Independently re-evaluates medical claims and associated records by applying knowledge of advanced coding, all relevant and applicable Federal and State regulatory requirements, and Molina policies.
Independently re-evaluates medical claims and associated records by applying knowledge of advanced coding, all relevant and applicable Federal and State regulatory requirements, and Molina policies.
Medical Billing Specialist
Los Angeles, CA · Remote
$18 - $23/hr
Medical Billing Specialist - fully remote Turn your job into a career with Evergreen Healthcare ... Full understanding of the UB-04 form including; revenue codes, value codes, occurrence codes and ...
Quick apply
Medical Billing Specialist
Los Angeles, CA · Remote
$18 - $23/hr
Medical Billing Specialist - fully remote Turn your job into a career with Evergreen Healthcare ... Full understanding of the UB-04 form including; revenue codes, value codes, occurrence codes and ...
Medical Billing Specialist
Los Angeles, CA · Remote
$18 - $23/hr
Medical Billing Specialist - fully remote Turn your job into a career with Evergreen Healthcare ... Full understanding of the UB-04 form including; revenue codes, value codes, occurrence codes and ...
Quick apply
Medical Billing Specialist
Los Angeles, CA · Remote
$18 - $23/hr
Medical Billing Specialist - fully remote Turn your job into a career with Evergreen Healthcare ... Full understanding of the UB-04 form including; revenue codes, value codes, occurrence codes and ...
Chief Medical Officer Location: This is a remote role with meaningful travel required. LA-based ... Drive cross-functional execution across Clinical, Product, Marketing, Finance, RCM, People, and ...
Quick apply
Chief Medical Officer Location: This is a remote role with meaningful travel required. LA-based ... Drive cross-functional execution across Clinical, Product, Marketing, Finance, RCM, People, and ...
Business Analyst
Long Beach, CA · Remote
Ability to work independently in a remote environment. * Ability to work with those in other time ... Medical Coding certification. To all current Molina employees: If you are interested in applying ...
Business Analyst
Long Beach, CA · Remote
Ability to work independently in a remote environment. * Ability to work with those in other time ... Medical Coding certification. To all current Molina employees: If you are interested in applying ...
Business Analyst
Long Beach, CA · On-site +1
$44K - $97K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Medical Coding certification. To all current Molina employees: If you are interested in applying ...
Business Analyst
Long Beach, CA · On-site +1
$44K - $97K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Medical Coding certification. To all current Molina employees: If you are interested in applying ...
Business Analyst
Long Beach, CA · On-site +1
$44K - $97K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Medical Coding certification. To all current Molina employees: If you are interested in applying ...
Business Analyst
Long Beach, CA · On-site +1
$44K - $97K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Medical Coding certification. To all current Molina employees: If you are interested in applying ...
Business Analyst (Medical Billing/Coding)
Long Beach, CA · Remote
$52K - $69K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Medical Coding certification. To all current Molina employees: If you are interested in applying ...
Business Analyst (Medical Billing/Coding)
Long Beach, CA · Remote
$52K - $69K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Medical Coding certification. To all current Molina employees: If you are interested in applying ...
Remote, but only considering candidates in PST. FLSA Status: Exempt Travel Requirement: None ... Review medical records for quality clinical documentation and compliance with licensing ...
Quick apply
Remote, but only considering candidates in PST. FLSA Status: Exempt Travel Requirement: None ... Review medical records for quality clinical documentation and compliance with licensing ...
Senior Software Engineer, Rejections & Denials
Los Angeles, CA · Remote
$170K - $240K/yr
About the Role At Commure, our Revenue Cycle Management (RCM) Core team is building the autonomous ... Generate appeal letters and medical-record packets automatically, with validation scoring that ...
Quick apply
Senior Software Engineer, Rejections & Denials
Los Angeles, CA · Remote
$170K - $240K/yr
About the Role At Commure, our Revenue Cycle Management (RCM) Core team is building the autonomous ... Generate appeal letters and medical-record packets automatically, with validation scoring that ...
This is a remote role with minimal travel requirements A successful candidate would possess these ... management (RCM) services, including billing and claims submission, A/R follow-up, denials ...
