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Coding Integrity Specialist Jobs in California (NOW HIRING)

Aquent

Coding Specialist

Sacramento, CA · On-site +1

$38.29 - $41.07/hr

... to quality, integrity, and community well-being. Join a team where your expertise directly ... coding guidelines and ethics. * Collaborate effectively with clinical documentation specialists and ...

MedPOINT Management

HCC Coding Specialist

Sherman Oaks, CA · On-site

$75K - $95K/yr

MedPOINT Management in Sherman Oaks, CA is looking for a detail-oriented HCC Coding Specialist to ... Our provider partners and health plan clients trust us for our expertise, integrity, and commitment ...

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Coding Integrity Specialist information

How does a coding integrity specialist typically collaborate with clinical staff and other departments?

Coding Integrity Specialists frequently work closely with clinical staff, billing teams, and compliance departments to ensure accurate medical coding and adherence to regulatory guidelines. They often clarify documentation with healthcare providers, participate in cross-departmental meetings, and provide education on coding best practices. This collaborative approach helps reduce errors, prevent claim denials, and maintain high standards for data integrity across the organization.

What is the difference between Coding Integrity Specialist vs Medical Coder?

AspectCoding Integrity SpecialistMedical Coder
CertificationsAHIMA or AAPC coding credentials, compliance trainingAHIMA or AAPC coding credentials, certification often preferred
Work EnvironmentHealthcare organizations, compliance departmentsHospitals, clinics, billing companies
Job FocusEnsuring coding accuracy, compliance, auditingAssigning medical codes for billing and documentation

The Coding Integrity Specialist and Medical Coder roles both require coding certifications and work within healthcare settings. However, the Coding Integrity Specialist primarily focuses on auditing, compliance, and maintaining coding accuracy, while Medical Coders are responsible for assigning codes for billing purposes. The Specialist role emphasizes oversight and integrity, whereas the Coder role centers on code assignment.

What are the key skills and qualifications needed to thrive as a coding integrity specialist, and why are they important?

To thrive as a Coding Integrity Specialist, you need comprehensive knowledge of medical coding systems (such as ICD-10, CPT, and HCPCS), healthcare regulations, and typically a certification like CCS or CPC. Proficiency with coding auditing software, electronic health record (EHR) systems, and compliance tools is essential. Attention to detail, analytical thinking, and strong communication skills are crucial soft skills for ensuring accuracy and collaborating with healthcare teams. These skills ensure accurate coding, regulatory compliance, and optimized reimbursement for healthcare organizations.

What is a coding integrity specialist?

Coding Integrity Specialists are professionals who ensure the accuracy and compliance of medical coding within healthcare organizations. They review clinical documentation and coding processes to make sure that diagnoses, procedures, and services are coded correctly according to regulatory requirements and industry standards. Their work helps organizations receive appropriate reimbursement, avoid coding errors, and maintain compliance with healthcare laws. Coding Integrity Specialists often collaborate with medical coders, auditors, and healthcare providers to resolve discrepancies and provide education on best practices.
What are popular job titles related to Coding Integrity Specialist jobs in California? For Coding Integrity Specialist jobs in California, the most frequently searched job titles are:
What job categories do people searching Coding Integrity Specialist jobs in California look for? The top searched job categories for Coding Integrity Specialist jobs in California are:
What cities in California are hiring for Coding Integrity Specialist jobs? Cities in California with the most Coding Integrity Specialist job openings:
Coding Integrity Specialist jobs near you
Infographic showing various Coding Integrity Specialist job openings in California as of August 2026, with employment types broken down into 82% Full Time, 15% Part Time, and 3% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution.

