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Medical Coding Compliance Jobs in California (NOW HIRING)

APS

Medical Coder

Modesto, CA · On-site

$19.50 - $26/hr

Ensure coding documentation is complete and compliant * Maintain accuracy and strong follow-through on all assigned work Qualifications * Minimum 1 year of medical coding experience required

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Medical Coding Compliance information

What is medical coding compliance?

Medical coding compliance refers to the process of ensuring that medical coding practices adhere to federal, state, and organizational regulations and guidelines. This involves accurately translating medical diagnoses, procedures, and services into standardized codes for billing and documentation purposes. Compliance helps prevent fraud, reduce billing errors, and ensures that healthcare providers receive appropriate reimbursement while avoiding legal penalties. Professionals in this field stay updated on changing regulations, conduct audits, and provide training to staff to maintain high standards of accuracy and integrity.

What are the key skills and qualifications needed to thrive in medical coding compliance, and why are they important?

To thrive in Medical Coding Compliance, you need a thorough understanding of medical coding systems (such as ICD-10, CPT, and HCPCS), healthcare regulations, and compliance standards, often backed by certifications like CPC, CCS, or CHC. Proficiency with electronic health record (EHR) systems, coding software, and compliance auditing tools is typically required. Attention to detail, analytical thinking, and effective communication are essential soft skills for identifying discrepancies and educating staff. These skills ensure accurate coding, reduce legal risks, and maintain organizational compliance with healthcare regulations.

What are some common challenges faced in a medical coding compliance role, and how can they be addressed?

Medical Coding Compliance professionals often encounter challenges such as staying updated with frequent changes to coding regulations, ensuring consistent adherence to compliance standards across departments, and accurately interpreting complex clinical documentation. To address these, it’s crucial to participate in ongoing education, maintain close communication with healthcare providers, and utilize robust auditing tools. Collaborating with compliance officers and regularly attending training sessions can also help reinforce best practices and minimize errors.

What is the difference between Medical Coding Compliance vs Medical Coding Specialist?

AspectMedical Coding ComplianceMedical Coding Specialist
CertificationsCPMA, CPC, CCSCPC, CCS
Work EnvironmentCompliance departments, healthcare organizationsMedical offices, hospitals, clinics
Primary FocusEnsuring coding accuracy and regulatory adherenceAssigning codes to medical procedures and diagnoses
Employer & Industry UsageHealthcare compliance and auditing firms, hospitalsHealthcare providers, billing companies

Medical Coding Compliance professionals focus on ensuring that coding practices adhere to regulations and standards, often working in compliance or auditing roles. Medical Coding Specialists primarily assign codes to medical records for billing and documentation. While both roles require similar certifications, their responsibilities and work environments differ significantly.

What does a medical coding compliance specialist do?

A medical coding compliance specialist ensures that healthcare providers accurately code medical procedures and diagnoses according to industry standards and regulations. They review coding practices, monitor for compliance with legal and payer requirements, and implement policies to prevent fraud and errors, often using coding software and staying updated on coding guidelines.

What are popular job titles related to Medical Coding Compliance jobs in California?

For Medical Coding Compliance jobs in California, the most frequently searched job titles are:

What job categories do people searching Medical Coding Compliance jobs in California look for?

The top searched job categories for Medical Coding Compliance jobs in California are:

What cities in California are hiring for Medical Coding Compliance jobs?

Cities in California with the most Medical Coding Compliance job openings:

Medical Coding Compliance jobs near you
Infographic showing various Medical Coding Compliance job openings in California as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 16% Part Time, and 5% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution.

Accredited CPC Medical Coding Specialist

MLee Medical Employment

Winchester, CA • On-site

Other

Re-posted 8 days ago

Job description

Position Overview
This role is responsible for accurately determining codes for physicians' diagnoses and procedures, ensuring compliance with the latest medical reimbursement policies and CMS guidelines. The specialist reviews medical records to identify all appropriate coding, generates invoices for insurance and patient billing, and manages insurance claims and collections. Collaboration with clinical teams and patients is essential to ensure precise and complete charge preparation for patient visits.
Key Responsibilities
  • Maintain a safe and clean work environment, adhering to unit safety and infection control standards.
  • Coding Duties:
    • Utilize Electronic Health Records (EHR) to support claim coding.
    • Assign ICD-10-CM, CPT-4, and HCPCS codes for surgeries based on current guidelines.
    • Review physician notes for accuracy and completeness.
    • Communicate with physicians to clarify or correct documentation as needed.
    • Ensure all medical records are complete, including proper timing, dating, and signatures.
    • Apply modifiers according to payer guidelines.
    • Understand documentation and compliance requirements for coding.
    • Maintain strict confidentiality and comply with HIPAA regulations protecting Protected Health Information (PHI).
  • Insurance and Patient Billing:
    • Process and submit electronic claims efficiently.
    • Address and correct electronic claim rejections promptly.
    • Resolve all NCCI edits within two business days to ensure timely claim submission.
    • Print paper claims when necessary.
    • Provide cash quotes for self-pay surgeries and collect payments for non-covered procedures and injections.
  • Auditing:
    • Follow up on claim acceptance or rejection.
    • Investigate reasons for claim denials and take corrective action.
  • Perform additional duties as assigned.
Qualifications
  • At least one year of healthcare experience.
  • Strong knowledge of medical terminology, human anatomy, and coding methodologies.
  • Moderate understanding of Level 1 and 2 modifiers.
  • Ability to review documents for accuracy and completeness.
  • Detail-oriented with strong problem-solving skills.
  • Knowledgeable in NCCI, CCI edits, and LCDs, with the ability to apply regulations accurately.
  • Effective communication skills and ability to collaborate with coworkers.
  • High ethical standards and professional integrity.
  • Strong analytical and persuasive communication skills at all organizational levels.
Education
  • High school diploma or GED required.
  • Certificate or diploma from an accredited medical coding program.
Certification
  • Current CPC, CPC-A, CCS, or RHIT certification required.

Employment is contingent upon passing a physical evaluation, drug screening, and background checks prior to starting work.
This position is located in a regional healthcare setting within the Pacific Northwest, serving diverse coastal communities with a commitment to compassionate and quality patient care.
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About McCall and Lee

Sourced by ZipRecruiter

McCall and Lee is a well-known and reputable company, headquartered in Austin, Texas, United States. Operating in the healthcare industry, their primary services center around professional recruiting and executive search. They cater to the needs of various levels of medical practitioners and executive positions for healthcare establishments. McCall and Lee is founded on the premise of filling healthcare vacancies with the most suitable and competent professionals to ensure top-quality medical service delivery. Their core value revolves around integrity, excellence, commitment, and customer satisfaction.

Industry

Recruiting and staffing services and human resources consulting services

Company size

11 - 50 Employees

Headquarters location

Austin, TX, US

Social media

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