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Join our dynamic team as a Clinical Coding Analyst and contribute to the resolution of coding-related denials, ensuring accurate and compliant coding practices that maximize reimbursement and support optimal healthcare delivery.   . For over 20 years, we’ve been a leading middle market revenue cycle management (RCM) vendor, providing comprehensive financial and operational solutions to health systems, physician groups, or specialty medical practices.

Health Business Solutions

Clinical Coding Analyst - Florida payer experience preferred

In 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.

At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry.  We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

Blue Cross and Blue Shield Association

Clinical Coding Analyst RN, Consultant

Completes 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.

At Kaiser Permanente, we are relentless in our pursuit of excellence. Driven by our mission to provide the highest quality preventive medicine, we are committed to eliminating health care disparities, and to making lives better through innovation, technology, and research.

Our desire to deliver the best possible care inspires us to promote wellness among our members, communities, and each other. It also fuels our belief that everyone — regardless of circumstance — deserves access to affordable care, which further drives our motivation to expand our reach.

Founded nearly 80 years ago, our unique business model sets us apart — positioning us to drive improvements across the industry and around the world.

Kaiser Permanente

Compliance Consultant IV - Medical Coding - Risk Adjustment

Ability to operate personal computer and general office equipment as necessary to complete essential functions, including using spreadsheets, word processing, database, email, internet, and other computer programs. Performs reviews of appeal records received based on contract/regulatory requirements, coding guidelines, and coverage policies, prepares review summary for presentation to the appeals committee, and presents appeal review to the appeals committee.

South Florida Community Care Network

Medical Coding Auditor

The 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.

Senior Manager, Clinical and Coding

As 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.

P1 Dental Partners

Medical Billing and Coding Specialist

Health Business Solutions LLC

HiringThing

FULL_TIME

In 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.

MEDSURITY EXPERTS

Medical Billing and Coding Expert

This 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.

Jackson Health System

Clinical Coding Audit Specialist, HIM

Houston Methodist also includes a research institute; a comprehensive residency program; international patient services; freestanding comprehensive care clinics, emergency care and imaging centers; and outpatient facilities. The health system consists of eight hospitals: Houston Methodist Hospital, its flagship academic hospital in the Texas Medical Center, seven community hospitals and one long-term acute care hospital throughout the Greater Houston metropolitan area.

Houston Methodist Hospital

Coding Quality Auditor

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. 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.

CRD Careers

Medical Record Audit / Coding Auditor

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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. FLORIDA RESIDENCY REQUIRED (REMOTE)Experienced Inpatient Coding Specialist responsible for accurately coding and abstracting inpatient medical records using ICD‑10‑CM and ICD‑10‑PCS with a minimum 95% accuracy rate.

Mount Sinai Medical Center of Florida

Certified Inpatient Coding Specialist CCS

We 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.

YEAR

R1 RCM Inc

Clinical Coding Appeals Nurse

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. Experienced Inpatient Coding Specialist responsible for accurately coding and abstracting inpatient medical records using ICD‑10‑CM and ICD‑10‑PCS with a minimum 95% accuracy rate.

Mount Sinai Medical Center of Miami Beach

Serving as a subject matter expert, the Coding Quality Reviewer and Educator develops and delivers targeted education to coders, providers, and clinical departments to support compliant, defensible documentation and optimal revenue integrity outcomes. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another.

Brown University Health

Coding Quality Reviewer and Educator-3

All Chapters Health System employees performing services for Florida affiliates are submitted through the Florida Care Provider Background Screening Clearinghouse to verify eligibility after a conditional offer of employment is made as well as ongoing eligibility. Job Responsibilities: Analyzes and interprets information in the medical record and assigns the correct code(s) utilizing ICD-10-CM and or CPT-4 classification system to the diagnoses/procedures of medical records according to the coding guidelines.

HOUR

Chapters Health System Inc

Coding Specialist (remote position)

Must be a Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P), RHIT (Registered Health Information Technician), RHIA (Registered Health Information Administrator) through AHIMA (American Health Information Management Association) or AAPC's (American Academy of Professional Coders) Certified Professional Coder (CPC®) credential or Certified Professional Coder - Hospital (CPC-H®) or Certified Risk Adjustment Coder (CRC). Assists the coding process in serving as a liaison between the CCU team and practice management, including the providers and division leadership while building and maintaining strategic working relationships with the practice and division leadership (working through specific issues, committee meetings, monthly updates, etc.).

