UNKNOWN

FEED

The ideal candidate brings a strong background in clinical review, medical necessity denials, payer appeal processes, and team leadership—ideally across both U.S. and offshore teams (e.g., Philippines) . We are seeking an experienced and highly organized Manager of Clinical Appeals to lead our clinical appeals operations across commercial and government payers.

Health Business Solutions

Manager, Clinical Appeals

Review, analyze, and accurately assign ICD-10-CM, CPT, and HCPCS codes for inpatient and outpatient encounters, including surgeries, ancillary services, ER, observation, and clinic visits. The Certified Coder is responsible for performing accurate and compliant coding of inpatient (IP) and outpatient (OP) medical records to support timely billing and maximize revenue integrity.

Certified Coder

SKILLS AND KNOWLEDGE: Advanced knowledge of ICD-10 diagnosis coding conventions and requirements, knowledge of Quality Coding Program requirements such as the Medicare Advantage Coding Program/HCC, as well as medical terminology and abbreviations of disease, illness and injury process. Position Overview: This position conducts review of outpatient medical records using International Classification of Disease Coding ICD-10-CM and Current Procedural Terminology (CPT), Medicare Advantage, ICD-10-CM, and Centers for Medicare and Medicaid Services (CMS) coding and reporting guidelines.

HOUR

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

Clinical Quality Coder II

ea_via_bold

OrthoVirginia is seeking a Certified Orthopedic Surgical Coder | Charge Capture professional who understands what happens during an orthopedic surgical case, from the procedure performed to the implants and supplies used, and can translate that activity into accurate coding, charges, and reimbursement. With 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.

OrthoVirginia

Certified Orthopedic Surgical Coder | Charge Capture

Health Business Solutions LLC

HiringThing

Pursues Excellence: Seeks out learning, strives to develop and expand personally, and continuously helps others upgrade their capability to contribute to the managed care plan. Due to the nature of this position, it is understood that coding requirements are expected to change; therefore, participation in affiliated classes and individual efforts to maintain current knowledge of these changes is required.

Cano Health Inc

Risk Adjustment Coder

Cano Health

CORE COMPETENCIES, KNOWLEDGE/SKILLS/ABILITIES: Essential competencies and KSAs targeted to successfully performing in role: Analysis & Critical Thinking skills including solid problem solving, analysis, decision making, planning, time management and organizational skills. This individual works independently while also collaborating work with the denials team to resolve coding-related denials and work closely with the authorizations team to ensure proper authorizations are requested to meet and exceed customer expectations and needs.

Florida Cancer Specialists and Research Institute

Radiation Oncology Coder

Baptist Health is the region''s largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. Our approach is rooted in a "grow our own" philosophy, designed to help our team members build meaningful, long-term careers with us, supported by benefits that make a real difference, including: Career growth and development opportunities, with clear pathways and ongoing support.

Baptist Health South Florida is once again one of the 2020 Fortune 100 Best Companies to Work For! This is the 20th time Baptist Health has been recognized on the list. We have also been recognized for being among the best healthcare providers in the nation by U.S. News & World Reports in its 2020-2021 Best Hospitals and have been honored as one of PEOPLE's 2020 50 Companies that Care by PEOPLE magazine and Great Place to Work. Baptist Health South Florida is the region's largest not-for-profit healthcare organization with more than 23,000 employees working across 11 hospital campuses and more than 100 outpatient facilities throughout Miami-Dade, Monroe, Broward, and Palm Beach counties. In 2016 we welcomed the newest weapon in the fight against cancer, the world-class Miami Cancer Institute and proton therapy center. Everything we do at Baptist Health, we do to the best of our ability. That includes supporting our team with extensive training programs, millions of dollars in tuition assistance, comprehensive benefits and more. Working within our award-winning culture means getting the respect and support you need to do your best work ever. Find out why this is the best place to be your best!

