Claims Examiner
$28.85 - $33.65/hr
This role applies plan and contract rules, reimbursement methodologies, and medical billing/coding guidelines to ensure claims are processed accurately, timely, and in compliance with federal and ...
$28.85 - $33.65/hr
This role applies plan and contract rules, reimbursement methodologies, and medical billing/coding guidelines to ensure claims are processed accurately, timely, and in compliance with federal and ...
$28.85 - $33.65/hr
This role applies plan and contract rules, reimbursement methodologies, and medical billing/coding guidelines to ensure claims are processed accurately, timely, and in compliance with federal and ...
Redlands, CA · On-site
Expertise in medical billing, coding, compliance, and reimbursement methodologies. Experience with EHR and revenue cycle management systems (e.g., Epic, Cerner, Allscripts). Any combination of ...
Redlands, CA · On-site
Expertise in medical billing, coding, compliance, and reimbursement methodologies. Experience with EHR and revenue cycle management systems (e.g., Epic, Cerner, Allscripts). Any combination of ...
Redlands, CA · On-site
$120K - $150K/yr
Expertise in medical billing, coding, compliance, and reimbursement methodologies. Experience with EHR and revenue cycle management systems (e.g., Epic, Cerner, Allscripts). Any combination of ...
Redlands, CA · On-site
$120K - $150K/yr
Expertise in medical billing, coding, compliance, and reimbursement methodologies. Experience with EHR and revenue cycle management systems (e.g., Epic, Cerner, Allscripts). Any combination of ...
Redlands, CA · On-site
Expertise in medical billing, coding, compliance, and reimbursement methodologies. Experience with EHR and revenue cycle management systems (e.g., Epic, Cerner, Allscripts). Any combination of ...
Redlands, CA · On-site
Expertise in medical billing, coding, compliance, and reimbursement methodologies. Experience with EHR and revenue cycle management systems (e.g., Epic, Cerner, Allscripts). Any combination of ...
Irvine, CA · On-site
$21.75 - $27.75/hr
Knowledge of medical billing, coding (ICD-10, CPT, HCPCS), and insurance guidelines. * Experience with claim follow-up, AR management, and denial resolution. * Strong communication and negotiation ...
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Irvine, CA · On-site
$21.75 - $27.75/hr
Knowledge of medical billing, coding (ICD-10, CPT, HCPCS), and insurance guidelines. * Experience with claim follow-up, AR management, and denial resolution. * Strong communication and negotiation ...
Irvine, CA · On-site
$20 - $25.50/hr
Knowledge of ICD-10 Diagnosis and procedure codes and CPT/HCPCS codes. * Knowledge of rules and regulations relative to medical billing practices and regulations. * Knowledge of revenue cycle data ...
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Irvine, CA · On-site
$20 - $25.50/hr
Knowledge of ICD-10 Diagnosis and procedure codes and CPT/HCPCS codes. * Knowledge of rules and regulations relative to medical billing practices and regulations. * Knowledge of revenue cycle data ...
Mission Viejo, CA · On-site
$25 - $34/hr
Previous experience in medical billing, insurance claims processing, and/or medical coding required. * Knowledge of private insurance, Medicaid, and Medicare billing requirements. * Familiarity with ...
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Mission Viejo, CA · On-site
$25 - $34/hr
Previous experience in medical billing, insurance claims processing, and/or medical coding required. * Knowledge of private insurance, Medicaid, and Medicare billing requirements. * Familiarity with ...
Brea, CA · On-site
$20 - $27.50/hr
Collaborate with billing, coding, and front-office teams to address claim issues and prevent future ... Medical, Dental and Vision * Advancement Opportunities Experience: * Minimum 1-2 years of ...
Brea, CA · On-site
$20 - $27.50/hr
Collaborate with billing, coding, and front-office teams to address claim issues and prevent future ... Medical, Dental and Vision * Advancement Opportunities Experience: * Minimum 1-2 years of ...
Brea, CA · On-site
$20 - $27.50/hr
Collaborate with billing, coding, and front-office teams to address claim issues and prevent future ... Medical, Dental and Vision * Advancement Opportunities Experience: * Minimum 1-2 years of ...
Brea, CA · On-site
$20 - $27.50/hr
Collaborate with billing, coding, and front-office teams to address claim issues and prevent future ... Medical, Dental and Vision * Advancement Opportunities Experience: * Minimum 1-2 years of ...
Santa Ana, CA · On-site
$18 - $25/hr
Familiarity with billing codes (CPT, ICD-10) and medical billing procedures. * Coordinates submission of appropriate charges to billing department. * Utilize EHR/EMR systems efficiently for patient ...
