Associate Specialist, Appeals & Grievances Molina Healthcare IncAssociate Specialist, Appeals & GrievancesMiami, FLCustomer/provider experience in a managed care organization (Medicaid, Medicare, Marketplace and/or other government-sponsored program), or medical office/hospital setting experience. At least 1 year of experience in claims, and/or 1 year of customer/provider service experience in a health care setting, or equivalent combination of relevant education and experience.
Specialist, Appeals & Grievances Molina Healthcare IncSpecialist, Appeals & GrievancesFLRequests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina guidelines. Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or regulatory timelines are met.
Patient Services Specialist Cencora IncPatient Services SpecialistFLRemoteProvides integrated services to the health system and its component parts to increase prescription capture rate, ensure timely delivery of infusion medications to be infused in the hospital setting, improve patient outcomes and reduce readmissions. Work experience: This position requires broad training in fields such as Medical Office Administration, Social Work, Medical Records/Billing, Benefit Verification, Patient Financial Services, Pharmacy, Nursing, or similar vocations generally obtained through completion of a 2-year Associate.
Medical Collections Coordinator 2 VITAS Healthcare CorpMedical Collections Coordinator 2Miramar, FLSupported by industry-leading experts and an expanding network of programs in 15+ states, VITAS empowers team members to grow toward their goals while transforming patients' lives. Every day, you''ll combine your knowledge of medical billing and insurance claims with strong interpersonal skills to follow up on unpaid accounts, verify coverage, and assist in educating payers about the intricacies of Hospice.
Operatory Surgical Coding Specialist OrthoVirginiaOperatory Surgical Coding SpecialistWestchester, FloridaWith more than 159 physicians in over 35 locations—including Lynchburg, Northern Virginia, Richmond, Southwest Virginia, and Hampton Roads—OrthoVirginia is a leader in orthopedic surgery, non-surgical care, and physical, hand, and occupational therapy. In this role, you will ensure accurate posting of surgical cases, proper billing of supplies and implants, and correct CPT/HCPCS coding in collaboration with surgeons, clinical staff, and the Operatory Director.
A/R Specialist Leslie PrinceA/R SpecialistFort Lauderdale, Florida$25–$30 / hourThe ideal candidate brings deep hands-on AR experience, strong Excel skills, and comfort working in fast-paced, data-driven environments. We are seeking an experienced Accounts Receivable Specialist to support high-volume AR operations for a retail and wholesale-focused organization.
Medical Biller and Collections LUX InfusionMedical Biller and CollectionsPlantation, Florida$26–$28 / hourWhile performing the duties of this position, the employee may occasionally be required to stand, walk, or sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch, or crawl; and talk or hear. Employees in this position may be required to assist directly - or coordinate appropriate assistance - to ensure access to LUX Infusion’s services for individuals with disabilities, including patients, visitors, employees, or others.
NewExecutive Care Coordinator Valeris IncExecutive Care CoordinatorFLBacked by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. Provides personalized case management to patients and HCPs including outbound communication to HCPs, specialty pharmacies and patients to communicate benefit coverage and/or appropriately help drive next steps in obtaining coverage and/or access to prescribed medicine.
Patient Financial Advocate Firstsource SolutionsPatient Financial AdvocateMiami Beach, FLThe P/T Bilingual Patient Financial Advocate (Weekends Only) is responsible for screening patients on-site at hospitals for eligibility assistance programs either bedside or in the ER. Essential Duties and Responsibilities: Review the hospital census or utilize established referral method to identify self-pay patients consistently throughout the day.
Certified Medical Coder II CPC Mount Sinai Medical Center of FloridaCertified Medical Coder II CPCMiami Beach, FloridaWe offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Performs coding and abstracting on all outpatient/inpatient procedures, evaluation and management encounter documentation and/or operative report by selecting and reporting ICD-10 diagnoses, CPT and HCPCS procedure codes and append modifiers when applicable.
Insurance Verification Representative Care Resource Community Health Centers, Inc.Insurance Verification RepresentativeMiami, FLThe Insurance Verification Representative (IVR) is responsible for assisting all Client Service Specialists in processing insurance eligibility for all Care Resource patients, including Medical, Behavioral Health and Dental prior to scheduling appointments. Provides accurate information by identifying and alerting appropriate front desk support staff about patients' financial responsibility, to effectively collect owed money at the time of check in, including past due balances.
