Medical Billing and Coding Specialist P1 Dental PartnersMedical Billing and Coding SpecialistMiami, FloridaAs a remote Medical Billing and Coding Specialist, you will be responsible for accurately assigning appropriate medical codes to patient records, ensuring timely reimbursement from insurance companies, and maintaining compliance with all relevant regulations and guidelines. To be successful in this role, candidates must possess the following qualifications: - Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification.
Medical Billing and Coding Expert MEDSURITY EXPERTSMedical Billing and Coding ExpertWESTON, FLRemoteFull timeIn this role, you will provide detailed analysis of reviewing medical records, confirming the CPT Codes, and providing your opinion on whether or not the medical bills are being overcharged. Strong Microsoft Excel skills, especially with the V-Lookup formula.
MEDICAL CODING SPECIALIST FLORIDA DOCTORS GROUP CORPMEDICAL CODING SPECIALISTcoral gables, FLFull timeThis role requires a detail-oriented professional who understands medical coding guidelines, managed care workflows, and the importance of accuracy in a fast-paced healthcare environment. Florida Doctors Group is seeking an experienced Medical Coding Specialist with a strong background in managed care to join our team.
NewMedical Coding Quality Team Lead PacificSource Health PlansMedical Coding Quality Team LeadFL$65,296.83–$111,004.62 / yearOversee and support the Claims Refunds team with adjusting claims for refunds, sending refund letters and follow-up, sending to PRS for collection, posting refunds, balancing daily deposit and month end report. Skills: Accountable leadership, Collaboration, Communication (written/verbal), Critical Thinking, Decision Making, Influencing, Listening (active), Organizational skills/Planning and Organization.
NewCompliance Consultant IV, Medical Coding Kaiser PermanenteCompliance Consultant IV, Medical CodingFlorida, FLCompletes work assignments and supports business-specific projects by applying expertise in subject area; supporting the development of work plans to meet business priorities and deadlines; ensuring team follows all procedures and policies; coordinating resources to accomplish priorities and deadlines; collaborating cross-functionally to make effective business decisions; solving complex problems; escalating high priority issues or risks as appropriate; and recognizing and capitalizing on improvement opportunities. Assists with and supports the management of projects or compliance components of larger cross-functional projects by coordinating stakeholder contacts; recommending team resources based on project needs and team member strengths; assisting in the development, analysis, and management of project plans; and coordinating project schedules and resource forecasts.
Coding Analyst Unified Women's Healthcare LLCCoding AnalystFLThis position will be directly involved in analyzing pre-bill claim edits, claim denials and AR management, and working alongside the Revenue Specialists, will review and amend denied claims to ensure accurate coding and adherence to payor policy requirements. Audit medical record documentation to identify under-coded and over-coded services; prepare reports of findings and meet with providers to provide education and training on accurate coding practices and compliance issues.
Senior Coding Associate - Customer Insights athenahealth IncSenior Coding Associate - Customer InsightsFL$77,000–$131,000 / yearWe offer IT solutions and expert services that eliminate the daily hurdles preventing healthcare providers from focusing entirely on their patients - powered by our vision to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all. What we can do for you: Along with health and financial benefits, athenistas enjoy perks specific to each location, including commuter support, employee assistance programs, tuition assistance, employee resource groups, and collaborative workspaces - some offices even welcome dogs.
Auditor, ACO Coding Cano Health IncAuditor, ACO CodingMiami, FLThe ACO Coding Auditor is responsible for reviewing medical records and identifying, collecting, assessing, monitoring, and documenting claims and encountering information as it pertains to Medicare Risk Adjustment. You implement ongoing quality improvement activities to assure the Medicare Risk score meets all requirements and act as a consulting MRA advisor to the practices you support.
Medical Record Audit / Coding Auditor CRD CareersMedical Record Audit / Coding AuditorMiami, FloridaIN THIS ROLE YOU are responsible to assist in the development, undertaking and maintenance of a long term comprehensive, clinical coding audit program for inpatient and outpatient activity. Identify training needs through the audit program of work and liaise with the clinical coding training manager and audit manager to provide the necessary training identified.
Clinical Coding Analyst RN, Consultant Blue Cross and Blue Shield AssociationClinical Coding Analyst RN, ConsultantMiami, FLIn this role you will be supporting the FCR team in addition to a small clinical coder team of 2 clinical coders who will be responsible for performing in-depth quality audits of hospital claims to support ICD-10-CM and ICD-10 PCS codes as well as EDC (Emergency Department Coding), MS-DRG and APR-DRG reviews based on clinical determination. Acts as a resource and helps to validate post claim DRG downgrade denials related to coding and clinical determination to support appeal strategy, tracking by disease, payer and denial activity and works with teams to create transparency and improvements to mitigate and prevent denials.
