Qualifications: Education:. Collaborates with healthcare providers to clarify documentation, resolve coding discrepancies, and ensure the integrity of coded data for billing and reporting purposes.
We 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. - Lead detailed claim adjudication analysis to triage rejections, denials, and payer edits; convert adjudication scenarios into consumable, effective processes that identify true root causes and lead to successful outcomes.
The Medical Coding Services team partners closely with Product, Operations, Commercial, Revenue Cycle, and R&D stakeholders to improve coding quality, reduce denials, optimize claim adjudication outcomes, and strengthen service integrity. In this role, the Medical Coding Automation Senior Associate will partner across Product, Operations, Commercial and R&D teams to identify workflow improvements, support automation initiatives, and drive operational excellence through data analysis and process optimization.
p/>Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. Deployed by over 75 health plans, including many of the top 20, and representing more than 170 million lives, Machinify’s AI operating system, combined with proven expertise, untangles healthcare data to deliver industry-leading speed, quality, and accuracy.
Palm Beach Gardens, FL5 days ago
Understand and follow all department and company SOP'sPerform special projects as assigned by the managerQualifications: Required Work Experience: 2+ years experience in medical coding preferred2+ years of related work in pathology/laboratory billing preferredSkills: Strong verbal and written communication skillsStrong organizational skillsAbility to work independently and on a teamExcellent problem solving and decision-making skillsStrong time management skillsStrong aptitude for learning new software, tools, and digital workflows to maintain operational efficiencyEducationHigh School Diploma or Equivalent (Required)AAPC CPC Certification is required62576Quest Diagnostics honors our service members and encourages veterans to apply. Responsibilities: Performs various clerical functions as requested by the supervisor or group lead Responsibilities include Applying CPT-4 and ICD-10 codes by translating dictated pathology reports, in a timely and accurate mannerResponds to accounts receivable department when coding discrepancies need reviewed due to payor denials.
Clearwater, FL30+ days ago
p>Health and Wellness initiatives • 100% employee health care coverage • Option for dependent health care • Life Insurance • Optional Dental, Vision, AFLAC • Employee Assistance Program (EAP) • Retirement -General Employee Pension Plan • Voluntary Tax-deferred 457 Plan • Paid holiday, vacation, sick leave plans • Competitive Salaries • Tuition assistance • Training and development opportunities • Travel compensation • Military leave • Bereavement leave • Discount coupons • Service and employee recognition awards. Bachelor's Degree in law enforcement, criminal justice, public administration, or a related field AND three (3) years of experience in regulatory compliance and enforcement, law enforcement, or a related field AND one (1) year of lead worker or supervisory experience; OR an equivalent combination of education, training, and/or experience may be considered.
Fort Myers, FL30+ days ago
The Coder reviews charts as assigned by the Coding Supervisor, scans them for errors and omissions, makes edits as necessary, and submits them for processing. Audits clinical documentation and coded data to validate documentation supports diagnoses, procedures and all services rendered for reimbursement and reporting purposes.
Orange City, Florida1 day ago
p>This position is responsible for the enforcement of the City of Orange City Code of Ordinances and other related laws, preferably through voluntary compliance, followed by enforcement through the issuance of citations or other legal proceedings with the City of Orange City Special Magistrate. Conducts research regarding property ownerships, current and past permits and applications, applicable codes and laws, and coordinates code enforcement actions with other city departments and other government agencies when necessary.
Clearwater, FL30+ days ago
p>Summary: Performs advanced coding functions by reviewing short-stay focused encounters and assigning accurate diagnosis and procedural codes using ICD-10-CM and CPT-4 coding systems. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians.
The IT Healthcare Consultant – Business Analyst (Clinical and Coding Specialist) serves as a subject matter expert supporting Medicaid systems, medical coding processes, and policy-driven initiatives. This role focuses on analyzing and implementing coding updates, supporting MMIS enhancements, and advising policy and process stakeholders.
Fort Lauderdale, FL30+ days ago
The benefits offered include but not limited to: Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA, Limited Healthcare FSA, FSAs for Transportation and Parking & HSAs. The Analyst, Clinical Documentation Integrity (CDI) is responsible for reviewing patient medical records to ensure clinical documentation is accurate, complete, and compliant, bridging the gap between clinical care and coding.
p>NCH is transforming into an Advanced Community Healthcare System(TM) and we're proud to: Provide higher acuity care and Centers of Excellence; Offer Graduate Medical Education and fellowships; Have endowed chairs; Conduct research and participate in national clinical trials; and partner with other health market leaders, like Hospital for Special Surgery, Encompass, and ProScan. The Coding Specialist will understand ICD-10, CPT and HCPCS coding; have the ability to interpret insurance guidelines relative to medical coding; understand abbreviations and medical terminology; have the ability to read a medical chart; and be able to understand the basic components of medical and ancillary procedures.
