and procedural codes ensuring optimal reimbursement while remaining compliant with all regulatory ...
Pomona, CA · On-site
$39.89 - $56.13/hr
Responsible for the review and evaluation of the medical record in order to assign accurate diagnosis and procedural codes ensuring optimal reimbursement while remaining compliant with all regulatory ...
Pomona, CA · On-site
$39.89 - $56.13/hr
Responsible for the review and evaluation of the medical record in order to assign accurate diagnosis and procedural codes ensuring optimal reimbursement while remaining compliant with all regulatory ...
Red Bluff, CA · On-site
$25.75 - $33.99/hr
New Clinician Audits * Clinician audits for correct coding and optimal reimbursement (Random Audits) * Provider education to clinicians with coding/documentation * Reports quarterly on Bell Curves
Red Bluff, CA · On-site
$25.75 - $33.99/hr
New Clinician Audits * Clinician audits for correct coding and optimal reimbursement (Random Audits) * Provider education to clinicians with coding/documentation * Reports quarterly on Bell Curves
Encino, CA · On-site
$19.75 - $25.25/hr
This position reports directly to the Supervisor Clinical/Coding Payment Resolution. Essential Functions * Knows, understands, incorporates, and demonstrates the Client Mission, Vision, and Values in ...
Encino, CA · On-site
$19.75 - $25.25/hr
This position reports directly to the Supervisor Clinical/Coding Payment Resolution. Essential Functions * Knows, understands, incorporates, and demonstrates the Client Mission, Vision, and Values in ...
Pomona, CA · On-site
$39.89 - $56.13/hr
Responsible for the review and evaluation of the medical record in order to assign accurate diagnosis and procedural codes ensuring optimal reimbursement while remaining compliant with all regulatory ...
Pomona, CA · On-site
$39.89 - $56.13/hr
Responsible for the review and evaluation of the medical record in order to assign accurate diagnosis and procedural codes ensuring optimal reimbursement while remaining compliant with all regulatory ...
Red Bluff, CA · On-site
$25.75 - $33.99/hr
New Clinician Audits * Clinician audits for correct coding and optimal reimbursement (Random Audits) * Provider education to clinicians with coding/documentation * Reports quarterly on Bell Curves
Red Bluff, CA · On-site
$25.75 - $33.99/hr
New Clinician Audits * Clinician audits for correct coding and optimal reimbursement (Random Audits) * Provider education to clinicians with coding/documentation * Reports quarterly on Bell Curves
Long Beach, CA · On-site
$17 - $19/hr
HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical ... Coding guidelines knowledge * Claims experience Additional Information Advantages of this ...
Long Beach, CA · On-site
$17 - $19/hr
HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical ... Coding guidelines knowledge * Claims experience Additional Information Advantages of this ...
Alhambra, CA · On-site
$22 - $26/hr
Medical Coder Astrana Health is currently seeking a highly motivated Medical Coder. This role will ... Our mission is to combine our clinical experience, best-in-class delivery network, and ...
Alhambra, CA · On-site
$22 - $26/hr
Medical Coder Astrana Health is currently seeking a highly motivated Medical Coder. This role will ... Our mission is to combine our clinical experience, best-in-class delivery network, and ...
$19 - $25.25/hr
Where Clinical Excellence Meets Cutting-Edge Care Here, you'll work alongside an award-winning team ... Job Summary Coder III The Coder III is responsible for analyzing medical records for completion by ...
$19 - $25.25/hr
Where Clinical Excellence Meets Cutting-Edge Care Here, you'll work alongside an award-winning team ... Job Summary Coder III The Coder III is responsible for analyzing medical records for completion by ...
Santa Clarita, CA · On-site
$37.92 - $60.68/hr
CODER III - $37.92 to $60.68 Your Work Here Matters. Your Career Here Thrives. Imagine coming to ... Where Clinical Excellence Meets Cutting-Edge Care Here, you'll work alongside an award-winning team ...
Santa Clarita, CA · On-site
$37.92 - $60.68/hr
CODER III - $37.92 to $60.68 Your Work Here Matters. Your Career Here Thrives. Imagine coming to ... Where Clinical Excellence Meets Cutting-Edge Care Here, you'll work alongside an award-winning team ...
$28.6K - $33.2K
4% of jobs
$33.2K - $37.9K
14% of jobs
$37.9K - $42.5K
4% of jobs
$45.7K is the 25th percentile. Wages below this are outliers.
$42.5K - $47.1K
4% of jobs
$47.1K - $51.7K
4% of jobs
$51.7K - $56.3K
12% of jobs
The median wage is $58.5K / yr.
$56.3K - $61K
17% of jobs
$61K - $65.6K
16% of jobs
$65.7K is the 75th percentile. Wages above this are outliers.
$65.6K - $70.2K
13% of jobs
$70.2K - $74.8K
6% of jobs
$74.8K - $79.4K
6% of jobs
$28.6K
$56.6K
$79.4K
A Clinical Coder is responsible for translating medical diagnoses, procedures, and treatments into standardized codes used for billing, healthcare records, and insurance purposes. They analyze patient records and apply classification systems such as ICD-10 and CPT to ensure accurate and consistent data entry. Clinical Coders work in hospitals, clinics, and healthcare organizations, playing a vital role in healthcare administration. Their work helps with reimbursement, research, and healthcare planning. Strong attention to detail and a thorough understanding of medical terminology, anatomy, and coding guidelines are essential for this role.
To thrive as a Clinical Coder, you need a solid understanding of medical terminology, anatomy, and clinical procedures, usually backed by a relevant qualification in health information management or medical coding. Familiarity with coding systems like ICD-10, CPT, and specialized medical coding software is essential, and certifications such as CCS, CPC, or equivalent are highly valued. Attention to detail, analytical thinking, and effective communication are important soft skills for success in this field. Mastering these skills ensures accurate translation of clinical data into standardized codes, which is critical for billing, compliance, and healthcare quality reporting.
Clinical Coders often encounter challenges such as deciphering incomplete or unclear clinical documentation, staying current with frequent updates to coding standards, and managing high volumes of records within tight deadlines. These professionals must constantly collaborate with healthcare providers to clarify details and ensure that codes accurately reflect the care delivered. Adapting to new coding software or changes in healthcare regulations can also be part of the job. However, these challenges offer valuable opportunities for growth and skill development, and strong problem-solving abilities can help you excel in this dynamic field.

$132K - $163K/yr
Other
Medical, Dental, Vision, Retirement, PTO
Re-posted 5 days ago
9.0
Based on 8 frontline employees who took The Breakroom Quiz
33rd of 281 rated insurance
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.
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.
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.
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.
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
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Health care and social assistance
1,001 - 5,000 Employees
Los Angeles, CA, US
1997