Senior Revenue Integrity Specialist - Clinical Rev Integrity - Full Time 8 Hour Days (REMOTE) (Exemp

University of Southern California

Los Angeles, CA • On-site, Remote

Full-time

Re-posted 13 hours ago

University Of Southern California rating

8.4

Company rating: 8.4 out of 10

Based on 53 frontline employees who took The Breakroom Quiz

99th of 618 rated colleges and universities

Job description

As the center of clinical charge capture, the Revenue Integrity (RI) Specialist provides leadership to the daily CDM maintenance workflow between the various entities of Keck Medical Center of USC and monitors the alignment of the various entities to the standard policy for maintaining the CDM. The RI Specialist is responsible for the timely and accurate synchronization of data between the CDM residing in the billing system and CDM management tools . The Senior RI Specialist shall ensure that the Chargemaster (CDM) is consistent with all coding and billing regulations and accurately represents services provided. This includes ensuring all annual updates required by Medicare and other third-party payers are up to date. The Senior RI Specialist delivers direction to the documentation of all policies and procedures regarding CDM Maintenance and charge process; and conducts meetings to evaluate department charge processes to improve charge capture and coding compliance. The Senior RI Specialist also coordinates with Keck Medical Center of USC Administration, IS, Compliance, Clinical Informatics and Integration personnel on technology projects impacting charge entry, charge dictionaries, and charge, and provides data derived from multiple entities of Keck Medical Center of USC for the management and support of critical decisions and functions related the Chargemaster, CDM Maintenance, and the improvement of charge capture. As a subject matter expert in the area of compliance and pricing of services, the Senior RI Specialist responds to inquiries regarding Chargemaster issues and is responsible for supervising meetings for projects associated with educating and communicating to clinical revenue generating departmental staff regarding the CDM Maintenance process, coding updates, compliance issues, and charge capture improvement. The Senior RI Specialist works closely with revenue auditors and provides leadership by providing direction to the revenue auditor team to all entities of Keck Medical Center of USC in the research and resolution of requests in a timely manner; and aid in the training and skill development of auditors to maximize available tools for Chargemaster and billing compliance.
Essential Duties:
  • Performs maintenance to the Keck Medical Center of USC Charge Description Master (Keck & Norris) ensuring all annual updates required by Medicare and other third-party payers are up to date. Assists the Revenue Cycle in annual coding review and processing of updates.

  • Reviews and process requests for new code additions, code set corrections, revenue code to CPT/HCPCS code mismatch corrections and on-going identified changes for current systems to maintain compliance with both state and federal regulatory agencies.

  • Leads and conducts meetings with Operations Leaders, Revenue Auditors, Clinical Department Staff, and Gatekeepers to address issues involving compliance with government regulations, third party payor needs and industry standards.

  • Acts a subject matter expert for projects that impact revenue integrity and CDM. Subject matter expert to meet and/or communicate with various stakeholders for projects that impacts revenue integrity and the CDM.

  • Takes the lead and exercises significant judgement and discretion on projects that have a broad, organizational impact.

  • Coordinates and provides leadership to Revenue/Chart Audit team associated with research and resolution of account issues related to the CDM, charge capture, and other issues considered to be revenue integrity.

  • Synchronizes CDM data between CDM and CDM Workflow & Management Tool for Keck Medical Center of USC entities on a monthly basis.

  • Imports/extracts data from various sources and in various formats as needed to review, monitor, track, and maintain the integrity of the CDM and associate charge flow process.

  • Provides CDM data as necessary based on identified issues in form of ad-hoc reports.

  • Provides guidance and education to ensure that CDM's and Charge Capture as needed of exist and newly acquired entities (i.e. Verdugo Hills) follow the standards and policies of Keck Medical Center of USC.

  • Performs charge reconciliation activities, industry best practice research, and identifies and deploys charge capture improvement initiatives.

  • Interprets and explains on details of charge services provided as needed.

  • Participates collaboratively with Revenue Cycle and Ancillary team in the development, execution, and follow-up of education programs for USC Administration, Managers and Staff on all issues related to the charge master, charge capture, and new applications related processes.

  • Participates in the development of policies and procedures, monitoring tools for late charges and establishment of procedures for timely and accurate charge capture mechanisms.

  • Enhances professional growth and development

  • Actively participates in team development, contributes to dashboards, and in accomplishing team, departmental, and organizational goals and objectives.

  • Performs other duties as assigned.

Required Qualifications:
  • Req Associate's Degree Business Administration, Accounting, Finance, Healthcare Administration, Nursing, or similar/related field.

  • Req Specialized/technical training Certification from an accredited program of Certified Coder (CPC/CCS/COC) or Certificate of Auditing (CPMA) within one year from date of hire.

