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Job Description We are seeking a Claims Auditor to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. The Claims Auditor plays an essential role in ensuring the accuracy, compliance, and integrity of health care claims within the organization. This position involves conducting thorough audits of submitted claims to verify adherence to regulatory standards, contractual obligations, and internal policies. The Claims Auditor will identify discrepancies, potential fraud, and areas for process improvement, thereby safeguarding the organization's financial health and reputation. By collaborating with claims processors, healthcare providers, and compliance teams, the auditor helps to streamline claims management and reduce errors. Ultimately, this role supports the delivery of efficient and ethical services by maintaining transparent and accountable claims operations. Minimum Qualifications: • Bachelor’s degree in Health Administration, or a related field., • At least 2 years of experience in claims auditing, health care compliance, or a similar role within the health care industry., • Strong knowledge of health care claims processes, insurance billing, and regulatory requirements such as HIPAA and CMS guidelines., • Proficiency in audit software and Microsoft Office Suite, particularly Excel for data analysis., • Relevant experience may substitute for the educational requirement on a year-for-year basis. Preferred Qualifications: • Master’s degree in Health Administration, or a related field., • Certification such as Certified Internal Auditor (CIA), Certified Professional Coder (CPC), or Certified Healthcare Auditor (CHA)., • Experience with claims management software., • Familiarity with fraud detection techniques and health care fraud prevention programs., • Demonstrated ability to lead audit projects or mentor junior auditors. Responsibilities: • Demonstrate commitment to Our Mission and models ILS Experience Standards of Excellence., • Conduct detailed audits of healthcare claims to ensure accuracy, compliance with regulations, and adherence to organizational policies., • Analyze claim data and documentation to identify errors, inconsistencies, or potential fraud., • Prepare comprehensive audit reports with findings, recommendations, and corrective actions for management and stakeholders., • Collaborate with claims teams and healthcare providers to resolve discrepancies and drive process improvements., • Stay updated on healthcare regulations and industry best practices, while supporting internal and external audits with relevant documentation and insights., • Perform other duties as assigned.

Job Description Hi, we're Oscar. We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The Associate, Risk Adjustment Auditor conducts internal and external quality audits. Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and identified clinical documentation improvement opportunities. You will work with management to implement benchmarks, establish acceptable thresholds, and quality assurance programs. You will report into the Manager, Risk Adjustment. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $82,717 - $108,566 per year You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: • Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record retrieval efforts., • Mitigate risk by validating Encounter Data Gathering Environment Server (EDGE) data is supported within provider encounter documentation, • Review the performance of the Risk Adjustment Coding team and report audit trends to Leadership in a timely, consistent and effective manner to ensure the appropriate changes and education are implemented., • Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, as well as compliance with Risk adjustment production standards., • Conduct CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits., • Develop relationships with key individuals to foster an increased understanding of the Risk Adjustment process., • Identify and execute on the creation of clinical document improvement resources for provider education in both MA and ACA line of business., • Manage the implementation process improvements that will maximize risk adjustment factor increases., • Compliance with all applicable laws and regulations, • Other duties as assigned Requirements: • Bachelor's degree in a relevant field of study or commensurate work experience., • Certified professional coder (CPC), • 3+ year(s) retrospective risk adjustment coding experience., • 1+ year(s) experience Quality Auditing and/or Risk Adjustment Data Validation Audit (RADV) experience Bonus points: • Certified Risk Adjustment Coder (CRC) or similar certification, • Experience coding in a variety of different Electronic Medical Record (EMR) systems. This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