At its founding in 1968, Nashville-based HCA was one of the nation's first hospital companies. Today, we are the nation's leading provider of healthcare services, a company comprised of locally managed facilities that includes about 165 hospitals and 115 freestanding surgery centers in 20 states and England and employing approximately 204,000 people. Approximately four to five percent of all inpatient care delivered in the country today is provided by HCA facilities. Richard M. Bracken serves as Chairman of HCA and R. Milton Johnson is the company's President and Chief Executive Officer. HCA is committed to the care and improvement of human life and strives to deliver high quality, cost effective healthcare in the communities we serve. Building on the foundation provided by our Mission & Values, HCA puts patients first and works to constantly improve the care we give them by implementing measures that support our caregivers, help ensure patient safety and provide the highest possible quality. Investing in our communities is important to us. HCA typically invests about $1.5 billion annually to keep our facilities modern and up-to-date technologically and to expand and add services where needed. Focusing primarily on communities where the company is a leading healthcare provider, HCA selectively adds new facilities in order to better serve our communities. And because two HCA founders were physicians, we value highly the strong relationships we've created with local physicians. We endeavor to provide them with a wide array of services and modern facilities in order to help them deliver the best possible care.

HCA Healthcare

Regional Coding Operations Manager WFH

Jobvite Talemetry Organic Easy Apply

This role reviews professional and facility claims, identifies payment discrepancies, evaluates claims against benefits, contracts, reimbursement methodologies, and applicable policies, and works with internal teams to resolve issues and improve claims processing. In this role, you'll use your claims expertise and analytical skills to protect payment accuracy, identify opportunities for improvement, and help strengthen the processes that support our members and providers.

Claims Analyst

Position Overview: Responsible for activities which improve the accuracy of facility outpatient clinical documentation coding and charging, including education with the clinical departments and coding staff and root cause correction to support accurate charging and coding in compliance with policies. Demonstrated ability to utilize official coding/billing resources including CPT/HCPCS references, OPPS Manual, NCCI Manual, NUBC Manual, etc. to determine applicable charges/codes as documented in the health record.

Sutter Health has a long history in California. Some of our facilities have been providing care in the communities we serve for more than 100 years. Today, we’re proud to partner with more than 12,000 doctors to care for more than 3 million people.
We’re inspired by our Northern California community and work tirelessly to deliver top-rated, affordable healthcare. Doctors, hospitals, care teams and employees in the Sutter Health network are always looking for new, meaningful ways to care for you and your loved ones. We believe that every moment matters when it comes to helping you live a longer, healthier and happier life.
Our not-for-profit network delivers top-rated, personalized care in more than 100 Northern California communities. Recently ranked among the Top 15 Health Systems in the nation by Truven Health Analytics™, our team of more than 50,000 doctors, employees and volunteers partner to spread innovation, improve access to healthcare services and put our patients’ needs first—all to achieve the highest levels of quality, access and affordability.

Sutter Health

Charge Audit Analyst

Minimum 2-5 years of clinical experience (acute care, utilization review, case management, or similar role).Experience in medical claims review, appeals, or denial management within a hospital, managed care, or health system. POSITION SUMMARY Under the director of the CBO Director, the Post-Claims Denial Analyst RN is responsible for investigating, analyzing, and resolving clinical denied medical claims to optimize reimbursement.

Coding Analyst Jobs in Miami, FL

Clinical Coding Analyst - Florida payer experience preferred Health Business Solutions

Clinical Coding Analyst RN, Consultant Blue Cross and Blue Shield Association

Compliance Consultant IV - Medical Coding - Risk Adjustment Kaiser Permanente

Medical Coding Auditor South Florida Community Care Network

Senior Manager, Clinical and Coding Health Business Solutions

Medical Billing and Coding Specialist P1 Dental Partners

Senior Manager, Clinical and Coding Health Business Solutions LLC

Medical Billing and Coding Expert MEDSURITY EXPERTS

Clinical Coding Audit Specialist, HIM Jackson Health System

Coding Quality Auditor Houston Methodist Hospital

Medical Record Audit / Coding Auditor CRD Careers

Certified Inpatient Coding Specialist CCS Mount Sinai Medical Center of Florida

Clinical Coding Appeals Nurse R1 RCM Inc

Certified Inpatient Coding Specialist CCS Mount Sinai Medical Center of Miami Beach

Coding Quality Reviewer and Educator-3 Brown University Health

Coding Specialist (remote position) Chapters Health System Inc

Regional Coding Operations Manager WFH HCA Healthcare

Claims Analyst South Florida Community Care Network

Charge Audit Analyst Sutter Health

Registered Nurse (RN) Post-Claims Denial Analyst, Full Time Hialeah Hospital

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