This is a remote role with minimal travel requirements A successful candidate would possess these ... management (RCM) services, including billing and claims submission, A/R follow-up, denials ...
This is a remote role with minimal travel requirements A successful candidate would possess these ... management (RCM) services, including billing and claims submission, A/R follow-up, denials ...
This is a remote role with minimal travel requirements A successful candidate would possess these ... management (RCM) services, including billing and claims submission, A/R follow-up, denials ...
Medical Biller (Remote- CA, TX, AZ, ID)
Orange, CA · Remote
$23/hr
... medical records to assign/verify appropriate diagnostic and procedure ... codes • Run and analyze payment balancing report to ensure accurate posting • Perform other ...
Quick apply
Medical Biller (Remote- CA, TX, AZ, ID)
Orange, CA · Remote
$23/hr
... medical records to assign/verify appropriate diagnostic and procedure ... codes • Run and analyze payment balancing report to ensure accurate posting • Perform other ...
Senior Business Analyst
Long Beach, CA · On-site +1
$49K - $107K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Medical Coding certification. To all current Molina employees: If you are interested in applying ...
Senior Business Analyst
Long Beach, CA · On-site +1
$49K - $107K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Medical Coding certification. To all current Molina employees: If you are interested in applying ...
This is a remote role with minimal travel requirements A successful candidate would possess these ... management (RCM) services, including billing and claims submission, A/R follow-up, denials ...
This is a remote role with minimal travel requirements A successful candidate would possess these ... management (RCM) services, including billing and claims submission, A/R follow-up, denials ...
Lead day-to-day Medical Affairs Operations, ensuring smooth execution across programs and ... Knowledge of anti-kickback statute, Sunshine Reporting, and PhRMA Code * Knowledge of Good Clinical ...
Lead day-to-day Medical Affairs Operations, ensuring smooth execution across programs and ... Knowledge of anti-kickback statute, Sunshine Reporting, and PhRMA Code * Knowledge of Good Clinical ...
Senior Business Analyst (Medical Billing/Coding)
Long Beach, CA · Remote
$101K - $130K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Medical Coding certification. To all current Molina employees: If you are interested in applying ...
Senior Business Analyst (Medical Billing/Coding)
Long Beach, CA · Remote
$101K - $130K/yr
Ability to work independently in a remote environment. * Ability to work with those in other time ... Medical Coding certification. To all current Molina employees: If you are interested in applying ...
... coded diagnoses, procedures, revenue codes, and corresponding reimbursement methodologies ... Assesses medical records for clinical accuracy, acuity alignment, and documentation integrity.
... coded diagnoses, procedures, revenue codes, and corresponding reimbursement methodologies ... Assesses medical records for clinical accuracy, acuity alignment, and documentation integrity.
Remote DRG Clinical Validation Reviewer (Coding RN)
Long Beach, CA · On-site +1
$26.14 - $56.64/hr
... coded diagnoses, procedures, revenue codes, and corresponding reimbursement methodologies ... Assesses medical records for clinical accuracy, acuity alignment, and documentation integrity.
Remote DRG Clinical Validation Reviewer (Coding RN)
Long Beach, CA · On-site +1
$26.14 - $56.64/hr
... coded diagnoses, procedures, revenue codes, and corresponding reimbursement methodologies ... Assesses medical records for clinical accuracy, acuity alignment, and documentation integrity.
Qualifications * 5+ years of business analyst, implementation, client/payer-side, or healthcare RCM ... Core benefits including medical, dental, vision, and matching 401K * Flexible work environment ...
Qualifications * 5+ years of business analyst, implementation, client/payer-side, or healthcare RCM ... Core benefits including medical, dental, vision, and matching 401K * Flexible work environment ...
Remote R1 Rcm Medical Coding information
See Anaheim, CA salary details
$16.61 - $18.37
6% of jobs
$19.62 is the 25th percentile. Wages below this are outliers.
$18.37 - $20.13
26% of jobs
The median wage is $21.14 / hr.
$20.13 - $21.89
31% of jobs
$21.89 - $23.66
7% of jobs
$24.41 is the 75th percentile. Wages above this are outliers.