Job Description POSITION PURPOSE: The Credentialing Specialist is responsible for credentialing and recredentialing all billable providers, specialties, and facilities. Obtain access to the different MCO, Medicaid, and Medicare portals for credentialing. The purpose is to credential the providers in a timely manner to enable CHI to bill for services provided. Will provide support to the Director of Managed Care. POSITION REQUIREMENTS / QUALIFICATIONS: Education/Experience: Five years of experience in a healthcare-related position and/or Associate's degree or equivalent from a two-year college or technical school or equivalent combined experience. Experience working in a health care organization preferred Coding experience preferred Licensure / Certification: Must maintain current CPR certification from the American Heart Association. Certified Professional Coder (CPC/CPCA) required. Skills / Ability: Knowledge of PC usage, Windows and Microsoft Office Applications, Database software, spreadsheet software, word processing software. Knowledge of healthcare and/or community health center industry and practices. Knowledge of Managed Care Organizations and their different lines of business; Commercial, Medicaid, Medicare, Exchange, Healthy Kids, etc. CMS (Medicaid and Medicare) Clear understanding of credentialing process POSITION RESPONSIBILITIES § Primarily responsible for leading, coordinating, monitoring, and maintaining the credentialing and recredentialing process § Primarily responsible for processing credentialing, re-credentialing and enrollment applications of healthcare providers and sites, enforces regulatory compliance and adheres to quality assurance standards. § Performs accurate and timely credentialing processes for all initial applications and reappointments § Maintains current knowledge and ensures compliance with all accreditation, regulatory, health plan standards, and CMS § Ensures all primary source verification is completed within the time-frame as allowed by regulatory and accreditation entities. § Proactively works with center designees to acquire necessary materials and information. § Processes all appropriate queries for licensure, or any appropriate regulatory credentialing requirements, and maintains documentation in the database § Collects and verifies sensitive provider data through confidential sources and maintains a credentialing database § Performs analysis and appropriate follow-up of all applications § Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up § Ensures proper escalation of any issues impacting the completion of the application(s) or concerns brought forth by center/stakeholder § Completes accurate and timely data entry into the database to ensure consistency and integrity of the data § Tracks license and certification expirations for all providers to ensure timely renewals. § Prepares files for presentation to leadership and the credentialing committee § Ensures timely and effective communication with centers and stakeholders on the progress of all applications, addresses any inquiries set forth § Provides monthly reports of the credentialing and enrollment status to centers on the status of all assigned providers § Assists with internal auditing functions and performs peer evaluations as assigned § Audits health plan directories for current and accurate provider information. § Supports credentialing committee meetings as needed § Subject Matter Expert on Delegated and 3rd Party Payers § Internal Team Resource for Special Projects and Assisting Team Members who need additional credentialing application help § Other duties as assigned WE ARE AN EQUAL OPPORTUNITY EMPLOYER

Job Description CAREER OPPORTUNITY OFFERING: • Bonus Incentives, • Paid Certifications, • Tuition Reimbursement, • Comprehensive Benefits, • Career Advancement, • This position pays between $57,400 to $99,000 annually based on experience The Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines. Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties. Job Responsibilities: • Quality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts. Performs initial baselines as well as quarterly performance quality assurance reviews to assess coders’ comprehension and further assess ongoing education. Also assists in special project audits, as assigned., • Educating - Assesses the educational needs of coding staff based on individual coder audit results and overall trends. Creates presentations, develops learning material, handbook and other educational materials., • Edits/Denials/Coding - Assists operational coding team with initial coding, edits, and denials and appeals on an as needed basis., • Training - Assists with training new and existing staff. Develops all training materials and coding aids for both formal training and use by coders in daily work. Identifies coders to be cross-trained and suggests areas for training improvement. Assists in the implementation and administration of effective systems, processes, and procedures., • Resource - Serves as a technical resource for all involved personnel; ensures that information is accurate and current, meeting AMA, CMS, and professional coding standards. Performs miscellaneous job-related duties as assigned., • Reporting - Provides reports of audit findings to coding management, individual coders and leadership as needed/requested along with providers that are contracted/employed and outlined in the client SOW. Assists with the creation of various documents and reports as requested. Immediately provides reports related to compliance risks when requested. Experience We Love: 5+ years of coding experience. 3+ years of auditing experience. Proficiency in multiple EMR’s, encoders, and the Microsoft Office suite. Educated in HIPAA regulations; must maintain strict confidentiality of patient and client information. Consistently achieves quality and productivity standards. Ability to organize and complete work in a timely manner. Ability to read, write and effectively communicate in English. Ability to understand medical/surgical terminology. Above average written and verbal communication skills. Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences. This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require. Minimum Education: • Associates degree or equivalent experience Required Certifications: Candidates must have and keep current at least one of the following professional certifications (CPC, CPMA or CCS Preferred): • CPC (Certified Professional Coder), • CCS-P (Certified Coding Specialist-Phys Based), • CCS (Certified Coding Specialist), • CMPA (Certified Professional Medical Auditor), • RHIA (Registered Health Information Administrator), • RHIT (Registered Health Information Technician) #LI-HB1 #LI-REMOTE

