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JOB DESCRIPTION Looking for a RN that has a current active unrestricted license This a remote role and can sit anywhere within the United States. Work Schedule Monday to Friday - operation hours 6 AM to 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review, and medical coding. Job Summary Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and claim submitted support correct coding to ensure appropriate reimbursement to providers. Job Duties • Performs clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases, in which an appeal has been submitted, to ensure medical necessity and appropriate/accurate billing and claims processing., • Identifies and reports quality of care issues., • Assists with Complex Claim review including DRG Validation, Itemized Bill Review, Appropriate Level of Care, Inpatient Readmission, and any opportunity identified by the Payment Integrity analytical team; requires decision making pertinent to clinical experience, • Documents clinical review summaries, bill audit findings and audit details in the database, • Provides supporting documentation for denial and modification of payment decisions, • Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of all relevant and applicable Federal and State regulatory requirements and guidelines, knowledge of Molina policies and procedures, and individual judgment and experience to assess the appropriateness of service provided, length of stay and level of care., • Reviews medically appropriate clinical guidelines and other appropriate criteria with Medical Directors on denial decisions., • Supplies criteria supporting all recommendations for denial or modification of payment decisions., • Serves as a clinical resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals., • Provides training and support to clinical peers., • Identifies and refers members with special needs to the appropriate Molina Healthcare program per policy/protocol. JOB QUALIFICATIONS Graduate from an Accredited School of Nursing REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: • Minimum 3 years clinical nursing experience., • Minimum one year Utilization Review and/or Medical Claims Review., • Minimum two years of experience in Claims Auditing, Medical Necessity Review and Coding experience Active, unrestricted State Registered Nursing (RN) license in good standing. PREFERRED EDUCATION: Bachelors’s Degree in Nursing or Health Related Field PREFERRED EXPERIENCE: Nursing experience in Critical Care, Emergency Medicine, Medical Surgical, or Pediatrics. Advanced Practice Nursing. Billing and coding experience. PREFERRED LICENSE, CERTIFICATION, ASSOCIATION: Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified Professional in Healthcare Quality or other healthcare certification. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $26.41 - $61.79 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Job DescriptionAre you passionate about making a difference in patients' lives through compassionate care and technical expertise? We are seeking a dedicated and skilled Allied Healthcare Professional's to join our dynamic healthcare team. If you're driven by a commitment to patient well-being and are ready to work in a fast-paced, rewarding environment, we invite you to apply and become a valued member of our healthcare team Position: Technicians and Technologist needed Various Schedules: AM & PM Shifts What You'll Do: In this role, you will provide essential support in patient diagnosis, treatment, and rehabilitation, collaborating closely with physicians, nurses, and other healthcare professionals. Whether you specialize in diagnostic imaging, laboratory work, rehabilitation, or patient care, your contributions will play a crucial role in delivering exceptional healthcare services. Each specialty within allied health requires different certifications and specific technical skills but overall focuses on supporting medical teams in diagnosis, treatment, rehabilitation, or administrative tasks. Why Join Us: • Professional Growth: Expand your nursing proficiency and knowledge while experiencing a range of cases and scenarios that enrich your career journey., • Adventurous Opportunities: As a Travel Registered Nurse, you will have the chance to explore diverse locations across the United States. Expand your professional horizons while enjoying the adventure of new environments. Assisting in diagnosis: * • Operating equipment like X-rays, MRIs, or ultrasound machines (radiology technicians, sonographers)., • Laboratory work: Performing blood tests, urine tests, or other lab work (lab technicians)., • Physical therapy: Assisting in the development and execution of physical therapy treatments (physical therapy assistants). Direct patient care: * • Assisting with patient mobility, bathing, feeding, or monitoring vital signs (patient care technicians, certified nursing assistants)., • Education and counseling: Providing patient education on treatments, conditions, and medications (health educators, dietitians)., • Rehabilitation support: Assisting patients in rehabilitative activities to improve mobility and function (occupational therapy assistants). Maintaining patient records: * • Ensuring that accurate medical documentation is up to date (medical record technicians)., • Scheduling and coordination: Arranging appointments, tests, or procedures for patients (medical office assistants). Billing and coding: * • Handling insurance claims and medical billing using appropriate coding systems (medical billers and coders)., • Operating specialized equipment: Such as in radiology, sonography, respiratory therapy, or anesthesiology. Sterilizing instruments: * • Ensuring that all medical instruments and environments are sterile (surgical technologists). Respiratory therapists: * • Provide breathing treatments and manage ventilators. Pharmacy technicians: * • Assist pharmacists in dispensing medications and providing information to patients. Requirements Authorized to work in the US without sponsorship This is NOT a Virtual/Remote position. Confirm you are willing to travel, if not already a local, to Texas, Louisiana, Tennessee or Arkansas Must have Certification applicable to the Medical Technician Specilaity English Equal Opportunity Employer Hire Energy provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. Requisition #cm0gvsmvy2f1l0pnqys2tkgkl