Senior Manager, Clinical and Coding Health Business Solutions LLCSenior Manager, Clinical and CodingCooper City, FLRemoteThe Senior Manager will provide leadership to multidisciplinary audit teams, support complex audit responses, analyze trends, and partner with internal and external stakeholders to mitigate risk and improve documentation, coding, and reimbursement practices. Health Business Solutions (HBiz) is seeking an experienced and strategic Senior Manager, Clinical & Coding to lead and oversee clinical and coding operations across government and commercial payers, including post-pay audit.
NewOperatory 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.
Clinical Coding Appeals Nurse R1 RCM IncClinical Coding Appeals NurseFL$65,000–$116,747.20 / yearWe are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. To thrive in this role, you must have experience identifying different types of hospital documentation including, but not limited to, medical records, UB-04s, EOBs, itemized bills, hospital account notes, appeal letters, and denial/approval letters.
Clinical Coding Audit Specialist, HIM Jackson Health SystemClinical Coding Audit Specialist, HIMMiami, FLThis role oversees the review, analysis, and appeal of DRG downgrades and payer denials, working closely with Clinical Documentation Improvement (CDI), coding, billing, and clinical teams to promote appropriate reimbursement and maintain compliance with regulatory requirements. Track appeals through all levels (first level, second level, external review) and ensure compliance with Medicare regulations, OCE/MCE edits, and LCD/NCD requirements.
Clinical Coding Audit Specialist, HIM, Full Time, Days Jackson Health SystemClinical Coding Audit Specialist, HIM, Full Time, DaysMiami, FLThis role oversees the review, analysis, and appeal of DRG downgrades and payer denials, working closely with Clinical Documentation Improvement (CDI), coding, billing, and clinical teams to promote appropriate reimbursement and maintain compliance with regulatory requirements. Track appeals through all levels (first level, second level, external review) and ensure compliance with Medicare regulations, OCE/MCE edits, and LCD/NCD requirements.
Auditor, ACO Coding Cano HealthAuditor, ACO CodingMiami, FLThe ACO Coding Auditor is responsible for reviewing medical records and identifying, collecting, assessing, monitoring, and documenting claims and encountering information as it pertains to Medicare Risk Adjustment. You implement ongoing quality improvement activities to assure the Medicare Risk score meets all requirements and act as a consulting MRA advisor to the practices you support.
NewOutpatient Coding Specialist CCS Mount Sinai Medical Center of FloridaOutpatient Coding Specialist CCSMiami Beach, FloridaFLORIDA RESIDENCY REQUIREDThe Coding Outpatient Specialist (Per Diem) position is essential to support the increasing volume and complexity of outpatient services, including clinic visits, same-day surgeries, diagnostic procedures, oncology, and wound care. We 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.
Coding Compliance Auditor 1, HIM Jackson Health SystemCoding Compliance Auditor 1, HIMMiami, FLprioritizes and supports develops training/education protocols for UHS hospital coders in ICD-9-CM, CPT-4, APCs, Emergency Room Evaluation and Management Coding, Level II coding guidelines, modifier guidelines, proper diagnosis and procedure code selection. The HIM Coding Compliance Auditor 1 analyzes abstracted/coded data for the purpose of ensuring accuracy and timeliness as it relates to DNFB management, quarterly AHCA data submissions and PFS communication.
NewHealth Information Management (HIM) Assistant - Nursing home and ICD-10-CM Coding experience Solaris HealthCare Coconut Creek LLCHealth Information Management (HIM) Assistant - Nursing home and ICD-10-CM Coding experienceCoconut Creek, FLPosition Summary: The primary purpose of your job position is assist the HIM Director in ensuring all record-keeping functions of the facility are implemented, maintained, and reviewed. Maintains a thorough knowledge of the centers and professional best practices for creation, maintaining, storing, and destruction of patient health records.
NewCoding Quality Assurance (QA) Manager, Remote Aledade IncCoding Quality Assurance (QA) Manager, RemoteFort Lauderdale, FLRemoteQuality Audits: Oversee and perform comprehensive quality assurance reviews for coding completed by internal CDI staff and external vendor partners, ensuring compliance with official ICD-10-CM guidelines and risk adjustment models. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care.