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Santa Ana, CA · On-site
$18 - $25/hr
Familiarity with billing codes (CPT, ICD-10) and medical billing procedures. * Coordinates submission of appropriate charges to billing department. * Utilize EHR/EMR systems efficiently for patient ...
Santa Ana, CA · On-site
$18 - $25/hr
Familiarity with billing codes (CPT, ICD-10) and medical billing procedures. * Coordinates submission of appropriate charges to billing department. * Utilize EHR/EMR systems efficiently for patient ...
Quick apply
Santa Ana, CA · On-site
$18 - $25/hr
Familiarity with billing codes (CPT, ICD-10) and medical billing procedures. * Coordinates submission of appropriate charges to billing department. * Utilize EHR/EMR systems efficiently for patient ...
Anaheim, CA · On-site
$25 - $30/hr
Billing & Coding: Manage medical billing, Medicare/Medicaid compliance, and medical collection efforts using ICD-9/10 and CPT codes. Complex Coordination: Handle insurance verification for outpatient ...
Anaheim, CA · On-site
$25 - $30/hr
Billing & Coding: Manage medical billing, Medicare/Medicaid compliance, and medical collection efforts using ICD-9/10 and CPT codes. Complex Coordination: Handle insurance verification for outpatient ...
Anaheim, CA · On-site
$25 - $30/hr
Billing & Coding: Manage medical billing, Medicare/Medicaid compliance, and medical collection efforts using ICD-9/10 and CPT codes. Complex Coordination: Handle insurance verification for outpatient ...
Anaheim, CA · On-site
$25 - $30/hr
Billing & Coding: Manage medical billing, Medicare/Medicaid compliance, and medical collection efforts using ICD-9/10 and CPT codes. Complex Coordination: Handle insurance verification for outpatient ...
Tustin, CA · On-site
$23 - $26/hr
Education, Qualifications, and Experience: · Billing or Coder Certification · 0-2 years in medical billing or healthcare administrative support . EClinical Works experience ( Required
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Tustin, CA · On-site
$23 - $26/hr
Education, Qualifications, and Experience: · Billing or Coder Certification · 0-2 years in medical billing or healthcare administrative support . EClinical Works experience ( Required
City Of Industry, CA · On-site
$56.18/hr
About the Employer Hacienda La Puente Unified School District (HLPUSD) is proud to serve a diverse student population, from Transitional Kindergarten to Adult Education of 31,000 total students. Two ...
City Of Industry, CA · On-site
$56.18/hr
About the Employer Hacienda La Puente Unified School District (HLPUSD) is proud to serve a diverse student population, from Transitional Kindergarten to Adult Education of 31,000 total students. Two ...
Irvine, CA · On-site
$23 - $28/hr
The Billing & Credentialing Specialist is responsible for managing the full revenue cycle for ... Review, analyze, and resolve claim denials related to medical necessity, coding, benefit coverage ...
Irvine, CA · On-site
$23 - $28/hr
The Billing & Credentialing Specialist is responsible for managing the full revenue cycle for ... Review, analyze, and resolve claim denials related to medical necessity, coding, benefit coverage ...
Irvine, CA · On-site
$23 - $28/hr
The Billing & Credentialing Specialist is responsible for managing the full revenue cycle for ... Review, analyze, and resolve claim denials related to medical necessity, coding, benefit coverage ...
Irvine, CA · On-site
$23 - $28/hr
The Billing & Credentialing Specialist is responsible for managing the full revenue cycle for ... Review, analyze, and resolve claim denials related to medical necessity, coding, benefit coverage ...
Irvine, CA · On-site
$23 - $28/hr
The Billing & Credentialing Specialist is responsible for managing the full revenue cycle for ... Review, analyze, and resolve claim denials related to medical necessity, coding, benefit coverage ...
Irvine, CA · On-site
$23 - $28/hr
The Billing & Credentialing Specialist is responsible for managing the full revenue cycle for ... Review, analyze, and resolve claim denials related to medical necessity, coding, benefit coverage ...
Anaheim, CA · On-site
$52K - $65K/yr
Knowledge of payor guidelines, industry billing, and coding standards, and Medi-Cal denials reason ... Electronic medical records experience may also be required. * Abortion patients are cared for at ...
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Anaheim, CA · On-site
$52K - $65K/yr
Knowledge of payor guidelines, industry billing, and coding standards, and Medi-Cal denials reason ... Electronic medical records experience may also be required. * Abortion patients are cared for at ...