Job DescriptionBenefits: • 401(k) matching, • Competitive salary, • Dental insurance, • Health insurance, • Paid time off About Us We are a fast-growing, innovative medical billing company committed to transforming the healthcare revenue cycle through technology, transparency, and top-tier customer service. Our team is passionate about simplifying the complexities of medical billing so healthcare providers can focus on what matters mostpatient care. We're seeking a highly motivated and experienced Charge Posting (Coder) Supervisor to join our leadership team and help us continue delivering exceptional results to our clients across the country. Job Overview As the Medical Coder Supervisor, you will lead group of certified coders to accurately review and approval encounters using industry coding guidelines, optimize workflow efficiency, and oversee a high-performing medical coding team. You'll be responsible for the training, on-going development, quality assurance audits, and covering for coder when necessary to maintain overall high level performance of the assigned team. Key Responsibilities • Oversee and manage the data entry and coding guidelines for commercial, Medicaid, and Medicare to ensure first pass claim submissions., • Develop and implement coding policies, procedures, and performance metrics to ensure efficient and accurate billing processes., • Lead, mentor, and evaluate the performance of the Charge Posting team., • Monitor KPIs including DSO, denial rates, and collection percentages, and proactively address areas of concern., • Collaborate with internal departments and external clients to troubleshoot complex billing issues., • Stay current on healthcare regulations, payer policies, and industry best practices., • Drive continuous improvement through data analysis, automation opportunities, and workflow redesign. Qualifications • Certified Coder with 3+ years of progressive experience in medical billing and revenue cycle management., • Proven leadership experience in a dynamic, high-volume billing environment., • Strong knowledge of commercial and government payer guidelines, CPT/ICD-10 coding, and compliance requirements., • Excellent analytical, communication, and problem-solving skills., • Experience with medical billing software (e.g., AdvanceMD, Kareo, eClinicalWorks, Greenway-Intergy, Athenahealth, or similar platforms)., • Ability to thrive in a fast-paced, client-focused environment. Why Join Us? • Competitive salary, • Opportunities for growth and professional development, • Supportive and collaborative company culture, • Impactful work that makes a real difference for healthcare providers and patients Ready to lead the charge in revenue optimization and operational excellence? Apply today and help us redefine the future of medical billing.

