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18 jobs found in Miami

JH
Coding Compliance Auditor 2 HIM
Jackson Health System Miami, FL, USA
Jackson Memorial Hospital Health Information Management Dept. Days, FT Position Summary: The HIM Coding/Compliance Auditor 2 analyzes abstracted, coded data for the purpose of ensuring coding accuracy. Serves as a resource for expert knowledge in coding and documentation requirements. Performs coding audits on inpatient and outpatients coders, reviews SMART edits, external coding audits, claim denials and audits from insurance companies, as well as, any other coding audits. Works very closely with the CDI Department. Must be an expert on ICD-9 and CPT Coding systems. Must have ICD-10 knowledge. This position acts in a confidential capacity to assist or aid department management. The position will have a significant role in processing confidential information. Duties & Responsibilities: Performs Internal Coding Audits on inpatient and outpatient coders providing feedback and re-training as required. Reviews findings from External Coding Audits for validity of DRG...

Sep 28, 2023
KT
Medical Science Liaison, Southeast (Senior Manager - Associate Director)
Karuna Therapeutics Miami, FL, USA
Position: Medical Science Liaison, Southeast (Senior Manager - Associate Director) Position Summary The Medical Science Liaison (MSL) is a field-based role focused on developing and maintaining professional relationships with key medical experts and decision makers as they relate to company products. Collaborating compliantly with colleagues from Medical Affairs and other corporate functions, the MSL engages in scientific exchange and enters into strategic discussions as they relate to medical, clinical, scientific, and health economics and outcomes research (HEOR) data with health care professionals.  These include, but are not limited to, individual physicians, nurse practitioners, physician assistants, researchers, managed care professionals, medical and pharmacy directors, hospital decision-makers, formulary committees, consultant pharmacists, state Medicaid decision-makers, and others. Responsibilities Develop and maintain peer-to-peer relationships and...

Sep 28, 2023
AS
JPC - 5147 REMOTE: Rx Claims Coder -_100% REMOTE
Amtex Systems Inc. Miami, FL, USA
Amtex Systems Inc is an information technology and talent solutions company offering talent and BI consulting to the companies in US for over 20 years. Our solutions are designed to fill resource gaps, by providing the right candidates who deliver value to the organization. Our propensity to nurture and build strong relationships with our clients helps us better understand their business demands and gives us the ability to provide services that are on time and rise above the rest. We are urgently looking for Rx Claim coders for one of our healthcare client. Multiple positions open 100% REMOTE Must have experience Rx claims experience in most recent project Responsibilities Responsible for adjudicating all CoPay Assist Rx claims electronically. Responsible for adjudicating all Rx claims and billing. Build, maintain, and audit benefits in RxClaim Automated and manual testing using RxClaim Run patient Rx claim to get paid, and contact them for co-pay amount RXCLAIM And...

Sep 28, 2023
IG
Medical Billing Supervisor (Transitions to REMOTE)
Insight Global Miami, FL, USA
This position starts out onsite for the first 60-90 days and then will go remote reporting onsite one day a month! Insight Global is seeking a Billing Supervisor to support a large heathcare customer in Atlanta, GA. This individual is responsible for coordinating and supervises the billing and government follow-up functions for all hospital facilities in the system. Oversee a team of 18 individuals. Ensures daily billing of hospital revenue and accuracy and quality of billing activities. Works with hospital departments such as Admissions, Data Processing, Medical Records, ancillary areas, and patient care departments to monitor issues with account registration, charging, and coding to ensure efficiency in the patient account process. This supervisor will be hands on and required to step into the bill when needed. The individual needs to be strong with reporting and looking for trends! Qualifications: Associate degree preferably Bachelor degree 3+ years of...

Sep 28, 2023
VM
Risk Adjustment Coder - Kendall
VivaMas Medical Centers Miami, FL, USA
Job Description Job Description At Viva Mas Medical Centers, we are guided by the saying “The Hands that Care for You.” We are growing and are looking for great people to join our mission! En los Centros Médicos Viva Más, nos guiamos por el lema “Las manos que te cuidan”. ¡Estamos creciendo y buscamos personas buena para unirse a nuestra misión! We currently have an opportunity for a Risk Adjustment Coder for our Kendall location. Position Overview: We are seeking a skilled and detail-oriented Risk Adjustment Coder to join our dynamic team. As a Risk Adjustment Coder, you will be responsible for accurately coding and documenting medical records to ensure that our organization receives appropriate reimbursement for services rendered. You will closely collaborate with healthcare providers, coding auditors, and billing teams to ensure compliance with coding guidelines and successfully identify and document all relevant diagnoses for risk adjustment purposes. The...