INSURANCE VERIFICATION REPRESENTATIVE Care Resource Community Health Centers, Inc.INSURANCE VERIFICATION REPRESENTATIVEMiami, FLThe Insurance Verification Representative (IVR) is responsible for assisting all Client Service Specialists in processing insurance eligibility for all Care Resource patients, including Medical, Behavioral Health and Dental prior to scheduling appointments. Provides accurate information by identifying and alerting appropriate front desk support staff about patients' financial responsibility, to effectively collect owed money at the time of check in, including past due balances.
Denial & Appeals Coordinator- Onsite Coral Gables, Florida Knight Health Holdings LLCDenial & Appeals Coordinator- Onsite Coral Gables, FloridaCoral Gables, FLThis role actively tracks, organizes, and reports denial activity, partnering with case management teams, the Centralized Business Office, managed care, facility controllers, Clinical Denials Management, and Regional leadership to ensure alignment and swift resolution. The Denials & Appeals Coordinator serves as the operational driver for timely and effective denial management, working closely with other members of the team, especially utilization management, to ensure no step is missed in preventing and resolving authorization-related denials.
Access and Affordability Pharmacy Technician Cencora IncAccess and Affordability Pharmacy TechnicianFLThis encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. The Patient Services Specialist I also coordinates refill calls, performs documented adherence activities, and coordinates dispensing for specialty medications, high cost prescriptions, and/or infusion medications.
Physician Practice E&M Auditor Educator, Mcvi Administration, FT, 8A-4:30P (Hybrid) Baptist Health South FloridaPhysician Practice E&M Auditor Educator, Mcvi Administration, FT, 8A-4:30P (Hybrid)Coral Gables, FL$26.13–$33.97 / hourDevelops and executes provider comprehensive educational opportunities/curriculums (coding resources, materials, tools, webinars, campaigns, etc.) based on audit results, noted trends & changes within coding compliance and regulatory guidelines, while supporting organizational compliance models. E&M Coding Auditor/Educator performs comprehensive audits to determine integrity of coding/billing for physician & clinical fees, detection/correction of documentation, coding/billing errors and/or medical necessity of services billed.
NewClaim Benefit Specialist CVS Health CorpClaim Benefit SpecialistFL$17–$28.46 / hourAnalyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department. Documents claim information in the company system, assigning appropriate codes, modifiers, and other necessary data elements to ensure accurate tracking, reporting, and processing of claims.
Medical Equipment Customer Service Representative Rotech Healthcare Inc.Medical Equipment Customer Service RepresentativeDAVIE, FloridaWith hundreds of locations across 45 states, our team delivers high-quality products, exceptional service, and compassionate support that helps patients live more comfortably, independently, and actively. As a national leader in ventilators, oxygen therapy, sleep apnea treatment, wound care, diabetic solutions, and other home medical equipment, we empower patients to manage their health from the comfort of home.
RCM Contracts Manager Integrated HomeRCM Contracts ManagerMiramar, FloridaThe Manager of Contracts works closely with payers, revenue cycle leadership, compliance, credentialing, billing operations, and IT/system teams to ensure payer contract terms and reimbursement requirements are accurately translated into operational workflows and system configurations. Integrated Home Care Services (IHCS) provides a comprehensive Integrated Delivery System in the home setting, offering Durable Medical Equipment (DME), Respiratory, Home Health, and Home Infusion services.
Operations Manager Di Rezze Family OfficeOperations ManagerSunny Isles Beach, FLThe platform brings together physician-led virtual care, lab-based health screening, membership, and modern technology in one patient experience across four clinical focus areas: PMOS (formerly PCOS), Weight and Metabolic Health, Endometriosis, and Perimenopause. The Operations Manager is the central coordination point for the day-to-day running of the platform: patient support, document and records management, pharmacy and vendor coordination, billing, and the operational health of our backend systems.
Patient Care Coordinator Children's Dental CenterPatient Care CoordinatorFishers, INFull timeMaster the Desk: From answering phones like a total pro to managing insurance, billing, and treatment plans, you’ll keep everything running like a well-oiled machine. If you have a passion for providing top-tier patient care and want to join a team that feels like family, we want YOU to join our smile squad!