Job DescriptionSUMMARYThis position is intended to provide billing and claims management support to Alivi Specialty Networks and Business Process Outsourcing (BPO) Services. The Medical Claims Examiner will ensure all claims received comply with all health plan, regulatory, contractual, compliance, and Alivi billing guidelines and processes.DUTIES & RESPONSIBILITIES • Responsible for accurate and timely adjudication of professional and institutional claims according to state and federal regulations., • Demonstrates knowledge of insurance regulations and policies, payment policies/guidelines and the ability to communicate and work with payers to get claims resolved and paid accurately., • Demonstrate skills in problem solving, benefit plan, and provider contract Interpretation., • Analyzes, processes, researches, adjusts, and adjudicates claims with the use of accurate procedure/revenue and ICD-10 Codes, under the correct provider contract and member benefits., • Responds to provider disputes in a timely and accurate manner., • Research provider disputes to ensure appropriate claims dispute resolutions., • Works Directly with Clinical Review Board and Network Operations Team to resolve complex issues or disputes., • Adjudicates claims that have been overturned by the Clinical Review Board or Network Operations Team., • Generates written correspondence to members, providers, and regulatory agencies., • Responds and assists other departments with complex issues for resolution or affirmation of previously processed claims and existing guidelines., • Determines and processes overpayments (provider refunds) and reimbursement requests according to specific state and/or federal guidelines or as agreed to in provider contract., • Determines and processes underpayments (internal errors) and provider reimbursement requests, which may involve the use of spreadsheet research and correspondence., • Maintains the department’s claim edit rules and processing claims according to client specific verification of eligibility, interpretation of program benefits and provider contracts to include manual pricing., • Identifies trends in claims flows and suggests process improvements., • Assist in preparation with Claims Audits., • This position description identifies the responsibilities and tasks typically associated with the performance of the position.REQUIREMENTS, • High School diploma or equivalent., • 3 years’ work experience in claims operations environment in the healthcare insurance processing Medicare., • Hands-on working experience processing medical claims in insurance industry., • Knowledge of Medicare Fee Schedule and alternative payment methods (global, cap, flat fees)., • Self-starter, ability to work independently and in a team environment., • Strategic, analytical, process oriented and must have critical thinking skills., • Excellent written and verbal communication skills., • Ability to manage multiple priorities., • Excellent problem-solving skills, good follow-up abilities and willingness to be flexible and adaptable to changing priorities., • Works well under pressure., • Proficient with Excel, PowerPoint, Word & Outlook., • Knowledge of medical terminology and comprehension in the usage of CPT Codes, ICD-10 Codes and Revenue Codes., • Knowledge of Correct Coding (CCI) Edits., • Experience in gathering all necessary documentation in preparation of Delegation Audits., • Detailed knowledge of electronic billing processes universal billing forms., • Knowledge of CMS/ACHA Regulations is desirable., • Previous Experience using Health Suite is desirable. Certified Professional Coder (CPC) is desirable. Powered by JazzHR 6B8Srn28MU

Job Description Job Title: Revenue Cycle Management (RCM) Supervisor Department: Revenue Cycle Management Reports To: Manager of Revenue Cycle Services Position Summary The RCM Supervisor is responsible for overseeing daily revenue cycle operations for a portfolio of independent physician practices served by the company. This role supervises billing, collections, payment posting, denial management, and accounts receivable teams to ensure clients achieve optimal reimbursement, reduced A/R days, and high clean-claim rates. The RCM Supervisor serves as a key liaison between clients, payers, providers, and internal teams, ensuring service excellence and compliance with industry regulations. Essential Duties and Responsibilities Team Leadership • Supervise and support a team of billing specialists, A/R representatives, payment posters, and denial management staff., • Monitor productivity, quality, and performance against established KPIs., • Conduct employee coaching, training, and performance evaluations., • Assist with recruiting, onboarding, and staff development initiatives., • Foster a culture of accountability, customer service, and continuous improvement.Revenue Cycle Operations, • Oversee end-to-end revenue cycle processes for assigned physician practice clients., • Ensure timely claim submission and resolution of claim edits and rejections., • Monitor insurance follow-up activities and collection efforts., • Review and manage aged accounts receivable and work queues., • Ensure accurate payment posting, adjustments, and reconciliation activities., • Oversee denial management and appeals processes to maximize reimbursement., • Escalate payer issues and identify reimbursement trends affecting client revenue.Client Relationship Management, • Serve as the primary operational contact for assigned client accounts., • Participates in regular client meetings to review financial performance and operational metrics., • Present reports on collections, A/R aging, denial trends, and revenue opportunities., • Address client concerns and develop action plans to improve performance., • Collaborate with providers and practice managers to resolve workflow and documentation issues impacting reimbursement.Performance Management & Reporting, • Monitor and analyze key performance indicators, including:, • Days in Accounts Receivable (A/R), • Net Collection Rate, • Gross Collection Rate, • First-Pass Resolution Rate, • Clean Claim Rate, • Denial Rate, • Aging Over 90 and 120 Days, • Charge Lag, • Payment Posting Turnaround Time, • Prepare and distribute operational and financial reports to management and clients., • Identify revenue leakage and recommend corrective actions.Compliance & Quality Assurance, • Ensure compliance with HIPAA, payer regulations, and billing guidelines., • Monitor adherence to Medicare, Medicaid, and commercial payer requirements., • Conduct quality audits of claims, payment posting, and collection activities., • Maintain documentation and process standards required for client contracts and audits.Process Improvement, • Identify workflow inefficiencies and implement best practices., • Collaborate with coding, credentialing, and implementation teams to improve revenue cycle outcomes., • Support system enhancements, software implementations, and automation initiatives., • Develop standard operating procedures (SOPs) and training materials.Qualifications Education • Associate's degree required; Bachelor's degree in Healthcare Administration, Business Administration, Finance, or related field preferred.Experience, • Minimum 5 years of medical billing and revenue cycle management experience., • Minimum 2 years of supervisory or team leadership experience., • Experience managing multi-specialty physician practice accounts preferred., • Experience working for a medical billing company, RCM vendor, or physician management organization strongly preferred.Knowledge & Skills, • Comprehensive knowledge of physician billing and revenue cycle operations., • Strong understanding of CPT, ICD-10, HCPCS, and payer reimbursement methodologies., • Experience with Medicare, Medicaid, commercial insurance, and managed care plans., • Proficiency with practice management systems and EHR platforms., • Advanced Excel and reporting skills., • Strong analytical, organizational, and client-facing communication abilities., • Ability to manage multiple client accounts simultaneously.Preferred Certifications, • Certified Revenue Cycle Representative (CRCR), • Certified Professional Biller (CPB), • Certified Professional Coder (CPC)Key Success Metrics, • Achieve or exceed client collection goals., • Maintain A/R days within target benchmarks., • Improve first-pass claim acceptance rates., • Reduce denial volumes and aged receivables., • Meet client service level agreements (SLAs)., • Maintain high client satisfaction and retention rates., • Achieve team productivity and quality standards.