Job DescriptionCompany Description WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients. Job Description As outlined below, provide quality improvement focused work for all delegated entities and support for ACO quality reporting for all contracted ACOs. WHAT YOU’LL BE DOING • Work in a fully remote environment and virtually engage with company and team in your daily work., • Subject Matter Expert (SME) on entire scope of Medicare Advantage STAR measures, services, customers and quality initiatives under various commercial and governmental payers., • Conduct proactive patient outreach initiatives to identify and address quality gaps, engaging with patients to educate them on preventive care measures, schedule necessary screenings or appointments, and facilitate adherence to treatment plans and medications, thereby contributing to improved health outcomes and closing quality gaps, • Collect quality data using various methods of data sourcing-EMR, claims, provider / patient outreach., • Manage daily work using multiple systems and applications-EMR systems, payer portals, vendor platforms, Guidehealth applications, Microsoft 365 for Excel, Word and PowerPoint, Microsoft Outlook and Teams for messaging and meetings., • Work with patient lists, gap lists, sourced health data and medical records in your daily work., • Leverage all quality related resources to ensure accuracy and completeness of work-measure/project instructions, NCQA/HEDIS® specifications, coding documents, quick reference guides., • Prioritize daily work to meet various quality reporting deadlines and requirements., • Communicate quality performances, barriers and improvement strategies both internally and with customers., • Follow all established policies and procedures for various QI workflows to ensure overall success., • Collaborate w/ customers, payers, co-workers to accomplish daily work., • Participate in all departmental and payer sponsored webinars/trainings/support calls throughout the year., • Communicate professionally and develop positive relationships with co-workers, customers, providers and providers’ support staff. Qualifications WHAT YOU'LL NEED TO HAVE • Associate degree or greater in related field, • Minimum 1-3 years of experience in healthcare setting; time spent working/charting/data abstraction via EMR system/s, knowledge of medical terminology, quality measures, medical billing/coding., • Minimum 2 years’ experience in Medicare Advantage Quality data abstraction and patient outreach, • Tech savvy in managing the technical side of this position-working with health data, working in excel and PowerPoint, navigating multiple systems and applications., • Highly skilled in verbal and written communications., • Strong attention to detail, organized and ability to meet hard deadlines., • Certified/licensed professional-CMA, LPN, • Knowledge or experience in quality improvement initiatives and data submissions required by various health insurance payers., • Extensive experience with quality database entries and reporting., • Experience in interpreting and reporting quality information, as well as training staff., • Proficiency in Electronic Medical Record (EMR) software and cloud platformS Additional Information The base pay range for this role is between $28-$30 per hour paid bi-weekly ALIVE with Purpose: How We Thrive at Guidehealth At Guidehealth, our values come to life in everything we do. • We are Driven by Accountability — grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike., • Always Growing, Always Learning — staying curious and continuously improving inspires us to shape a better future for healthcare., • With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve., • At Guidehealth, Every Voice Matters — we believe our collective strength is rooted in the unique perspectives of each team member., • And through Empathy in Action, we build stronger connections with those who count on us. All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include: • Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs., • Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered., • Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution., • Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected., • Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times., • Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals., • Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need. The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications. OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment. OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager. REMOTE WORK TECHNICAL REQUIREMENTS Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 50 mbps download, 10 mbps upload. Please consult with your internet provider or run a speed test here to confirm your internet connection meets these requirements.

Job Description About us: Solis Health Plans is a new kind of Medicare Advantage company. We provide solutions that are transparent, connected, and effective for both our members and providers. Solis was created with a desire to offer a more personalized experience throughout every stage of the healthcare journey. Our team consists of experts who take pride in delivering quality service. We foster a culture of collaboration and support, where success is shared, and every employee is valued. To learn more about us, please visit our website at ! Position is fully onsite Mon-Friday, Bilingual in ENGLISH & SPANISH is required Location: 9250 NW 36th St, Miami, FL 33178. Bilingual in English & Spanish or Creole is required Full benefits package offered on the first on the month following date of hire including: Medical, Dental, Vision, 401K plan with a 100% company match! Our company has doubled size and we have experienced exponential growth in membership from 2,000 members to over 10,000 members in the last year! Join our winning Solis Team! Position Summary: This position is responsible for the coordination of HEDIS and STARs data gathering process. This evaluates the quality and completeness of clinical documentation processes by performing quality medical record reviews, assisting in the improvement of the clinical documentation process, identifying trends, maintaining accurate records of review activities, ensures all data submitted to the health plan meets the HEDIS/Star technical specifications for medical records. contribute to a positive, patient-centered care experience. This role is essential to improving quality performance, supporting HEDIS and Stars initiatives, and enhancing overall member satisfaction. Essential Functions and Duties: · Provide excellent customer service by addressing patients and client needs promptly and courteously. · Phone calls to patients for scheduling or education on HEDIS Measures. · Assisting in the review of medical records to highlight Star/HEDIS opportunities for the medical staff. · Review medical records for data collection, data entry, and quality monitoring including health plan form submission and chart collection activities that close gaps in care. · Partner with the leadership team, the practice administrative or clinical staff to identify trends observed and potential strategies to support the practice. · Communicate scheduling challenges or trends that may negatively impact quality outcomes. · Track and trend barriers/challenges that exist at their assigned groups so that better outcomes can be achieved including access to appointments, lack of follow up on referrals, or inconsistent billing practices. · Activities may include data collection, data entry, quality monitoring, health plan form submission and chart collection activities. · Assists with local IRR audits. · Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS/Star measures. · Support chart chase process by requesting records from provider's offices as needed. · Maintains education/knowledge base of HEDIS/STARs. · Performs all other related duties as assigned. Required qualifications: · High school diploma or equivalent is required. · 2+ years’ experience working for a Health Plan in reviewing medical records for data collection, data entry, abstraction, overreads and chart collection activities that close gaps in care. OR · 2+ years of experience working with HEDIS/STAR measures. · 2 or more years of HEDIS experience working in a physician, provider, and/or medical office. · Two (2) or more years of experience proficiency in using electronic medical record (EMR) systems and other healthcare management software. Required. · Proficiency in Microsoft Office (Word, Excel, PowerPoint, Outlook). Required. · ICD 9/10 and CPT coding experience. Required. · Excellent verbal communication skills with a customer-focused approach. Preferred qualifications: · 2+ years of college, in pursuance of a Bachelor's or Associate's degree in Health Care. · Licensed Vocational/Registered Nurse, Certified Professional Coder, or Foreign Medical Graduate (FMG/IMG). Required Languages: Bilingual English & Spanish or Creole. What set us apart: Join Solis Health Plans as a HEDIS/Stars Coordinator and become a catalyst for positive change in the lives of our members. At Solis, you will be part of a locally rooted organization deeply committed to understanding and serving our communities. If you are eager to embark on a purpose-driven career that promises growth and the chance to make a significant impact, we encourage you to explore the opportunities available at Solis Health Plans. Join us and be the difference.