Baptist Health South Florida Inc

Physician Practice E&M Auditor Educator, MCVI Administration, FT, 8A-4:30P (Hybrid)

Develops and executes provider comprehensive educational opportunities/curriculums (coding resources, materials, tools, webinars, campaigns, etc.) based on audit results, noted trends & changes within coding compliance and regulatory guidelines, while supporting organizational compliance models. E&M Coding Auditor/Educator performs comprehensive audits to determine integrity of coding/billing for physician & clinical fees, detection/correction of documentation, coding/billing errors and/or medical necessity of services billed.

Baptist Health South Florida

Physician Practice E&M Auditor Educator, Mcvi Administration, FT, 8A-4:30P (Hybrid)

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.

Mount Sinai Medical Center of Florida

Certified Risk Adjustment Coder

We are seeking an experienced Accounts Payable Specialist who will be responsible for overseeing the accounts payable process and ensuring the accurate and timely processing of invoices, payments, and expense reports. Manage vendor relationships, including addressing inquiries, resolving discrepancies, managing the vendor shield process and negotiating favorable payment terms when applicable.

Flow

Accounts Payable Manager

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

Inpatient Coder

This role performs high-volume, production-based coding and chart review activities, following defined policies and procedures to ensure compliance and data accuracy. Perform detailed chart reviews to ensure accurate capture of diagnoses, including HCC codes, following risk adjustment requirements.

Risk Adjustment Coder III

Participates in and actively supports development and enhancement of clinical documentation, integrity practice with emphasis on quality monitoring, management of on-going competencies for Clinical Documentation Specialists, identification of programmatic opportunities for growth and improvement. Collaborates with the Professional Development Department to develop and provide new hire CDI onboarding and department specific orientation program and competencies for new CDI Specialists, as well as educational programs to address and enhance the CDI team performance.

University of Miami

Director, Clinical Documentation Integrity

JBL Resources is proud to have earned the reputation of being a premier provider of top talent professionals in the fields of engineering, human resources, logistics, operations, and supply chain management. Working here means joining a team of top technical professionals bringing cutting-edge products to the forefrontoffering driven individuals the opportunity to make a meaningful impact every day.

JBL Resources

Software Engineer

HaleyMarketing

Salary Range: $28 – $53/hour Northwell is the largest not-for-profit health system in the Northeast, serving residents of New York and Connecticut with 28 hospitals, more than 1,000 outpatient facilities, 22,000 nurses and over 20,000 physicians. Northwell cares for more than three million people annually in the New York metro area, including Long Island, the Hudson Valley, Connecticut and beyond, thanks to philanthropic support from our communities.

Northwell Health

Sr Professional Facility Auditor

Jobvite Talemetry Organic Easy Apply

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. The Company's employment practices, including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person's age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law.

Medical Coding Specialist Jobs in Miami, FL

Manager, Clinical Appeals Health Business Solutions

Certified Coder Health Business Solutions

Clinical Quality Coder II Sutter Health

Certified Orthopedic Surgical Coder | Charge Capture OrthoVirginia

Certified Coder Health Business Solutions LLC

Risk Adjustment Coder Cano Health Inc

Risk Adjustment Coder Cano Health

Radiation Oncology Coder Florida Cancer Specialists and Research Institute

Physician Practice E&M Auditor Educator, MCVI Administration, FT, 8A-4:30P (Hybrid) Baptist Health South Florida Inc

Physician Practice E&M Auditor Educator, Mcvi Administration, FT, 8A-4:30P (Hybrid) Baptist Health South Florida

Certified Risk Adjustment Coder Mount Sinai Medical Center of Florida

Accounts Payable Manager Flow

Inpatient Coder Houston Methodist Hospital

Risk Adjustment Coder III Cano Health

Risk Adjustment Coder III Cano Health Inc

Manager, Clinical Appeals Health Business Solutions LLC

Director, Clinical Documentation Integrity University of Miami

Software Engineer JBL Resources

Sr Professional Facility Auditor Northwell Health

Forward Deployed Process Consultant- R37 R1 RCM Inc

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