At ClareMedica, exceptional is the standard. Driven by our purpose to enhance the lives of the seniors in the communities where we have the privilege to work, live, and play, the ClareMedica team is comprised of the brightest and best in their fields of expertise. From clinical excellence to unparalleled administrative support and beyond, we're working together to help seniors live happier, healthier, fuller lives. That kind of teamwork and passion for excelling can only exist in a workplace that fosters employees' growth and wellness and where their full potential and value are realized. At ClareMedica, we're excited about great people like you. We're even more excited to support you with the resources, training, benefits, competitive compensation, and more to help you thrive and succeed in our communities. Opportunity awaits welcome to ClareMedica. We are seeking an accurate, detailed oriented Coder to join our team. You will play a key role in reviewing medical records and identifying, collecting, assessing, monitoring, and documenting claims and encounter coding information for adherence to risk adjustment models. You will review and accurately code office procedures. Duties and Responsibilities: • Review patient's charts to verify and ensure the accuracy, completeness, specificity, and appropriate coding., • Reviews medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries to identify any chronic or new conditions to be sent to providers for validation., • Performs ongoing analysis of medical charts for appropriate coding compliance., • Ensures compliance with all applicable Federal, State, and/or County laws and regulations related to coding and documentation guidelines., • Cooperates with other personnel to achieve department objectives and maintain good employee relations, and interdepartmental objectives., • Meet daily coding production., • Attends departmental meetings as required., • Performs additional duties assigned by the Manager as needed. Qualifications: • CPC - Certified Professional Coder; by AAPC or AHIMA., • High school degree or equivalent; Bachelor's degree in related field preferred., • CRC Certified Risk Adjustment Coder, preferred., • Maintain coding certification and attend in-service training as required., • Two (2) years of medical coding experience, preferably., • Understanding of medical terminology, anatomy, and physiology., • Strong computer skills in data entry, coding, and knowledge of Electronic Medical Record software; Microsoft Office Suite., • Accurate and precise attention to detail., • Ability to multitask, prioritize, and manage time efficiently., • Excellent verbal and written communication skills., • Goal-oriented, organized team player. Working Conditions: General office working conditions. Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential function. While performing the duties of this job, the employee will be required to stand, walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs, balance; stoop, kneel, crouch or crawl; talk or hear. The employee must occasionally lift and or move up to 15 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust to focus. Manual dexterity is required to use desktop computers and peripherals. Work Environment: Work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of his job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. Travel: Occasional travel to the centers and attend special continuous education seminars. Travel is primarily local during the business day. Safety Hazard of the Job: Minimal Hazards