Job DescriptionBenefits/Perks • Competitive Compensation, • Great Work Environment, • Retirement Plan, • Health Insurance, • Dental Insurance, • Vision InsuranceJob SummaryWe are seeking a Medical Office Manager to join our team! In this role, you will oversee the daily operations of our medical office, including staff supervision, appointment scheduling, and surgical coordination. You will work closely with other team members to ensure efficient office flow and full compliance with state and federal regulations. Responsibilities will also include managing accounts payable and receivable. The ideal candidate will have excellent communication and interpersonal skills, proven management experience, and a strong understanding of healthcare regulations and compliance requirements applicable to medical offices. Responsibilities: • Supervise front and back office staff and oversee daily operations and office flow, • Coordinate patient appointments and surgical scheduling, • Ensure compliance with HIPAA, OSHA, and other healthcare regulations, • Manage office finances including accounts payable/receivable, • Assist with credentialing and insurance verification processes, • Maintain office supplies and vendor relationships, • Address patient concerns and escalate as appropriate, • Support physician and clinical staff needs Qualifications: • Minimum of 3–5 years of experience managing a medical office (orthopedic or specialty experience a plus), • Bachelor's degree in Healthcare Administration, Business, or a related field preferred, • Strong knowledge of medical billing, coding (CPT/ICD-10), and insurance processes, • Proficiency in EMR/EHR systems and Microsoft Office Suite, • Excellent leadership, communication, and problem-solving skills, • Ability to multitask and adapt in a fast-paced environment, • Bilingual (English/Spanish) a plus, • Strong familiarity with regulations

Job Description Language Requirement: Bilingual (Creole and English) Job Summary: The Medicare Performance Manager is responsible for overseeing and optimizing the performance of Medicare-related services for our three locations for all of the healthcare plans we service. This role involves daily interaction with staff and collaboration with healthcare providers to ensure compliance with best practices, improve patient outcomes, and enhance service delivery. Key Responsibilities: Daily Tasks: • Review daily hospital census, including Emergency Room (ER) visits and inpatient stays., • Contact patients to schedule follow-up visits within 7 days of ER and inpatient stays. Weekly Tasks: • Analyze Medication Adherence Reports to ensure patients are following prescribed regimens., • Review all referrals to ensure they are directed to approved providers., • Reconcile specialist referrals with consultation reports, ensuring proper documentation is scanned into patient charts. Monthly Tasks: • Call new patients to welcome them to the center, schedule their initial appointments, and request previous medical records. Ensure patients sign medical record release forms and request records from prior Primary Care Providers (PCPs)., • Conduct monthly meetings with department heads to gather statistics related to:, • HEDIS (Healthcare Effectiveness Data and Information Set) metrics., • Billing and coding performance., • Medical Risk Adjustment (MRA) assessments., • Review monthly claims submitted by health plans/MSOs and make necessary corrections., • Evaluate RX Cost Saving Reports and implement required medication switches to optimize cost-effectiveness., • Reconcile ten patient charts monthly and present outcomes to stakeholders during the monthly meeting. Qualifications: • Fluency in both Creole and English is required., • Experience in healthcare management, preferably in Medicare services., • Strong organizational and communication skills., • Ability to work collaboratively with multidisciplinary teams., • Proficient in data analysis and reporting., • Knowledge of HEDIS metrics and compliance standards.

Job Summary The RCM OPEX Specialist plays a critical role in optimizing the financial performance of healthcare organizations by ensuring that revenue cycle management processes are efficient and compliant with industry regulations. This position requires detail-oriented professionals who can navigate complex insurance claims and reimbursement processes. Essential Job Functions • Manage internal and external customer communications to maximize collections and reimbursements., • Analyze revenue cycle data to identify trends and proactively remediate suboptimal processes., • Maintain fee schedule uploads in financial and practice operating systems., • Review and resolve escalations on denied and unpaid claims., • Collaborate with healthcare providers, payors, and business partners to ensure revenue best practices are promoted., • Monitor accounts receivable and expedite the recovery of outstanding payments., • Prepare regular reports on refunds, under/over payments., • Stay updated on changes in healthcare regulations and coding guidelines. *NOTE: The list of tasks is illustrative only and is not a comprehensive list of all functions and tasks performed by this position. Other Essential Tasks/Responsibilities/Abilities • Must be consistent with Femwell’s core values., • Excellent verbal and written communication skills., • Professional and tactful interpersonal skills with the ability to interact with a variety of personalities., • Excellent organizational skills and attention to detail., • Excellent time management skills with proven ability to meet deadlines and work under pressure., • Ability to manage and prioritize multiple projects and tasks efficiently., • Must demonstrate commitment to high professional ethical standards and a diverse workplace., • Must have excellent listening skills., • Must have the ability to maintain reasonably regular, punctual attendance consistent with the ADA, FMLA, and other federal, state, and local standards and organization attendance policies and procedures., • Must maintain compliance with all personnel policies and procedures., • Must be self-disciplined, organized, and able to effectively coordinate and collaborate with team members., • Extremely proficient with Microsoft Office Suite or related software; as well as Excel, PPT, Internet, Cloud, Forums, Google, and other business tools required for this position. Education, Experience, Skills, and Requirements • Bachelor's degree preferred., • Minimum of 2 years of experience in medical billing, coding, revenue cycle or practice management., • Strong knowledge of healthcare regulations and insurance processes., • Knowledgeable in change control., • Proficiency with healthcare billing software and electronic health records (EHR)., • Knowledge of HIPAA Security preferred., • Hybrid rotation schedule and/or onsite as needed., • Medical coding (ICD-10, CPT, HCPCS), • Claims management (X12), • Revenue cycle management, • Denials management, • Insurance verification, • Data analysis, • Compliance knowledge, • Comprehensive understanding of provider reimbursement methodologies, • Billing software proficiency

Job Description Summary: The center administrator oversees the patient flow and the daily operations of the medical center. This role is responsible for the effective administration of the center and its employees. Duties and Responsibilities: • Provide direct supervision to medical staff, front desk staff, environmental staff and other staff as assigned including hiring, terminating, conducting performance reviews, recommendation of salary increases, review and approval of employee’s timecards and approving personal time off (PTO) requests on a bi-weekly basis., • Responsible for exercising independent judgment and discretion about matters of significant impact to the operations., • Handle confidential information including patient information in an ethical and professional manner., • Establish work schedules and assignments for staff according to workload, space and equipment availability., • Approve and submit pending invoices to our accounting department in a timely manner., • Ensure that all staff members answer telephone calls in a timely and polite manner; demonstrate exceptional customer service; and communicate with customers in a courteous, professional, cooperative and mature manner., • Oversee and maintain a safe environment for employees, patients and visitors., • Administer HIPAA and OSHA training., • Work closely with physicians to ensure patient satisfaction., • Work with billing department to assure proper coding as per physician diagnosis., • Supervise the completion of HEDIS/5-Star measures., • Accomplish employment objectives by recruiting, selecting, orienting, training, assigning, scheduling, coaching, counseling, and disciplining employees; communicating job expectations; planning, monitoring, appraising, and reviewing job contributions; planning and reviewing compensation actions; enforcing policies and procedures., • Maintain office supply inventory by checking stock to determine inventory level., • Maintain sufficient medical supplies for the proper treatment of patients., • Ensure that all employees conduct themselves in according to the policies established by the company. Administers disciplinary action according to company policy and submits documentation to the Department of HR., • Ensure compliance with all company policies., • Ensure that all HIPAA standards are in compliance., • Maintain medical center to AHCA standards., • Perform duties in honest and ethical manner., • Open and follow up any outstanding IT or Facilities service tickets, • Perform other duties as assigned. QualificationsEducation/Experience: • High school diploma or equivalent., • At least two (2) years of medical office or administrative experience., • Prior supervisory experience preferred., • MS Office programs experience., • Must have CPR certification from the American Heart Association. Training and certification can be provided upon hire. Skills: • Use relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards., • Use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems., • Ability to work with individuals within and outside the organization, in professional and courteous manner., • Understand written sentences and paragraphs in work related documents., • Strong ability to use independent judgment and initiative., • Organized and able to manage competing priorities., • Resourcefulness in problem solving., • Strong written and verbal communications skills