This position functions under the supervision and direction of the Medical Director and works in collaboration with the Director of Nursing, Medical Executive Director, Business Manager, and Residency Program Director to contrive, guide, organize, and monitor clinical services provided at FDOH Walton and Walton Community Health Center clinics. The State's total compensation package for employees features a highly competitive set of employee benefits including: - Annual and Sick Leave benefits;
- Nine paid holidays and one Personal Holiday each year;
- State Group Insurance coverage options, including health, life, dental, vision, and other supplemental insurance options;
- Retirement plan options, including employer contributions.
p>Knowledge of Medicare Allowable rate calculations for: DRGs for inpatient hospital claims, APC rates for outpatient hospital claims, drug, ASC and physician payment rates for global, technical and professional rates by modifiers. Minimum five years of Payer Contracting or Revenue Cycle experience that includes payer contract modeling, familiarity with fee schedules and charge masters, pricing transparency, billing, prior authorization, and denial processes.
Deerfield Beach, FL30+ days ago
p class="MsoNormal">Information collected and processed through your application with INSPYR Solutions (including any job applications you choose to submit) is subject to INSPYR Solutions’ Privacy Policy and INSPYR Solutions’ AI and Automated Employment Decision Tool Policy: https://www.inspyrsolutions.com/policies/. The analyst will help shift the program from a primarily tool- and vendor-driven model toward a build-first approach, leveraging software engineering, automation, and AI-assisted techniques to increase coverage, depth, and repeatability of offensive security activities.
p>Interact with others by effectively communicating, both orally and in writing.- and -Operate computers and other office equipment requiring the ability to move fingers and hands.- and -See and read computer monitors and documents.- and -Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.- and -May require lifting and transporting objects and office supplies, bending, kneeling and reaching. The following states are currently paused for sourcing new candidates or for new relocation requests for current caregivers:
California, Connecticut, Hawaii, Illinois, Massachusetts, Minnesota, New York, Pennsylvania, Rhode Island, Vermont, Washington.
p>We are open to remote work in the following approved states: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin.
Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at https://speedtest.net).
Deerfield Beach, FL30+ days ago
p class="MsoNormal">Information collected and processed through your application with INSPYR Solutions (including any job applications you choose to submit) is subject to INSPYR Solutions’ Privacy Policy and INSPYR Solutions’ AI and Automated Employment Decision Tool Policy: https://www.inspyrsolutions.com/policies/. They will support transformation of offensive security program from a predominantly tool and vendor driven model to a build first approach, leveraging software engineering, automation, and AI assisted techniques to improve the coverage, depth, and repeatability of offensive security activities.
Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse : https://info.flclearinghouse.com/. • Proficiency in understanding professional and facility claims and managed care concepts such as risk adjustment, capitation, FFS, DRG, APG, APCs and other payment mechanisms [Required].
University Park, FL30+ days ago
About US Eye: US Eye is a physician-led, patient-centric network of eye care practices committed to providing exceptional patient service through premium technology and unrivaled provider expertise. Monitors and identifies the full revenue cycle, creates financial reports, and develops dashboards to ensure accurate, timely charge capture, collections and reimbursements.
The Mid Revenue Cycle Senior Data Analyst performs analytics and advanced reporting related to clinical and financial data to support the Mid Revenue Cycle area initiatives- Health Information Management and Revenue Integrity. A High School Diploma and four (4) years of additional relevant data analytics experience on top of the four (4) years required (for a total of 8 years) will be considered in lieu of the bachelor degree.
Required Qualifications: Requires an BA/BS degree in Information Technology, Computer Science or related field of study and minimum of 5 years experience with multi platform, two or more BI applications and/or multiple Business Intelligence tools required; or any combination of education and experience, which would provide an equivalent background. Position Overview: The Senior Risk Adjustment Analyst is a high-impact individual contributor on Elevance's Medicare Advantage Risk Adjustment team, reporting directly to the Staff VP of Analytics/Decision Support.
Jacksonville, FL30+ days ago
You must also attach the Veterans Preference Certification Form and if applicable, the additional forms as noted here: http://www.coj.net/departments/employee-services/veterans-preference. Our comprehensive benefit programs include medical, dental and vision plans; life insurance coverage for you and your dependents; flexible spending plans for medical reimbursement, dependent care, parking, and transit expenses; an employee assistance program for you and your dependents; a 457(b) tax-deferred compensation plan to supplement your retirement, and a ROTH IRA plan.