Flexible Work, Better Balance
CalOptima Health is seeking a highly motivated Certified Coding Specialist to join our team. The Certified Coding Specialist will assist the Manager Coding Quality in implementing coding standards for the organization, including researching relevant regulations, serving as a resource for other departments, and reviewing and recommending changes to systems, policies, or procedures to ensure current and appropriate coding guidelines are maintained. The incumbent will review the appropriateness of codes billed when reviewing medical records related to provider disputes and appeals. Additionally, the incumbent will respond to questions submitted to the coding support mailbox and provide code guidance based on Medicare, Medi-Cal and national standards of billing protocol.