Job DescriptionBenefits: • 401(k) matching, • Competitive salary, • Dental insurance 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 Assistant Manager of Revenue Cycle Management (RCM) to join our leadership team and help us continue delivering exceptional results to our clients across the country. Job Overview As the Assistant Manager of Revenue Cycle Management, you will lead the end-to-end billing operations, optimize workflow efficiency, and oversee a high-performing RCM team. You'll be responsible for managing key functions such as claims submission, payment posting, denial management, and A/R follow-up across multiple specialties and client accounts. Key Responsibilities • Oversee and manage the full revenue cycle process, from patient registration through final payment., • Develop and implement policies, procedures, and performance metrics to ensure efficient and accurate billing processes., • Lead, mentor, and evaluate the performance of the RCM 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 (preferred) Bachelors degree in Healthcare Administration, Business, or related field (Masters preferred)., • 5+ 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., 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 Description Position Title: Collector – Third-Party Payor Denials & Collections Reports To: Revenue Cycle Manager / Director of Operations Location: [Insert Location / Hybrid – occasional work-from-home] Employment Type: Temporary (with potential for Full-Time, Permanent Placement) Position Summary We are seeking an experienced Collector to join our team on a temporary basis, with the opportunity to transition into a full-time permanent position based on performance and business needs. This role focuses on third-party payor denials and collections, requiring expertise in contract interpretation, billing codes, and compliance with state and local regulations. The ideal candidate will be highly organized, detail-oriented, professional, and possess excellent work ethics. They should demonstrate a collaborative team spirit and have a solid understanding of medical terminology. This position also offers occasional flexibility to work from home. Please note: All offers of employment are contingent upon the successful completion of a background check and drug testing. Key Responsibilities • Review, analyze, and resolve third-party payor denials and underpayments to maximize reimbursement., • Interpret payer contracts and guidelines apply to appeal inappropriate denials., • The ideal candidate must have the ability to work closely with Registered Nurses (RNs) and collaborate on denial cases, providing recommendations and developing plans of action to resolve issues effectively. “Leverage knowledge in contract interpretation and (CPT, ICD-10, HCPCS, DRG) to validate claims and support appeals., • Draft and submit appeal letters with appropriate documentation in compliance with payor standards., • Ensure compliance with state and local billing regulations in all collection activities., • Collaborate with billing, coding, and case management staff to identify denial trends and improve processes., • Maintain accurate and timely documentation of collection activities in billing systems., • Support A/R management efforts, including aging analysis and denial tracking., • Stay updated on payer policy changes, regulatory updates, and industry best practices., • Promote teamwork and professional collaboration within the revenue cycle department.Company DescriptionExcel HealthCare Receivable Management & Consulting Corp. (“Excel”) is a specialized healthcare consulting firm dedicated to helping hospitals, physician groups, and healthcare systems optimize their revenue cycle operations. With proven expertise in Accounts Receivable reviews, denials management, appeals, and collections, we partner with providers to reduce revenue leakage, improve cash flow, and strengthen compliance with payer regulations. At Excel, we pride ourselves on integrity, transparency, and measurable results. Our approach combines deep industry knowledge, attention to detail, and hands-on consulting to ensure clients receive the highest level of support. We work closely with providers and clinical teams, including RNs and case management, to resolve denials, recommend corrective action, and implement sustainable revenue cycle improvements. As we continue to expand, we are seeking passionate professionals who share our commitment to excellence, teamwork, and making a meaningful impact in healthcare finance.Excel HealthCare Receivable Management & Consulting Corp. (“Excel”) is a specialized healthcare consulting firm dedicated to helping hospitals, physician groups, and healthcare systems optimize their revenue cycle operations. With proven expertise in Accounts Receivable reviews, denials management, appeals, and collections, we partner with providers to reduce revenue leakage, improve cash flow, and strengthen compliance with payer regulations.\r\n\r\nAt Excel, we pride ourselves on integrity, transparency, and measurable results. Our approach combines deep industry knowledge, attention to detail, and hands-on consulting to ensure clients receive the highest level of support. We work closely with providers and clinical teams, including RNs and case management, to resolve denials, recommend corrective action, and implement sustainable revenue cycle improvements.\r\n\r\nAs we continue to expand, we are seeking passionate professionals who share our commitment to excellence, teamwork, and making a meaningful impact in healthcare finance.

Job Description Job Objective: Under the direct supervision of the AVP of Revenue Cycle, or designee, the Business Office Collection Manager assists in the day-to-day centralized business office (CBO) operations related to insurance follow-up, cash and adjustment posting, customer service, billing and vendor management. Essential Duties: • Assist with job training for new employees, • Provides direction and support to department staff to answer and resolve problems relating to patient accounts, • Strategically create collector ATBs at least monthly to ensure cash consistently flows in without disruption, • Reviews and ensures that assigned work is completed accurately and timely, • Assist with special projects as assigned, • Helps in the development of procedures and job duties, • Handles difficult or complex questions and phone calls from customers, • Communicates backlogs, problems, and/or payor issues to leadership, • Interprets difficult contract language to maximize reimbursement, • Assists leadership with potential employee interviews, • Conduct employee performance reviews, • Works with all departments of the hospital, as needed, • Works with payors to ensure short pays and disputed claims are reimbursed timely and accurately, • Makes appropriate write off decisions per department guidelines, • Assures that any billing changes or follow up procedures are relayed to staff, • Monitor and report daily work for employees, • Prepares and sends collector productivity reports to leadership, • Approve and manage employee time off requests, • Approve timecards in the payroll system, • Other duties as assigned, within skillsets and abilities Skills and Abilities: • Excellent written and verbal communication, • Ability to be a team player and motivator, • Ability to give the highest level of customer satisfaction at all times, • Medical terminology as related to patient services support work, • Strong knowledge of policies and procedures relating to hospital Patient Accounting activities, • Strong knowledge of principles and techniques of patient accounting and billing including Common Procedural Terminology (CPT) and ICD-10 coding, • Ability to perform technical, specialized, complex or difficult patient billing services support, • Establish and maintain effective working relationships with patients, hospital departments, insurance carriers, physicians, and co-workers, • Establish and maintain accurate and systemic records, • Excellent ability to organize work and establish priorities, • Ability to expand on own initiative in performance of duties, • Bilingual, preferred Experience: • Minimum 5-years of experience in supervising and leading employees within an healthcare setting., • Expert working knowledge in Federal, State, and County reimbursement programs, as well as managed care contract interpretation and insurance follow up, related to Commercial, HMO, PPO, and Worker's Compensation hospital claims Education: • High school graduate or equivalent, • Completion of relevant college courses, preferred