Rancho Santa Margarita, CA · On-site
$19 - $25/hr
This position offers in-depth clinical training in a medical Back Office, including surgery assisting, phlebotomy, wound care, medical billing codes; pre-auths, and other tasks and procedures ...
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Rancho Santa Margarita, CA · On-site
$19 - $25/hr
This position offers in-depth clinical training in a medical Back Office, including surgery assisting, phlebotomy, wound care, medical billing codes; pre-auths, and other tasks and procedures ...
$13.54 - $14.91
2% of jobs
$14.91 - $16.28
4% of jobs
$16.28 - $17.65
12% of jobs
$18.42 is the 25th percentile. Wages below this are outliers.
$17.65 - $19.01
13% of jobs
$19.01 - $20.38
17% of jobs
The median wage is $20.63 / hr.
$20.38 - $21.75
15% of jobs
$22.95 is the 75th percentile. Wages above this are outliers.
$21.75 - $23.12
15% of jobs
$23.12 - $24.49
9% of jobs
$24.49 - $25.85
7% of jobs
$25.85 - $27.22
3% of jobs
$27.22 - $28.59
3% of jobs
$13
$21
$28
| Aspect | Intern Medical Billing And Coding | Medical Billing And Coding Specialist |
|---|---|---|
| Credentials | Typically enrolled in or recently completed training programs | Usually certified or credentialed (e.g., CPC, CCMA) |
| Work Environment | Entry-level, supervised training setting | Full-time, independent or team-based office environment |
| Employer & Industry Usage | Hospitals, clinics, training programs | Healthcare providers, billing companies, hospitals |
| Search & Comparison Intent | Learning about entry-level roles or internships | Understanding career progression or job requirements |
In summary, Intern Medical Billing And Coding roles are entry-level positions focused on training and gaining experience, often in educational settings. Medical Billing And Coding Specialists are fully credentialed professionals responsible for managing billing and coding tasks independently in healthcare settings.
The most popular types of Medical Billing And Coding jobs in Riverside, CA are:
Cities near Riverside, CA with the most Intern Medical Billing And Coding job openings:
$28.85 - $33.65/hr
Full-time
Re-posted 7 days ago
Description
JOB SUMMARY
The Claims Examiner is responsible for reviewing, analyzing, and adjudicating medical claims for a management services organization (MSO) supporting medical clinics and Independent Practice Association (IPA) groups. This role applies plan and contract rules, reimbursement methodologies, and medical billing/coding guidelines to ensure claims are processed accurately, timely, and in compliance with federal and California requirements. The Claims Examiner collaborates with Provider Relations/Network, Contracting, Utilization Management, Finance, Member/Patient Services, and Compliance to resolve pended claims, denials, adjustments, and provider disputes while meeting production and quality standards.
Requirements
MINIMUM & PREFERRED QUALIFICATIONS
Education
Minimum: High school diploma or equivalent, or equivalent combination of education and experience.
Experience
Minimum: Two years of healthcare claims processing or claims adjudication experience, including experience interpreting benefits and reimbursement rules. Experience working with claim denials, adjustments, and provider inquiries. Working knowledge of medical billing/coding basics (CPT, HCPCS, ICD-10, revenue codes) and how coding impacts adjudication. Experience using claims systems and/or EDI workflows preferred.
Skills, Knowledge & Abilities
Knowledge of end-to-end claims lifecycle including intake, edits, adjudication, pricing, payment, denials, adjustments, and recoveries.
Ability to interpret provider contracts, fee schedules, and reimbursement methodologies (FFS, DRG/APC, capitation, bundled payments).
Strong analytical and problem-solving skills; able to research discrepancies and determine appropriate resolution.
Attention to detail and accuracy with ability to meet production, turnaround time, and quality standards.
Effective written and verbal communication; professional customer service with providers and internal stakeholders.
Working knowledge of HIPAA transactions (837/835) and claims-related regulatory requirements including prompt pay and dispute resolution.
Proficient with claims systems, Microsoft Office/Google Workspace, and basic reporting tools.
PHYSICAL, MENTAL & ENVIRONMENTAL REQUIREMENTS:
The physical demands described here are represented by those that must be met by an employee to successfully perform the essential functions of this job. Work is primarily performed in an office or hybrid office environment and involves prolonged periods of sitting, computer use, and data review. The role requires sustained concentration, analytical thinking, and attention to detail to ensure claims accuracy and regulatory compliance. Occasional lifting of materials up to approximately 10-20 pounds may be required. The position may require extended work hours or weekend work to meet operational and regulatory deadlines.
PAY RANGE
$28.85 - $33.65 / hourly