22 claims supervisor jobs found

Job Description Job Description Hybrid-Sunrise, Florida Position Summary: The Medical Coding Auditor conducts audits to provide investigative support related to potential fraud, waste, abuse and/or overpayment. Through post payment medical records review, the Medical Coding Auditor ensures appropriate coding on claims paid and maintains compliance documentation of any fraud, waste or abuse identified based on coding guidelines and regulatory and contract requirements. Essential Duties and Responsibilities: Performs post payment medical record review audits of claims payments to identify potential fraud, waste, abuse and/or overpayment. Completes and maintains detailed documentation of audits including but not limited to coding guidelines reviewed, medical necessity documentation, decision methodology, and monetary discrepancies identified. Coordinates overpayment recoveries with the Fraud Investigative Unit Manager. Responsible for assisting the Fraud...

Job Description Job Description Description: NO WEEKENDS, NO EVENINGS, NO HOLIDAYS We offer competitive pay as well as PTO, Holiday pay, and comprehensive benefits package! Benefits: · Health insurance · Dental insurance · Vision insurance · Life Insurance · Pet Insurance · Health savings account · Paid sick time · Paid time off · Paid holidays · Profit sharing · Retirement plan GENERAL SUMMARY The Coder Certified is responsible for successfully and efficiently coding all cases to the highest level of accuracy to ensure maximum reimbursement. The Coder Certified will ensure quality and productivity standards are met. The Coder Certified will ensure accurate coding of documentation to include diagnoses, procedures, and modifiers with adherence to established coding guidelines for both government and third-party payers. They work with the Coding Supervisor to escalate coding issues and prevent untimely claim submission and denials....

Orlando Family Physicians, LLC It's fun to work in a company where people truly believe in what they're doing! We're committed to bringing passion and customer focus to the business. Responsible for providing coding services on all diagnosis and maintains a professional relationship with the managers and providers. Responsibilities: Audits records to ensure proper submission of services prior to billing on pre-determined charges Receives proper progress notes to properly bill provider services for services provided to patients Supplies correct ICD-10 CM diagnosis codes on all diagnosis provided Supplies correct HCPCS code on all procedures and services performed Supplies correct CPT code on all procedures and services performed Coding claims 100-150 a day Contacts providers to train and update them with correct coding information Remain current on coding issues Accurately follows coding guidelines and legal requirements to ensure compliance with federal...

At Palm Medical Centers (PMC) our patients have the peace of mind knowing that their health and well-being are our primary concerns. We give our health plan clients the confidence that their members are well taken care of. With more than 24,000 at-risk members, we provide primary care and other services to seniors and families in our medical centers that are comfortable, convenient and staffed with caring professionals. Our activity and wellness facilities are filled with health plan members who know us for our distinct events and programs that cater to the communities we serve. Every day, we deliver on our promise to bring value based, quality healthcare to our patients.   Overview PMC is looking for a CDI/Certified Professional Coder who will demonstrate deep knowledge in Medical Risk Adjustment, HEDIS, CNS Coding guidelines, billing standards and regulations.  A teamwork person who will deliver a high standard of quality of work to drive improved business performance....

Position Overview: CNA or LPN required 3 Years of Medical Assistant experience required Job Summary The Medical Assistant Services Supervisor has responsibility for the supervision and daily operations of the Care Resource Midtown facility; This includes providing support to the Sr. Medical Care Services Manager as needed in the supervision of non-licensed personnel. Provide ongoing Quality Improvement monitoring and ensure safe patient care to the clinic patients and ensure office staff are competent to perform patient care. The Medical Care Services Supervisor directs staff in following established policies and procedures, coordinates patient flow between front and back-office personnel, functions as a liaison for the medical staff and the Sr. Medical Care Services Manager. ESSENTIAL JOB RESPONSIBILITIES Management/Leadership Understand and participate in the interview, training, development and supervision of staff which includes work allocation and problem...

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...

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 University of Miami/UHealth Central Business Office has an exciting opportunity for a full-time Supervisor, Medical Collections (H) to work in Miami, FL. The Supervisor, Medical Collections (H) oversees staff responsible for third-party medical collections to ensure that outstanding accounts are resolved efficiently and accurately. Further, the incumbent acts as department expert on collection rules and regulations and mentors collections staff. CORE JOB SUMMARY The Supervisor, Medical Collections (H) oversees staff responsible for third-party...

Certified Medical Coder II - Surgical Coder - $2000 sign on bonus Hybrid - Remote. . Hourly Salary plus monthly bonus! As Mount Sinai grows, so does our legacy in high-quality health care. Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. 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. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers. Culture of Caring: The Sinai Way Our hardworking,...

" Sanitas is a global healthcare organization expanding across the United States. Our services include primary care, urgent care, nutrition, lab, diagnostic, health care education and resources for our patients. We strive to attract professionals who believe in our mission, vision and are dedicated to the service of our patients and their families creating a memorable experience through compassion, respect, and kindness." Job Summary The Medical Center Supervisor will be in charge of the successful management and operation of medical practices to include all specialty disciplines and clinic sites. They provide all medical specialists with resources necessary to meet the needs of patients and meet the financial objectives of the practice and group. Management and Leadership skills are essential to the success of this position. The main focus of the Supervisor is to support a team of highly qualified and dedicated staff to provide quality medicine while creating and maintaining...