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 customers with their account information., • File supplement or secondary insurance upon request of the patient., • Work with Respond Billing software to ensure the most efficient billing process., • Directs patient complaints to the Billing Operations Supervisor for completion and filing., • Manages workload in an ethical manner and within the intent of federal, state, and local laws and in alignment within National Health Transports Billing Protocols and Procedures., • High School Graduate/GED, • Medical coding training and experience, • Familiar with Medicare/Medicaid laws and billing, • Certified Ambulance Coder helpful Required Shifts/Schedule: Hours must be flexible to meet the demands of the office, but would generally be 8:00am-4:30pm, Monday through Friday. This position is not remote. Note: This description indicates, in general terms, the type and level of work performed and responsibilities held by the team member(s). Duties described are not to be interpreted as being all-inclusive or specific to any individual team member. No Third Party Agencies or Submissions Will Be Accepted. Our company is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. DFWP Opportunities posted here do not create any implied or express employment contract between you and our company / our clients and can be changed at our discretion and / or the discretion of our clients. Any and all information may change without notice. We reserve the right to solely determine applicant suitability. By your submission you agree to all terms herein. Powered by JazzHR J9LV7lLZPg

Job Description Job Title: Medical Billing & Coding Specialist Company: Pinnacle Wound Management Employment Type: Full-Time Location: This is an on-site location in Gainesville, GA About Us: At Pinnacle Wound Management, we are dedicated to improving the lives of patients through high-quality wound care delivered by expert physicians, nurse practitioners, and physician assistants. As a growing leader in this specialized healthcare field, we’re looking for a detail-oriented and proactive Medical Billing & Coding Specialist to join our administrative team and ensure accurate, timely, and compliant billing operations. Position Overview: The Medical Billing and Coding Specialist will be responsible for reviewing clinical documentation, assigning appropriate diagnostic and procedural codes, and submitting claims to insurance companies. This role plays a vital part in our revenue cycle and overall patient experience. Key Responsibilities: * Review and accurately code medical procedures, diagnoses, and treatments using ICD-10, CPT, and HCPCS codes * Prepare and submit clean claims to insurance companies both electronically and by paper * Follow up on unpaid or rejected claims and resolve billing issues * Ensure compliance with HIPAA and other federal regulations * Collaborate with clinical staff to clarify documentation and improve coding accuracy * Maintain up-to-date knowledge of billing regulations and payer guidelines Qualifications: * Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent required * 2+ years of medical billing and coding experience (specialty experience a plus) * Strong knowledge of insurance guidelines, including Medicare and Medicaid * Proficiency with electronic medical records (EMR) and billing software * Excellent attention to detail and organizational skills * Ability to handle confidential information with discretion Why Join Us? * Opportunity to be part of a mission-driven team making a direct impact on patient care. * Supportive and collaborative work environment. * Competitive salary and benefits package.

Job Description The Medical Billing Specialist is responsible for the timely and accurate submission of insurance claims, reviewing and updating denied claims for resubmission and performing reconciliations to ensure timely billing for services provided. The Medical Billing Specialist collaborates with patients, revenue cycle counterparts and work units, clinical staff, and insurance providers to drive the efficiency of the billing process and reduce the amount of denied claims. This position is available in either Cooper City or Miami. Essential Responsibilities: • Reviews patient demographic and insurance information and confirms patient benefit details related to services provided by the clinic from insurance providers., • Obtains necessary medical documentation from clinicians to provide to insurance companies as required for review and prior authorization of treatment. Documents authorization reference numbers in EMR and/or other systems., • Updates and maintains EMR and/or other systems based on documentation provided by physician/clinic for creation of medical claim and/or posting of self-pay charges to patient accounts. Prepares electronic claim files for submission., • Monitors accepted/denied claims and updates claims as required for resubmission., • Compares transaction reports with daily schedules to ensure timely billing of all services provided each month., • Resolves and prepares paperwork for any credit balances and prepares statements for collection of outstanding patient balances., • Performs daily charge capture functions as outlined by each Clinic in a timely and appropriate manner. This includes but not limited to the actual data entry of charges per patient into the EMR platform, eIVF., • Ensures charge reconciliation to the schedule for all patients seen daily., • Ensures appropriateness of charges based upon services rendered and works in conjunction with Clinic leadership, RCM Leadership, and Coding Team to ensure such accuracy., • High School Diploma or equivalent required, Associate’s preferred., • 1 - 2 years of medical billing experience required in a women's clinic/physician practice setting., • 1-2 years of medical billing experience related to a lab and ASC setting also preferred., • Versed in CPT code sets and requirements including but not limited to modifiers, CPT bundling/unbundling, proper diagnosis assignment, Evaluation and Management Codes, Lab Codes, and ASC HCPC code sets. ???? Comprehensive Health Coverage: Medical, dental, and vision plans for our full-time employees, along with complimentary basic life insurance, Employee Assistance Program, and long-term disability insurance. FREE or low-cost employee-only healthcare coverage option is also available. ????️‍????️‍????️‍???? Family Building Support: Take advantage of our comprehensive fertility benefits, adoption assistance, and surrogacy support to help grow your family. ???? Paid Parental Leave: Generous maternity, paternity, and partner leave so you can focus on what matters most. ???? Plenty of Paid Time Off: Start with 18 days of PTO annually and enjoy 11 paid holidays, including one floating holiday to use as you choose! ???? Retirement Ready: Invest in your future with our 401(k) plan, featuring a competitive company match and full vesting after just 2 years. ???? Lifestyle Spending Account: Access a company-funded account to reimburse expenses that boost your physical, financial, and emotional well-being. ???? Health Savings Account (HSA): If eligible, enjoy regular employer contributions to your HSA with every paycheck. ???? Rewards for Connections: Earn extra money with our Employee Referral Program—your network is invaluable! ???? Growth Opportunities: We support your career with continuing education reimbursement and dedicated time off for professional development. ???? Premium Calm Health Subscription: Enjoy a free premium Calm Health app subscription to support your mental wellness. ???? Emotional & Work-Life Support: Through our Employee Assistance Program (EAP) with SupportLinc, you'll have access to emotional well-being and work-life resources whenever you need them. ???? Extra Peace of Mind: Explore additional coverage options including Accident, Critical Illness, Hospital Indemnity, and Pet Insurance, to suit your needs. Familiar with medical billing platforms utilized in clinic and physician practice settings.

