{"schemaVersion":"jobsearcher.job.v1","id":"d2bdec8ec4578fbdbf071e99","url":"https://jobsearcher.com/jobs/d2bdec8ec4578fbdbf071e99","canonicalUrl":"https://jobsearcher.com/jobs/d2bdec8ec4578fbdbf071e99","title":"Jr. Quality Improvement Coder","description":"Junior Quality Improvement Coder Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize accessibility, affordability, and quality in all aspects of our services. Join us in our mission to transform healthcare delivery and make a meaningful difference in the lives of our members.\nThe Junior Quality Improvement Coder is responsible for providing director support to all departmental QI initiatives. In this role, the Junior QI Coder will partner with the Director to collaborate with network providers and IPA's to improve the quality of care through quality improvement activities that will include RAF, HEDIS, CMS Star Ratings and other health plan reporting.\nEssential Duties And Responsibilities Include The Following:\nAnalyze data from contracted IPA network providers that allows for proper review of data to evaluate HEDIS and Risk Adjustment Factor.\nConduct internal reviews of documentation and billing on a timely basis.\nIdentify coding and billing risk areas, conduct focused reviews. Ensure accurate coding by utilizing official coding resources, Medicare manual and policies.\nCollaborate and educate provider practices on CMS guidelines for Star Measures (Part C & D). Review and advise on appropriate documentation and coding for HEDIS and RAF reporting.\nPrepare summary reporting of the coding review results as requested.\nParticipate in ongoing discussions concerning data collection and analysis for HEDIS gaps in care. Re-educate providers as needed.\nApply official CPT/HCPCS and ICD10 coding guidelines, internal guidelines, and state specific Medicare/Medicaid coding instructions to review and analyze professionally coded services and coding queries.\nCollaborate with internal departments and external partners to review and implement projects to improve delivery of services and quality of care.\nParticipate in provider and interdepartmental conference calls and meetings that support exceptional customer service.\nAttend health plan meetings as requested by department leadership.\nRegular and consistent attendance.\nOther duties as assigned.\nBenefits:\n401(k)\nDental Insurance\nHealth Insurance\nLife Insurance\nVision Insurance\nPaid Time Off\nFree catered lunches\nRequirements:\n0 - 1 year of prior experience as a coder in a quality improvement role within a health plan, IPA or medical group.\nCertified Coding certificate required.\nStrong understanding of coding principals including, HEDIS, Medicare Star ratings and Risk Adjustment.\nStrong understanding of the principals of HIPAA and able to maintain confidentiality.\nAble to build rapport with external providers and partners and internal teams.\nProfessionally present data and findings that support internal goals and objectives.\n\n#J-18808-Ljbffr","company":"Damar Staffing","rawCompany":"damar staffing","city":"Orange","state":"CA","isRemote":false,"isActive":false,"createdAt":"2026-08-31T03:20:06.919Z","occupations":[{"code":"29-9021.00","title":"Health Information Technologists and Medical Registrars","slug":"health-information-technologists-and-medical-registrars"},{"code":"29-2072.00","title":"Medical Records Specialists","slug":"medical-records-specialists"},{"code":"15-1211.01","title":"Health Informatics Specialists","slug":"health-informatics-specialists"}],"industries":[{"code":"621999","title":"All Other Miscellaneous Ambulatory Health Care Services","slug":"all-other-miscellaneous-ambulatory-health-care-services"},{"code":"624120","title":"Services for the Elderly and Persons with Disabilities","slug":"services-for-the-elderly-and-persons-with-disabilities"},{"code":"622110","title":"General Medical and Surgical Hospitals","slug":"general-medical-and-surgical-hospitals"}],"jobPosting":{"@context":"https://schema.org","@type":"JobPosting","title":"Jr. Quality Improvement Coder","description":"Junior Quality Improvement Coder Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize accessibility, affordability, and quality in all aspects of our services. Join us in our mission to transform healthcare delivery and make a meaningful difference in the lives of our members.\nThe Junior Quality Improvement Coder is responsible for providing director support to all departmental QI initiatives. In this role, the Junior QI Coder will partner with the Director to collaborate with network providers and IPA's to improve the quality of care through quality improvement activities that will include RAF, HEDIS, CMS Star Ratings and other health plan reporting.\nEssential Duties And Responsibilities Include The Following:\nAnalyze data from contracted IPA network providers that allows for proper review of data to evaluate HEDIS and Risk Adjustment Factor.\nConduct internal reviews of documentation and billing on a timely basis.\nIdentify coding and billing risk areas, conduct focused reviews. Ensure accurate coding by utilizing official coding resources, Medicare manual and policies.\nCollaborate and educate provider practices on CMS guidelines for Star Measures (Part C & D). Review and advise on appropriate documentation and coding for HEDIS and RAF reporting.\nPrepare summary reporting of the coding review results as requested.\nParticipate in ongoing discussions concerning data collection and analysis for HEDIS gaps in care. Re-educate providers as needed.\nApply official CPT/HCPCS and ICD10 coding guidelines, internal guidelines, and state specific Medicare/Medicaid coding instructions to review and analyze professionally coded services and coding queries.\nCollaborate with internal departments and external partners to review and implement projects to improve delivery of services and quality of care.\nParticipate in provider and interdepartmental conference calls and meetings that support exceptional customer service.\nAttend health plan meetings as requested by department leadership.\nRegular and consistent attendance.\nOther duties as assigned.\nBenefits:\n401(k)\nDental Insurance\nHealth Insurance\nLife Insurance\nVision Insurance\nPaid Time Off\nFree catered lunches\nRequirements:\n0 - 1 year of prior experience as a coder in a quality improvement role within a health plan, IPA or medical group.\nCertified Coding certificate required.\nStrong understanding of coding principals including, HEDIS, Medicare Star ratings and Risk Adjustment.\nStrong understanding of the principals of HIPAA and able to maintain confidentiality.\nAble to build rapport with external providers and partners and internal teams.\nProfessionally present data and findings that support internal goals and objectives.\n\n#J-18808-Ljbffr","datePosted":"2026-08-31T03:20:06.919Z","dateModified":"2026-08-31T03:20:06.919Z","hiringOrganization":{"@type":"Organization","name":"Damar Staffing","sameAs":"https://jobsearcher.com"},"jobLocation":{"@type":"Place","address":{"@type":"PostalAddress","addressLocality":"Orange","addressRegion":"CA","addressCountry":"US"}},"identifier":{"@type":"PropertyValue","name":"JobSearcher","value":"d2bdec8ec4578fbdbf071e99"},"url":"https://jobsearcher.com/jobs/d2bdec8ec4578fbdbf071e99"}}