Description The Orthopedic Clinic is a leader in the orthopedic community of East Central Florida. Our team of ten Surgeons, ten Mid-Level Providers, and a Physical Therapy team serve patients at four locations within Volusia and Flagler counties, dedicated to providing compassionate and cutting-edge orthopedic care. The Orthopedic Clinic was established in 1961 and has a rich history of providing exceptional orthopedic care to the community. Position Expectations As an A/R Billing Specialist you will monitor, manage, and fully work outstanding assigned insurance claims, including researching and correcting claims, writing appeals, and facilitating submission to our EHR (Athena) for appealing adverse decisions, contacting payers as needed and all other activities that lead to the successful adjudication of eligible claims. Other responsibilities of this position include: Responsible for taking action on each non-payment or zero pay claim, including contacting insurance...

" Sanitas is a global healthcare organization expanding across the United States. Our services include primary care, urgent care, nutrition, lab, diagnostic, health care education and resources for our patients. We strive to attract professionals who believe in our mission, vision and are dedicated to the service of our patients and their families creating a memorable experience through compassion, respect, and kindness." Job Summary The Medical Center Supervisor will be in charge of the successful management and operation of medical practices to include all specialty disciplines and clinic sites. They provide all medical specialists with resources necessary to meet the needs of patients and meet the financial objectives of the practice and group. Management and Leadership skills are essential to the success of this position. The main focus of the Supervisor is to support a team of highly qualified and dedicated staff to provide quality medicine while creating and maintaining...

Professional Coder 3 The University of Miami/UHealth Department of Health Information Management has an exciting opportunity for a full-time Professional Coder 3 to work in Miami, FL. Medical coders help to complete, review, and process medical claims to help physician practices and hospitals get reimbursed from insurance companies for services and facilities provided to patients. A Professional Coder 3 at the University of Miami is responsible for reviewing the clinical documentation contained in the UHealth patient health records (regardless of medium in which the patient documentation is maintained) to validate the codes assigned by physicians. Abstract and or validates as necessary, abstract E&M, and Procedure codes for surgical specialties, Dermatology, Interventional Radiology and/or Interventional Cardiology, Neurosurgery, Ophthalmology, Orthopedics, Trauma and Transplant, and other specialties that are predominantly invasive codes for medical specialties including...

Coder III - Inpatient Coding - Baptist Metro Square Baptist Medical Center Jacksonville is currently hiring for a Full-time, Coder III to join our Inpatient Coding team. This is a remote position. The Inpatient Coder III Responsibilities include: Responsible for correctly identifying and assigning diagnosis and procedure codes using the ICD-10-CM/PCS Classification System to each patient's record for optimization in accordance with State and Federal requirements on Inpatient accounts. Be knowledgeable of CPT codes, edit resolution and assigning CPT-4 Codes on Observation accounts when applicable. Verifies and submits abstracted UB04 information across the billing system for claim submission. Must efficiently complete this activity for 100% of patient's discharged records daily to maintain the Coding A/R goals set forth. Works ACHA, DNFB and Post Bill error reports, such as A/B rebills, Claim Edits, and Denials when applicable. Advises and coordinates with Management, CDI...

Job Description Job Description Description: The Orthopedic Clinic is a leader in the orthopedic community of East Central Florida. Our team of ten Surgeons, ten Mid-Level Providers and a Physical Therapy team who serve patients at four locations within Volusia and Flagler counties are dedicated to providing compassionate and cutting-edge orthopedic care. The Orthopedic Clinic is a well-respected practice that was established in 1961 and has a rich history of providing exceptional Orthopedic care to the community. POSITION EXPECTATIONS: As an A/R Billing Specialist you will monitor, manage and fully work outstanding assigned insurance claims, to include researching and correcting claims, writing appeals, and facilitating submission to our EHR (Athena) for appealing adverse decisions, contacting payers as needed and all other activities that lead to the successful adjudication of eligible claims. Other responsibilities of this position include: • Responsible for...

Job Description Job Description Benefits: 401(k) Dental insurance Health insurance Opportunity for advancement Paid time off Vision insurance Medical Insurance Collection Supervisor ProMDs Revenue Cycle Management division is a rapidly growing medical billing company seeking an experienced Medical Insurance Collection Supervisor . This role requires a strong background in medical billing, appeals, insurance verification, and team leadership. We provide comprehensive one-on-one training to ensure success in delivering high-quality billing and collection services for our top-ranked multispecialty medical providers. NOTE: This department requires two supervisors and will work closely with upper management to ensure overall success. We currently have one highly knowledgeable supervisor in place. Qualifications Candidates must meet the following requirements: Proven experience supervising a medical insurance collection department. Strong knowledge of medical...