Job DescriptionFull-time, non-exempt Miami, Florida Hybrid About VUMI® VUMI® (VIP Universal Medical Insurance Group) is an international health insurance company committed to providing premier medical insurance products and VIP healthcare services to individuals and corporations worldwide. With operational offices in Panama, Ecuador, Colombia, and across the globe, we offer unique benefits and extensive global coverage. Privately owned and backed by over 35 years of experience in the healthcare industry, VUMI® employs a diverse team of 500+ professionals and is part of a leading international healthcare group. Join a top team of healthcare professionals driving innovation and excellence at one of the leading IPMI (International Private Medical Insurance) organizations in the industry. About You You are a knowledgeable and driven insurance professional with a strong understanding of claims handling procedures and insurance principles. With hands-on experience in the areas you lead, you bring a proactive, solutions-oriented mindset and a passion for continuous improvement. You excel at guiding and supporting team members, resolving complex claims, and maintaining high standards of accuracy and compliance. You're a confident communicator—able to handle escalations with professionalism—and you foster strong working relationships across teams. Bilingual in Spanish and/or Portuguese, you're comfortable navigating multicultural environments and thrive in dynamic, fast-paced settings. Your background in insurance or healthcare, along with your skills in process improvement, billing systems, and performance analysis, makes you a valuable contributor to operational excellence. If you’re someone who leads by example, embraces challenges, and is committed to delivering exceptional service, we’d love to meet you. POSITION SUMMARY The Claims Team Lead is responsible for providing guidance and support to a team of claims adjudicators and coordinators, helping ensure the accurate and timely processing of insurance claims. This role involves leading by example, resolving complex cases, supporting team development, and serving as a point of escalation—all while ensuring compliance with company policies and regulatory standards. The Team Lead plays a key role in promoting collaboration, efficiency, and service excellence within the claims team. ESSENTIAL FUNCTIONS Essential Duties and Responsibilities * Assign claims to team members based on workload and assignment of responsibility (AORs). * Monitor individual claim progress and key performance metrics. * Provide coaching, constructive feedback, and development opportunities to team members. * Support resolution of performance issues and team conflicts. * Review escalated claims for accuracy, completeness, and compliance with company policies and procedures. * Investigate and resolve complex claims requiring in-depth analysis. * Identify and escalate potentially fraudulent claims in accordance with protocols. * Contribute to the implementation of strategies that improve claims processing efficiency and accuracy. * Monitor and report on customer satisfaction related to claims handling. * Generate performance reports, including metrics such as claim volume, productivity, and turnaround times. * Analyze performance data to identify trends, gaps, and areas for continuous improvement. * Share performance insights and recommendations with management. * Address and resolve escalated customer inquiries or complaints related to claims. * Foster and maintain positive relationships with internal departments and external stakeholders. MINIMUM QUALIFICATIONS & SKILLS * High school diploma or equivalent required * In-depth understanding of insurance principles and claims handling procedures * Demonstrated expertise in assigned claims areas with a track record of success * Strong leadership skills with the ability to motivate and guide team members * Excellent analytical and problem-solving capabilities * Clear and effective communication skills, both verbal and written * Strong interpersonal skills with the ability to collaborate across teams * Proficiency in industry-related systems, tools, and technology * Knowledge of medical coding (preferred) * Ability to thrive in a fast-paced environment and meet tight deadlines PRFERED QAULIFICATIONS * Experience in the insurance and/or healthcare industry * Bilingual in Spanish and/or Portuguese * Proven experience in process improvement and change management to drive operational efficiency * Advanced knowledge of accounts receivable practices and billing systems BENEFITS At VUMI®, the well-being of our employees is our top priority. We offer a robust benefits package that includes: * Medical, Dental, and Vision Insurance * 401(k) Retirement Plan * Life Insurance * Short-Term Disability (STD) Coverage * Long-Term Disability (LTD) Coverage * Paid Time Off (PTO) * Paid Holidays * Hybrid Work Model (combination of remote and in-office work) * Wellness Programs, including free access to our building gym * A vibrant, engaging work environment that values and supports our employees’ growth, well-being, and success WORKING CONDITIONS The following job-related working conditions 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. WORK ENVIRONMENT The role primarily operates in an in-door, climate-controlled office setting working in close proximity to others. Noise level in the work environment is low to moderate. Light level provides adequate brightness for reading, computer work, and other tasks without causing glare or strain. PHYSICAL DEMANDS The job primarily involves sedentary work with prolonged periods sitting at a desk. While performing the duties of this job, employees may occasionally be expected to: • exert up to 10 pounds of force and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects., • operate standard office equipment such as copiers, computers, telephones, printers, etc. TRAVEL Minimal to no travel required SAFETY HAZARD OF THE JOB Minimal Hazards including potential ergonomic risks from prolonged sitting or repetitive motions. EEO STATEMENT VUMI Group is an equal opportunity employer. We celebrate diversity and are committed to an inclusive environment for all employees. NOTE This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are subject to possible modification to reasonably accommodate individuals with disabilities. The requirements listed in this job description are the minimum levels of knowledge, skills, or abilities necessary. This job positing does not create an employment contract, implied or otherwise, other than an “at will” relationship.

