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Flexible R1 Rcm Medical Coding Jobs in California

Nexus HR

FQHC Billing Account Manager

Santa Fe Springs, CA · On-site

$30 - $34/hr

... 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 ...

RCM HealthCare Travel

Travel Physical Therapist

Fresno, CA · On-site

$1.9K - $2.2K/wk

RCM HealthCare Travel is seeking a travel Physical Therapist for a travel job in Fresno, California ... Medical, Dental, and Vision Insurance * Life and Disability insurance * 401K Flex Spending

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Flexible R1 Rcm Medical Coding information

What is a Flexible R1 RCM Medical Coding?

A Flexible R1 RCM Medical Coding job involves reviewing and translating healthcare diagnoses, procedures, and medical services into standardized medical codes for billing and insurance purposes. The 'flexible' aspect typically refers to work hours or remote work options. R1 RCM stands for R1 Revenue Cycle Management, a company specializing in healthcare revenue cycle solutions. Medical coders in this role ensure that healthcare providers are reimbursed accurately and comply with healthcare regulations. This position requires knowledge of coding systems like ICD-10, CPT, and HCPCS, as well as attention to detail and familiarity with healthcare documentation.

What are the key skills and qualifications needed to thrive as a Flexible R1 RCM Medical Coder?

To thrive as a Flexible R1 RCM Medical Coder, you need a strong understanding of medical terminology, ICD-10/CPT coding systems, and healthcare revenue cycle management, typically supported by a certification such as CPC or CCS. Familiarity with coding software, electronic health records (EHR) systems, and medical billing platforms is essential. Attention to detail, analytical thinking, and strong communication skills help ensure accuracy and effective collaboration with healthcare teams. These competencies are crucial for maximizing reimbursement, maintaining compliance, and reducing claim denials in a dynamic healthcare environment.

What are the typical challenges faced by Flexible R1 RCM Medical Coders, and how can I prepare for them?

Flexible R1 RCM Medical Coders often navigate a fast-paced environment where accuracy and compliance are crucial. One common challenge is staying up-to-date with frequent changes in coding guidelines and payer requirements. Coders must also manage productivity targets while ensuring high-quality coded records. Preparing for these challenges involves continual learning, strong attention to detail, and effective time management. Collaborating with billing teams and participating in ongoing training can help you stay current and succeed in the role.

What is the difference between Flexible R1 Rcm Medical Coding vs Medical Billing Specialist?

AspectFlexible R1 Rcm Medical CodingMedical Billing Specialist
CertificationsAHIMA or AAPC coding credentials, CPC or CCS certificationsBilling and coding certifications preferred, such as CPC
Work EnvironmentHealthcare facilities, remote coding environmentsMedical offices, billing companies, healthcare facilities
Primary ResponsibilitiesAssigning accurate medical codes for diagnoses and proceduresProcessing patient bills, submitting claims, follow-up on payments

Flexible R1 Rcm Medical Coders focus on translating medical documentation into standardized codes, while Medical Billing Specialists handle the billing process and insurance claims. Both roles require coding certifications and often work in similar healthcare settings, but their core tasks differ significantly.

What are the most commonly searched types of R1 Rcm Medical Coding jobs in California?

The most popular types of R1 Rcm Medical Coding jobs in California are:

What cities in California are hiring for Flexible R1 Rcm Medical Coding jobs?

Cities in California with the most Flexible R1 Rcm Medical Coding job openings:

Flexible R1 Rcm Medical Coding jobs near you

FQHC Billing Account Manager

Nexus HR

Santa Fe Springs, CA • On-site

$28/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 26 days ago

Job description

FQHC Billing Account Manager - Santa Fe Springs, CA
Compensation: $28.00 per hour
Overview: 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)

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