  • Req 5 years Experience in healthcare field required. Related experience may include a combination of clinical service delivery (nursing or allied health), coding, provider billing, medical records, charge audit environment, CDM maintenance, Medicare/Medicaid reimbursement, managed care contractual arrangements, and patient accounting.

  • Req Experience with inpatient and outpatient billing requirements (UB-04) and CMS Medicare reimbursement methodology.

  • Req Knowledge of other government and third-party payer reimbursement methodology required.

  • Req Must be able to implement a systematic, self-motivated approach to problem solving and be able to identify, coordinate and optimize resources needed to execute plan

  • Req Proficient skills and knowledge in MS Office/ Windows

Preferred Qualifications:
  • Pref Bachelor's Degree Business Administration, Accounting, Finance, Healthcare Administration, Nursing, or similar/related field.

  • Pref Previous hospital Chargemaster experience, including the use of CDM Maintenance software (Craneware or Med Assets).

  • Pref Experience and knowledge of Hospital charging practices.

  • Pref Healthcare operations experience, particularly in an acute care hospital setting.

  • Pref Current knowledge of the Revenue cycle, specifically the flow of charges in and across hospital billing systems.

  • Pref Working knowledge of CPT, HCPCs and ICD9 coding principles.

  • Pref Skills and knowledge on the following software: Cerner and Craneware

Required Licenses/Certifications:
  • Req Specialty Certification Certified Coder (CCS or CPC), Certified Outpatient Coder-COC (AAPC) or Certified Auditor (CPMA) obtained within one (1) year of date of hire.

  • Pref Registered Nurse - RN (CA Board of Registered Nursing)

  • Pref Pharmacy Technician (CA DCA)

  • Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)

Keck Hospital of USC, a 343-bed acute care hospital, provides exceptional and innovative care for complex medical and surgical conditions across a wide range of specialties. The hospital's world-renowned physicians deliver compassionate, customized, patient-centered care and treat the most acutely ill patients with highly innovative techniques and treatment plans. As a leading academic medical center, hundreds of clinical trials are currently taking place at Keck Hospital and its affiliated research institutions, giving patients access to novel and promising therapies that are generally not available elsewhere. Every day at Keck Hospital, physicians, nurses and staff go beyond the science of exceptional medicine to bring patients breakthroughs in the art of caring. Join this world-class team providing highly specialized care, up-to-the-minute research, and innovative clinical trials.
The annual base salary range for this position is $99,507.00 - $130,000.00. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.
USC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other characteristic protected by law or USC policy. USC observes affirmative action obligations consistent with state and federal law. USC will consider for employment all qualified applicants with criminal records in a manner consistent with applicable laws and regulations, including the Los Angeles County Fair Chance Ordinance for employers and the Fair Chance Initiative for Hiring Ordinance, and with due consideration for patient and student safety. Please refer to the Background Screening Policy Appendix D for specific employment screen implications for the position for which you are applying.
We provide reasonable accommodations to applicants and employees with disabilities. Applicants with questions about access or requiring a reasonable accommodation for any part of the application or hiring process should contact USC Human Resources by phone at (213) 821-8100, or by email at uschr@usc.edu. Inquiries will be treated as confidential to the extent permitted by law.
  • Notice of Non-discrimination
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  • Read USC's Clery Act Annual Security Report
  • USC is a smoke-free environment
  • Digital Accessibility

If you are a current USC employee, please apply to this USC job posting in Workday by copying and pasting this link into your browser:
https://wd5.myworkday.com/usc/d/inst/1$9925/9925$150685.htmld

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About University of Southern California

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The University of Southern California (USC) is not a conventional company, but a private research university established in the heart of Los Angeles, CA, US. Founded in 1880, it's one of the oldest private research universities in California. USC operates in the education industry providing primary services of higher education, research, and community development. This prestigious institution offers a comprehensive array of undergraduate, graduate, and professional programs across various disciplines, including the humanities, social sciences, and STEM (Science, Technology, Engineering, and Mathematics). The University is guided by its commitment to foster creativity, innovation, leadership, and discovery through academic excellence.

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