Job Description Medical Biller with Experience in Electronic Claims Medical Billing & Payment Posting of Claims, Process Collection for Denial of Claims, Knowledge of CPT and ICD-10 coding. for an Orthotics and Prosthetics Company Preferred, Bilingual is important. Company DescriptionWe are an O & P Medical Company, we service patients for orthotic and prosthetic needs, We have been servicing miami dade since 1974We are an O & P Medical Company, we service patients for orthotic and prosthetic needs, We have been servicing miami dade since 1974

Job Description SUMMARY: Contribute to the company success by completing follow ups and collection for multi-specialty pediatric patient services. We’re looking for a dedicated individual to deliver outstanding customer service to our guarantors by addressing inquiries related to medical bills and ensuring a positive experience. In this role, you will work closely with our medical billing and coding teams, playing a key part in our revenue cycle management process. Your focus will be on providing accurate, timely responses to guarantor statements ensuring a positive experience DUTIES AND RESPONSIBILITIES: • Medical insurance A/R follow up, work on denials and appeal claims with insurance carriers., • Identify medical coding and billing errors from EOB’s and work with appropriate team to correct them., • Monitor insurance claims and contact insurance companies to ensure timely reimbursement., • Greet callers in a professional manner., • Respond to emails promptly and professionally., • Provide detailed information regarding medical bills., • Review claims within Athena and rebill claims as necessary., • Maintain patient accounts by obtaining, recording, and updating personal and financial information., • Verify healthcare insurance information., • Process payments and establish payment plans., • Contribute to team efforts by achieving department goals and metrics., • Review and manage self-pay AR worklist within Athena., • Address and resolve customer complaints, concerns, and inquiries in a timely manner., • Build effective relationships with customers, educate them about Kidz Medical Services, health insurance plans, and benefits such as deductibles, co-insurance, and copays., • Maintain patient care confidentiality., • Perform other related duties as assigned by management, • QUALIFICATIONS:, • High school diploma or equivalent., • Minimum of 1 year of related experience., • Excellent customer service, verbal, and written communication skills., • Exceptional organizational skills, with the ability to manage priorities and workflow., • Proficiency in understanding and following written and verbal instructions., • Bilingual., • Acute attention to detail and adaptability to changing priorities. Our team members enjoy a competitive compensation package. Benefits include: • Medical, dental, vision, life, and disability insurance, • 401(k) and profit sharing, • PTO and paid holidays, • Full-time position located in our business office in Coral Gables/South Miami., • Flexible schedule around the core hours 8:00 – 4:00 Monday – Thursday and Friday 8:00 - 2:00, • Paid Parking ABOUT US: KIDZ Medical Services (KIDZ) is a private, physician-owned and university affiliated medical group specialized in providing pediatric, neonatal and obstetrical healthcare. KIDZ is proud and privileged to have served the South Florida community since 1988, in partnership with the leading health systems in our region. KIDZ is committed to providing high quality, cost-effective, and compassionate medical care using evidence-based tools, a proficient level of training and education, clinical research, and state-of-the-art medical technology. Our team provides services throughout the continuum of care, both in hospital and office-based settings across 15+ pediatric subspecialties. Please visit our website at for more information on our services.

Job Description WE ARE HEALTHCARE SYSTEMS OF AMERICA. Our mission is to elevate healthcare standards, improve patient outcomes, and create value for communities across the United States. Healthcare Systems of America (HSA) is more than a healthcare provider-we're a community built on excellence, innovation, and compassion. If you're looking for a career that makes a difference, empowers you to grow, and gives you the opportunity to impact lives, HSA is where you belong. Healthcare Systems of America operates 8 community hospitals across 3 states. We service a multitude of patients and their families across our vast network, while remaining committed to the professional development of our staff, the functional improvement of our patients, and the cultivation of strong partnerships within our communities. WHAT WE OFFER • Career Growth & Development - We are an essential, stable and growing company with many opportunities for training and advancement within the medical field that all employees and team members can benefit from., • Supportive & Inclusive Culture - We foster an environment where every team member is valued, heard, and empowered to succeed. This IT Project Manager, Administrative and Revenue Cycle applications plays a pivotal role in ensuring the seamless integration of newly acquired healthcare facilities into the HSA Corporate health system's technology infrastructure. This individual oversees end-to-end IT project execution related to M&A activities, including due diligence, systems assessment, infrastructure alignment, and EMR/EHR onboarding. Working closely with leadership from IT, Revenue Cycle operations, compliance, and vendor partners, the Project Manager ensures timely, secure, and cost-effective technology transitions that align with organizational goals and regulatory requirements. The successful candidate will collaborate closely with the Administrative and Revenue Cycle IT Applications team to support system implementation initiatives across key operational workflows. Focus areas will include, but are not limited to: • User configuration and access provisioning, • Patient scheduling and registration workflows, • Health Information Management (HIM) and medical coding, • Case Management processes While the initial and primary focus of this role with be on large scale hospital acquisitions, this position is part of a dynamic and dynamic Project Management Office and, over time, may be assigned to lead or support other IT projects based on organizational needs, workload, and project volume. PRIMARY RESPONSIBILITIES • Develop and manage comprehensive project plans for IT systems integration, ensuring alignment with acquisition timelines and organizational objectives., • Develop and maintain detailed project plans, including schedules, milestones, resource allocation, risks, and mitigation strategies., • Track project performance, identify variances, and implement corrective actions as needed to ensure timely and on-budget delivery., • Work within a matrixed environment and large-scale implementation Program structure to iteratively deliver projects to meet the overarching goals of the organization and Corporate IT department., • Coordinating user access requirements during hospital ownership transitions, • Coordinating the implementation and integration of Hospital and Ambulatory front office applications including, but not limited to, MEDITECH, Formsfast, Experian, etc., • Coordinating the implementation and integration of Hospital and Ambulatory back office applications including, but not limited to, MEDITECH, FinThrive, RevSpring, Craneware, etc., • Collaborate with cross-functional teams, including IT, Revenue Cycle leadership, legal, compliance, and facility operations to ensure seamless transitions., • Manage vendor relationships related to transitional services, systems migration, and new technology deployments., • Ensure all IT activities comply with regulatory standards, such as HIPAA, and adhere to organizational cybersecurity protocols., • Track and report on project milestones, budgets, and resource utilization, providing regular updates to senior leadership., • Manage change control, testing coordination, go-live planning, and post-implementation support activities., • Coordinate change management and end-user training efforts, supporting smooth adoption of new systems, workflows, and overall operational readiness., • Document and standardize acquisition-related IT processes to streamline future integration efforts., • Provide project management support for additional IT or Administrative/Revenue Cycle projects as needed, based on organizational priorities and PMO resource planning. EXPERIENCE/EDUCATION REQUIREMENTS • Bachelor's degree in Healthcare Administration, Information Systems, or related field (Master's degree preferred)., • Minimum of 5 year of project management experience in a healthcare setting with a focus on Administrative and/or Revenue Cycle applications., • Hands-on experience with MEDITECH EHR is required, particularly in integration or optimization roles., • Previous experience managing large-scale, cross-functional projects in Administrative and/or Revenue Cycle environments. SKILLS/REQUIREMENTS • Proficient in healthcare IT standards including HL7, HIPAA, and security/privacy requirements., • Excellent project planning, coordination, and risk management skills., • Strong communication and stakeholder engagement abilities. Capable of working with Executives, IT staff, and vendors., • Ability to balance multiple priorities, navigate complex healthcare environments, and lead cross-functional teams., • Experience using project management tools (e.g. Microsoft Project, Smartsheet, Jira)., • PMP or similar project management certification preferred., • Ability to work independently, proactively resolve issues, and drive initiatives to completion.