$23.66 - $25.42
11% of jobs
$25.42 - $27.18
6% of jobs
$27.18 - $28.94
5% of jobs
$28.94 - $30.70
3% of jobs
$30.70 - $32.46
2% of jobs
$32.46 - $34.23
1% of jobs
$34.23 - $35.99
1% of jobs
$16
$23
$35
How much do remote r1 rcm medical coding jobs pay per hour?
As of Jul 9, 2026, the average hourly pay for remote r1 rcm medical coding in Anaheim, CA is $23.47, according to ZipRecruiter salary data. Most workers in this role earn between $18.89 and $25.14 per hour, depending on experience, location, and employer.
What are the most commonly searched types of R1 Rcm Medical Coding jobs in Anaheim, CA? The most popular types of R1 Rcm Medical Coding jobs in Anaheim, CA are:
What are popular job titles related to Remote R1 Rcm Medical Coding jobs in Anaheim, CA? For Remote R1 Rcm Medical Coding jobs in Anaheim, CA, the most frequently searched job titles are:
What job categories do people searching Remote R1 Rcm Medical Coding jobs in Anaheim, CA look for? The top searched job categories for Remote R1 Rcm Medical Coding jobs in Anaheim, CA are:
- Remote Pay Per Chart Medical Coder
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- Internship Remote Medical Coding Apprentice
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What cities near Anaheim, CA are hiring for Remote R1 Rcm Medical Coding jobs? Cities near Anaheim, CA with the most Remote R1 Rcm Medical Coding job openings:
Full-time
Posted 23 hours ago
Molina Healthcare rating
8.1
Based on 193 frontline employees who took The Breakroom Quiz
133rd of 278 rated insurance
Job description
JOB DESCRIPTION
Provides investigative support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates and resolves instances of health care fraud and abuse investigations of medical providers using informational tips from member benefits and medical records following review of post-payment claims.
Essential Job Duties
- Independently re-evaluates medical claims and associated records by applying knowledge of advanced coding, all relevant and applicable Federal and State regulatory requirements, and Molina policies.
- Reviews post-pay claims against corresponding medical records to determine accuracy of claims payments.
- Manages documents and prioritizes caseloads to ensure timely turnaround.
- Ensures adherence to applicable state/federal/internal policies, Current Procedural Terminology (CPT) guidelines and provider contract requirements.
- Devises clinical summary post-review.
- Communicates and participates in meetings related to cases.
- Completes medical review to facilitate referral to law enforcement or payment recovery.
- Supports investigation work as necessary and required by the regulatory agency.
Job Requirements
- At least 2 years CPT coding experience in a surgical, hospital and/or clinic setting, or equivalent combination of relevant education and experience.
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Professional Medical Auditor (CPMA), or American Academy of Professional Coders (AAPC) certified
- Critical-thinking, problem-solving and analytical skills.
- Ability to prioritize and manage multiple tasks.
- Ability to work in a team setting.
- Strong verbal/written communication skills, and presentation skills.
- Microsoft Office suite (including Excel), and applicable software program(s) proficiency.
- In some states, 5 years of experience working in a fraud, waste and abuse (FWA)/special investigations unit (SIU)/fraud investigations role may be required (dependent on state/contractual requirements).
- Knowledge of investigative and law enforcement procedures with emphasis on fraud investigations.
- Knowledge of Managed Care and the Medicaid, Medicare, and Marketplace programs.
- Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems.
- Ability to research and interpret regulatory requirements.
Preferred Qualifications
- Certified Professional Compliance Officer (CPCO).
- Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI).
- Experience working in group health insurance, particularly within claims processing or operations.
- Working knowledge of local, state and federal laws and regulations pertaining to health insurance, investigations and legal processes (commercial insurance, Medicare, Medicare Advantage, Medicare Part D, Medicaid, Tricare, Pharmacy, etc.).
- Experience with claims processing systems.
- Ability to use Microsoft Excel/Access platforms working with large quantities of data.
- Ability to answer questions, identify trends and patterns, and present findings.
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To all current Molina employees. If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
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About Molina Healthcare
Sourced by ZipRecruiter
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Long Beach, CA, US
Year founded
1980