About the Job About the Role: We are seeking a detail-oriented and dependable Medical Biller to join our team. The ideal candidate will be responsible for preparing, reviewing, and submitting accurate billing statements and claims, ensuring compliance with payer requirements and internal policies. Key Responsibilities: Prepare and submit accurate and timely billing for all services rendered. Review daily charges, coding, and supporting documentation to verify accuracy and completeness. Process electronic and paper claims to insurance carriers and other payers. Identify and correct billing discrepancies before claim submission. Monitor claim status, follow up on unpaid or denied claims, and ensure timely resolution. Post payments and adjustments accurately to patient accounts. Communicate effectively with insurance companies, patients, and internal departments to resolve billing issues. Maintain organized billing records and ensure compliance with...

Job Description Job Description Security Service Supervisor The Healthcare Security Service Supervisor is responsible for overseeing the day-to-day security operations within Lemontree Healthcare facilities. This role involves ensuring the safety and security of patients, staff, visitors, and property. The Supervisor will supervise security officers, enforce healthcare security policies, and collaborate with other departments to maintain a secure and safe environment. Job Type: Full-time Schedule: Monday-Friday and Weekends Shift: 3:00pm-11:30pm Key Responsibilities: Supervision & Training: Lead, supervise, and provide guidance to security officers on shift. Conduct regular performance evaluations and provide ongoing training to ensure staff is well-equipped to handle security protocols. Ensure all security personnel are following procedures related to safety, security, and emergency response. Security Operations: Oversee and monitor security systems,...

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, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER_eRecruiting_ApplyforaJob.pdf) . The University of Miami/UHealth Department of Health Information Management has an exciting opportunity for a full-time Professional Coder 3 to work in Miami, FL. Medical coders help to complete, review, and process medical claims to help physician practices and hospitals get reimbursed from insurance companies for services and facilities provided to patients. A Professional Coder 3 at the University of Miami is responsible for reviewing the clinical documentation contained in the UHealth patient health records (regardless of medium in which the patient documentation is...

" Sanitas is a global healthcare organization expanding across the United States. Our services include primary care, urgent care, nutrition, lab, diagnostic, health care education and resources for our patients. We strive to attract professionals who believe in our mission, vision and are dedicated to the service of our patients and their families creating a memorable experience through compassion, respect, and kindness." Job Summary The Medical Center Supervisor will be in charge of the successful management and operation of medical practices to include all specialty disciplines and clinic sites. They provide all medical specialists with resources necessary to meet the needs of patients and meet the financial objectives of the practice and group. Management and Leadership skills are essential to the success of this position. The main focus of the Supervisor is to support a team of highly qualified and dedicated staff to provide quality medicine while creating and maintaining...

Job Description Medical Coder - Wound Care (Long-Term Care) About Us Pinnacle Wound Management is a physician-led wound care provider dedicated to improving healing outcomes for patients in skilled nursing and long-term care facilities. We partner with facilities to deliver advanced wound care at the bedside, supported by thorough documentation, EMR integration, and compliance with payer guidelines. We are seeking a Medical Coder with wound care experience to join our team. This role is critical in ensuring timely, accurate coding and billing for patient encounters and cellular tissue product usage across multiple facilities. Key Responsibilities Accurately review and code wound care services performed in long-term care and post-acute settings, ensuring compliance with ICD-10, CPT, HCPCS, and payer requirements Code independently without reliance on a provider superbill , using clinical notes and documentation as the source of truth Release daily coding...

Job Description The Inpatient Medical Coder II is responsible for coding and applying ICD-10-CM and PCS codes as applicable to code medical records for Brooks Rehabilitation Hospital. Reviews data from the medical record to determine or confirm codes. Performs analysis of physician documentation and provides feedback for improvement. Collaborates with internal and external resources to obtain additional documentation to support the services provided, documentation and codes billed. Responsibilities: Reviews medical record to correctly apply and/or validate ICD-10-CM IRF-PAI codes. Supports timely, accurate and complete documentation of clinical information, facilitating modifications to clinical documentation to support services rendered and reimbursement received. Maintains knowledge of coding rules and regulations by staying current on issues regarding medical coding, compliance and reimbursement. Ability to accurately assign the IGC, etiologic diagnosis, and...

Job Type Full-time Description Job Title: Surgical Coder Department: Revenue Cycle Management Reports To: RCM Director Location: HQ West palm Beach Position Summary: The Surgical Coder is responsible for accurately reviewing, analyzing, and assigning the appropriate CPT, ICD-10-CM, and HCPCS codes for surgical and procedural documentation in patient medical records. This role ensures coding compliance with all applicable regulations and guidelines to optimize reimbursement and maintain the integrity of clinical and financial data. Key Responsibilities: Review operative reports and clinical documentation to assign appropriate CPT, ICD-10-CM, and HCPCS Level II codes. Ensure accurate capture of modifiers and adherence to payer-specific coding guidelines. Verify that all coded information supports medical necessity and aligns with regulatory requirements (e.g., CMS, AMA, and payer-specific policies). Query physicians for clarification or...