Sep 28, 2023
PF
Medical Coder Specialist
PayerFusion Holdings LLC Miami, FL, USA
Job Description Job Description Responsibilities for Medical Coder Assign codes to diagnoses and procedures, using ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes. Ensure codes are accurate and sequenced correctly in accordance with government and insurance regulations. Follow up with the provider on any documentation that is insufficient or unclear. Communicate with other clinical staff regarding documentation. Search for information in cases where the coding is complex or unusual. Receive and review patient charts and documents for accuracy. Review the previous day's batch of patient notes for evaluation and coding. Ensure that all codes are current and active. Benefits Excellent health and dental insurance coverage Free vision, life, and hospital gap insurance 12 paid holidays Paid Time Off 401K with company match up to 4% Requirements: Must have experience in medical claims processing and adjudication,...

Sep 28, 2023
CS
Active Reports Designer And Coder - Remote / Telecommute
Cynet Systems Miami, FL, USA
Job Description: The primary purpose of this position is to provide coding and report design expertise in support of client and team objectives. This self-driven person will be responsible for delivering coding and report design expertise in support of client and team objectives. Work will include enhancements to existing code, support changes, and new development, as assigned. A person in this position will work with development team members to modify and design new reports based on database tables, provide thorough documentation of report requirements as it relates to business processes, track report change requests and deliver products in an agile environment. This individual will set goals by identifying requirements, use cases, and tests, estimating hours required for business analysis and task completion, and ensure clear communication regarding components to be delivered to the business. Communication with...

Sep 26, 2023
IG
REMOTE Medical Coder
Insight Global Miami, FL, USA
Must Haves: Must have an active coding certification and 0-3 years of coding experience: Full list of accepted certs AHIMA CCS (Certified Coding Specialist) AAPC (Verify at AAPC Credential Verification, CPC Certification Verification) CPC (Certified Professional Coder) CPC-A (Certified Professional Coder Apprentice) CRC (Certified Risk Adjustment Coder) CCA (Certified Coding Associate) HCC/Risk Adjustment Coding experience ICD-10 proficiency/certification Production driven coding experience Must be able to commit to working 40+ hours per week and seasonal overtime, no part time jobs allowed Access to a private home office and high speed internet if Onshore Ability to commute to the Manilla, Philippines office if Offshore Plusses: Experience working in a remote setting Experience working in a production driven environment CPT Coding experience National RAD-V/HEDIS abstraction experience Clinical Care or Managed Care experience...

Sep 26, 2023
KP
Medical Billing Specialist
Kidney Partner LLC Miami, FL, USA
Job Description Job Description Description: About KidneySPA Health Centers: We inspire, empower and enhance the lives of our patients, through education, individualized care, and fear-free treatment in a nurturing and relaxing environment that can only be experienced at KidneySPA. Philosophy: We understand that true healing happens when the patient is comprehended in his/her whole dimension: Mind, Body & Spirit. Mission: We believe the rejuvenation of mind, body, and spirit is essential to increase life expectancy and general wellbeing. Our team of dedicated doctors, nurses, coaches and highly skilled technicians all operate under the same central philosophy that wellness begins with hospitality. We provide the finest, specialized care to every patient treated under our services. KidneySPA Culture: We embrace quality, professionalism, harmony, and commitment in a caring, friendly environment. We see dialysis from a unique perspective, and we maximize patient...

Sep 25, 2023
CR
Medical Record Audit / Coding Auditor
CRD Miami, FL, USA
About the job Medical Record Audit / Coding Auditor OUR CLIENT is a contracting and data management services organization dedicated to primary care physicians throughout Florida IN 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. To develop and Implement policies to support the clinical coding audit function Receive, review and communicate findings on patient billing coding related complaints. 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 Conduct routine, risk based, proactive or reactive compliance reviews of procedural and diagnosis coding/billing and medical record documentation performed by clinical service providers Prepare reports as required relative to these monitoring and review activities. Work...

Sep 20, 2023
TU
Supervisor, Medical Billing
The University of Miami Miami, FL, USA
Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet. The Department of Miami Transplant has an exciting opportunity for a Supervisor, Medical Billing position. The incumbent supervises, orients, trains, and monitors the performance of staff responsible for third party medical collections. This position processes and collects primary care and specialties accounts and ensures department compliance with applicable guidelines and regulations. CORE JOB FUNCTIONS Assists medical collectors with day-to-day collections issues and serves as subject matter expert for department staff and management of the Third Party unit. Reviews various third party reports, distributes them to staff for appropriate collections actions and uses the paperless...

Sep 20, 2023
HP
Risk Adjustment Coder
Healthy Partners Miami, FL, USA
Overview: Cano Health fosters a culture driven by providing superior primary care services in the communities we serve, while forming lifelong bonds with our members. Driven by our mission to improve the health, wellness, and quality of life of our patients, Cano Health continues to work towards making a difference in primary healthcare. At Cano Health , our service focused, patient-centered, and proactive approach to care succeeds because of the commitment, hearts, and minds of our people. Our values and guiding principles provide purpose to create meaningful change in the lives of our patients, with a leadership approach that empowers our people to directly contribute to the success of our health and wellness efforts. The Cano Movement is proof of what people with a passion for healthcare can accomplish. Join the Cano Movement! The movement that doesnt just offer a job, it offers an opportunity to serve and grow with purpose. At Cano Health, you can join a...