Hybrid work setting, Florida residency required 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. Our hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital role in our collective mission to deliver excellent healthcare through innovation, education, and research. At Mount Sinai, we take pride in our achievements, aiming to be a beacon of quality healthcare in South Florida. We welcome all healthcare professionals to join our thriving community and contribute to our pursuit for clinical excellence. The PB Audit Manager is responsible for leading and managing the auditing functions of Physician Practices across multiple specialties with a focus on Physician & Coder Education. This role ensures coding accuracy, compliance with regulatory guidelines, and optimal reimbursement through proactive audit strategies, education and collaboration with clinical, coding and financial teams • Audit Oversight & Execution, • Develop and implement a comprehensive auditing program for professional fee coding., • Conduct routine and targeted audits to assess coding accuracy, documentation quality, and compliance with CMS, CPT, ICD-10, and payer-specific guidelines., • Analyze audit findings and identify trends, risks, and opportunities for improvement in documentation and coding accuracy., • Team Leadership & Development, • Provide mentorship, performance feedback, and ongoing training., • Identify organizational opportunities to partner with Providers, improve coding quality and prevent unnecessary corrective actions, • Plan Provider education with Physician Practices as warranted, • Compliance & Risk Management, • Collaborate with Compliance and Legal departments to ensure adherence to federal and state regulations., • Support internal and external audit processes, including RAC, MAC, and payer audits., • Maintain documentation of audit results and corrective actions for compliance reporting., • Reporting & Analytics, • Prepare detailed audit reports and dashboards for leadership, highlighting key metrics and trends., • Roll-out targeted education for improvement based on findings, • Stakeholder Collaboration, • Work closely with physicians, Physician Practice Administration, Clinical Information Systems, and revenue cycle leadership to resolve coding discrepancies and improve documentation practices., • Serve as a subject matter expert on coding guidelines and reimbursement policies., • Education & Certification, • Bachelor's Degree in Health Information Management, Healthcare Administration, or related field (preferred)., • Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent credential required., • Certified Professional Medical Auditor (CPMA) preferred., • Experience, • Minimum 5 years of experience in coding, with at least 2 years in a leadership or auditing role., • Experience providing coder mentorship and physician education in PB coding matters., • Strong knowledge of CPT, ICD-10, HCPCS, and E/M coding guidelines., • Experience with electronic health records, coding software, and audit tools., • Skills, • Excellent analytical, organizational, and communication skills., • Proficiency in Microsoft Office Suite and data reporting tools. We believe in the physical and mental well-being of our employees and are committed to offering comprehensive benefits that fit their personal needs. Our robust employee benefits package includes: • Health benefits, • Life insurance, • Long-term disability coverage, • Healthcare spending accounts, • Retirement plan, • Paid time off, • Pet Insurance, • Tuition reimbursement, • Employee assistance program, • Wellness program, • On-site housing for select positions and more!

Certified Medical Coder II - Surgical Coder - $2000 sign on bonus Hybrid - Remote.

Prefer but not require American Academy of Professional Coder (AAPC) Certified Professional Coder (CPC) or American Health Information Management Association (AHIMA) Certified Coding Specialist (CCS). Education and Professional Experience. Knowledge of federal, state, and payer-specific regulations

Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification strongly preferred.

Medical Billing Specialist (Revenue Cycle Management) – Bilingual Spanish Preferred.This is not a Remote position; it is in the Office Monday - Friday.This is not an entry-level role and requires independent ownership of revenue cycle processes.Medical Billing Specialist with demonstrated .Revenu

Our team values collaboration, accountability, and continuous professional growth, creating an environment where employees can thrive and contribute to our firm's success. The successful candidate will possess strong analytical skills, excellent communication abilities, and a commitment to accuracy

To successfully function as part of a team and to be able to communicate professionally with clients and coworkers.