Sep 20, 2023
TU
Medical Biller
The University of Miami Miami, FL, USA
Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet. The Central Business Office has an exciting opportunity for a Full-Time Medical Biller to work Remote. The Medical Biller compiles amounts owed to medical facility and maintains order, invoice, and payments records. Reviews and releases all physician charges from the assigned WQ's in a timely fashion. Reviews encounters received for all pertinent information: patient demographic information, guarantor and insurance information, place of service, referrals, claim info record, and managed care authorization requirements. Runs insurance eligibility and fixes registration issues. Manually enters paper vouchers received for missing charges. Reviews and fixes erroneous and/or rejected...

Sep 20, 2023
CH
Risk Adjustment Coder
Cano Health Miami, FL, USA
Overview: Cano Health fosters a culture driven by providing superior primary care services in the communities we serve, while forming lifelong bonds with our members. Guided by our mission to improve the health, wellness, and quality of life of our patients, Cano Health continues to work towards making a difference in primary healthcare. At Cano Health, our cultural attributes are to be patient centered, service focused, results oriented, trustworthy, transparent, and to continuously improve. Join our collaborative team, dedicated to the pursuit of excellence in health and wellness. Cano Health offers competitive salaries, medical, dental & vision insurance, employee mental health program, paid time off, paid holidays, 401(k) with employer match, employee stock purchase program, tuition reimbursement and much more. The Risk Adjustment Coder will identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical...

Sep 20, 2023
Uo
Medical Biller
University of Miami Miami, FL, USA
Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here (https://www.myworkday.com/umiami/d/task/1422$7248.htmld) to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER_eRecruiting_ApplyforaJob.pdf) . The Central Business Office has an exciting opportunity for a Full-Time Medical Biller to work Remote. The Medical Biller compiles amounts owed to medical facility and maintains order, invoice, and payments records. + Reviews and releases all physician charges from the assigned WQs in a timely fashion. + Reviews encounters received for all pertinent information: patient demographic information, guarantor and insurance information, place of service, referrals, claim info record, and managed care authorization requirements. + Runs insurance...

Sep 20, 2023
FG
Value Based Coding Auditor
Femwell Group Health Miami, FL, USA
Femwell Group Health is Florida’s leading management services organization (MSO) providing cost-effective business solutions so physicians can efficiently and profitably run their practices. From managed care support to accounting and marketing, the members of our team work with physicians every step of the way to maximize productivity and efficiency for a better bottom line. We have a unique understanding of the complexities of operating a large physician group and have the expertise required to work with any medical group all the way from the early formation stages to on-going management. Position/Title: Value Based Coding Auditor Department: COMPLIANCE AND QUALITY ASSURANCE Required Time Commitment (Full Time/Part Time): Full Time, eligible for paid time off (PTO), 401K benefits, and medical benefits. Job Description: Perform various audits such as (but not limited to) data audits for HEDIS/MRA/HRA/Capitation Documentation, Coding/Special Audit Projects,...

Sep 18, 2023
NH
Medical Billing Specialist***Not a Remote Position***
National Health Transport Miami, FL, USA
Job Description Job Description Summary: Ambulance Medical Billing Specialist is responsible for billing and collection processes for National Health Transport's ambulance trips. Ambulance Medical Billing Specialist answers inquiries from insurance companies, patients, and processes claims accordingly. Essential duties and responsibilities : Promotes, develops, and fosters the mission, vision, and values of National Health Transport Inc. Provides the highest level of customer service to a wide variety of internal and external customers Manage and maintain National Health Transport Inc. billing processes. File complaints with the appropriate payer or their governing authority. Identify and separate denials by code and payer Follow through with payers correspondence in a timely manner. Review account status routinely as required for each payer type; minimum of 20 days. Identify recurring denials and make necessary system changes to resolve them. Assist...

Sep 12, 2023
Uo
Medical Compliance Specialist 2
University of Miami Miami, FL, USA
Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here (https://www.myworkday.com/umiami/d/task/1422$7248.htmld) to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER_eRecruiting_ApplyforaJob.pdf) . The Medical Compliance Specialist 2 is part of the compliance team and promotes healthcare compliance within UHealth. The incumbent is responsible for conducting research, performing audits, monitoring and investigations, documentation reviews of the UHealth policies, rules and regulations. Additionally, he/she will contribute to the success of the compliance program by strategizing compliance risk assessment, summarizing and documenting compliance related UHealth policies and procedures, while maintain accurate records of division actions and will...

Sep 06, 2023
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