ABA Billing Specialist (Medicaid & Commercial Insurance).Colorful Minds ABA is a growing pediatric ABA therapy provider committed to delivering high-quality, ethical, and family-centered services across clinic, home, and community settings.We value accountability, integrity, teamwork, and operationa

The Billing Specialist is responsible for managing the billing process, and billing arrangements,for assigned attorney portfolios.Verifying rates with the rate analysts, reviewing, and implementing the outside counsel guidelines, monitoring fee caps, tier discounts and matter budgets; setting-up and

Durable Medical Equipment provider specializing in urology supplies.We are building a structured Medicare revenue cycle team and are hiring an experienced DME Billing & AR Specialist.This role focuses exclusively on claim submission, denial management, and accounts receivable follow-up for Medicare

AR Specialist / Remote] - Anywhere in U.Comprehensive Benefits Package - As an Accounts Receivable Billing Specialist, you will: Manage and maintain accurate and timely billing records for all clients; Monitor and track outstanding balances and follow up with clients to ensure timely payment; Prepar

Accounts Receivable / Remote] - Anywhere in U.Competitive pay / Medical-Dental-Vision-Life-Travel / FSA + HSA / 403(b) Retirement Plan with employer contribution / Generous PTO / Study Abroad Program discounts / - As a Billing Specialist at CIEE, you will: Generate program bills for participants an

Certified Medical Coder preferred. We are heavily invested in training the next generation of health professionals, which is the core of our mission: to provide access to compassionate care of the highest quality in an educational environment.

Communication between Team Members should be clear, honest, and professional. We are seeking a detail-oriented and analytical Billing Professional to join our accounting team. Investigate and resolve billing discrepancies, client disputes, and uncollected claims in a professional manner.

Ability to clearly communicate in both written and oral form with professionals in the firm and with clients regarding billing issues. Ability to represent the department in a professional and positive manner.

Ability to create and maintain professional relationships with customers and carriers.

Carlton Fields is seeking a Billing Specialist for its Miami office.The Billing Specialist assists attorneys with the accurate and efficient preparation of bills for clients, ensuring that the client invoices are processed timely and in accordance with the client agreement.We will consider candidate

The Central Business Office has an exciting opportunity for a full-time Sr.Medical Biller processes billing information in appropriate system and assists supervising staff in maintaining quality control of data by identifying potential problems, and offering and implementing solutions.Assists manage

Ability to create and maintain professional relationships with customers and carriers.

The Billing Specialist will have excellent communication skills and a high level of professional service to clients, management, attorneys and other staff in order to effectively, efficiently and successfully administer monthly billing, and research, respond to and resolve inquiries or discrepancies

Accounts Receivable Specialist.This position is responsible for executing due diligence in working all assigned Accounts Receivable work-list.This position requires the employee to have a full understanding of End-To-End Revenue Cycle Operations relating to Accounts Receivable Management, Claims Man

Professional growth and career progression opportunities.

Quintairos, Prieto, Wood & Boyer, P.Billing Specialist to join our Miami Administrative Office.This is a full-time position with a competitive salary and benefits package offered.This position handles the billing activities for clients from initial matter intake through final bill production.This is

The Billing Specialist is a key contributor to the firm's financial operations, partnering closely with attorneys and legal professionals to ensure accurate, timely, and client-compliant billing. This role is ideal for a detail-driven professional who thrives in a fast-paced legal environment, enjoy

Professional development support.

Payment & Billing Operations Specialist.Hydra Host is a fast-growing technology company building the infrastructure layer of the AI economy.We connect a global network of independent data centers to AI and high performance computing demand, handling everything from procurement and deployment to orch

Key Responsibilities: Manage the monthly legal billing cycle, including preparation, review, revision, and finalization of pre-bills and client invoices, ensuring accuracy and timeliness Monitor and analyze Work-in-Progress (WIP), Accounts Receivable, trust balances, client costs, and third-party ex

DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day.As a Dasher, you’ll stay busy with a variety of earnings opportunities and can work when it works for you.Being a Dasher with DoorDash gives yo

DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day.As a Dasher, you’ll stay busy with a variety of earnings opportunities and can work when it works for you.Being a Dasher with DoorDash gives yo

DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day.As a Dasher, you’ll stay busy with a variety of earnings opportunities and can work when it works for you.Being a Dasher with DoorDash gives yo

DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day.As a Dasher, you’ll stay busy with a variety of earnings opportunities and can work when it works for you.Being a Dasher with DoorDash gives yo