Job DescriptionCompany: Harmony United Psychiatric Care Job Title: Psychiatric Office Assistant Internship/Outpatient Clinic (Certification Program) Program Duration: 3 to 6 months (600 hours total) Schedule: Flexible, minimum 20 hrs/week with 10 hrs/day (Full office day) Location: Coral Gables About Us Harmony United Psychiatric Care is part of Harmony United Healthcare LLC. We are a network of outpatient mental health clinics. We provide comprehensive, full-service outpatient mental health services in Florida through in-person and virtual visits through a secure online telehealth platform. Our services include Psychiatric/Psychological Evaluations, Medication Management, Psychotherapy & Counseling, and Neuropsychological Testing Services. Our team of mental health professionals includes psychiatrists, clinical psychologists/neuropsychologists, board-certified psychiatric nurse practitioners, certified physician assistants, and licensed therapists. We care for adults, adolescents, and children aged five and above. Each patient is treated with compassion and respect at Harmony United Psychiatric Care. We strive to provide the best treatment possible through individualized care for patients' needs. About the Program The Psychiatric Office Assistant Internship Program is designed for individuals seeking to transition into healthcare careers or entry-level candidates without prior medical experience. This hands-on program offers foundational exposure to medical office operations, particularly within behavioral and mental health settings. Participants will gain practical skills, industry knowledge, and mentorship, enhancing their resumes and employability in the healthcare field. After successfully completing the program, you will receive a Certificate of Completion stating the hours served and skills learned, which can be included in your resume as an experience. Voluntary, Unpaid Internship Program This internship is a voluntary and unpaid position. Participants will not receive financial compensation or wages for their time during the internship. However, they will gain valuable, hands-on experience and training in a professional mental health care environment. There are no fees charged by Harmony United Psychiatric Care for this internship program. All training and mentorship are provided at no cost to the intern. Eligibility Criteria • Individuals aged 18 or above, • Must be a High School graduate, • No prior healthcare or office experience required, • Able to commit a consistent schedule, • Must pass a basic screening ( e.g. background check), • Week 1 – Orientation and HIPAA/confidentiality training, • Week 2 to 4 – Front desk observation and shadowing, • Professional phone etiquette and patient scheduling, • Electronic Health Record (EHR) basics using MEDENT, • Patient check-in/check-out procedures, • Managing patient flow and waiting area, • Professionalism, discretion, and confidentiality in healthcare, • Appointment scheduling and front desk duties including faxing, copying and filing, • Basics of psychiatric services offered, • General medical terminology, • Introduction to insurance billing and coding, • HIPAA compliance and patient privacy, • Assigned supervisor, • Weekly feedback and progress check-ins, • Real-time guidance and corrections, • Structured training checklist to track learning milestones, • Certificate of completion detailing hours and skills acquired, • Reference letter for employment or further education Drug-free policy: Harmony United Psychiatric Care enforces a comprehensive drug-free workplace policy to ensure the safety and security of our employees and visitors. We prohibit the use of illegal drugs and the unauthorized use of controlled substances on company premises or during work hours. To ensure compliance, we conduct pre-joining drug screening and random drug testing. Violations of this policy will lead to disciplinary action, including termination of internship. By applying for an internship with us, candidates acknowledge their understanding of these terms and willingness to abide by our drug policy. Powered by JazzHR qqMuOZF3Ui

Job Description Patient Advocate Miami, FL ChasmTeam is partnering with a growing national company, to build a team that provides real benefits to patients! We are seeking hard working, self starters who enjoy a challenge as we work together to help patients. The Patient Advocate plays a critical role in identifying, educating, and enrolling eligible hospital patients into the Health Insurance Premium Payment (HIPP) Program. You'll clearly explain program details, gather required documentation, and serve as a compassionate, professional advocate throughout each step of the enrollment process. This role demands mission-driven advocacy, proactive problem-solving, empathetic communication, and resilience—all while balancing compassion with an urgency to ensure patients receive timely support. By facilitating employer-sponsored health insurance coverage, the Patient Helper Program helps medically complex Medicaid beneficiaries access comprehensive care. We’re looking for driven individuals with a “can-do” spirit, unwavering perseverance, and the capacity to support diverse patient populations navigating complex healthcare systems. Key Responsibilities Patient Engagement & Advocacy • Educate patients and families in a clear, compassionate, and culturally sensitive manner about the HIPP program., • Assess family dynamics and adapt communication style to effectively meet their needs., • Obtain necessary authorizations and documentation from patients/families., • Foster trust with patients while maintaining appropriate professional boundaries., • Accurately collect all essential data for HIPP applications (e.g., employer information, insurance details)., • Employ proactive problem-solving to overcome barriers and ensure timely, accurate submissions., • Collaborate seamlessly with the Patient Financial Assistance team to finalize enrollments., • Clarify how employer-provided health insurance works in coordination with Medicaid., • Verify and update ongoing patient eligibility for HIPP to maintain continuity., • Utilize CRM/case management system to manage referrals and patient records., • Upload, scan, and securely transmit required documentation., • Record patient interactions meticulously in compliance with privacy and legal standards., • Represent the organization as the onsite contact at the hospital., • Establish and maintain collaborative relationships with hospital staff, state agency personnel, and community partners., • High school diploma or GED and completion of formal training in customer service, patient services, healthcare administration, social services, or case management., • Foundational knowledge of healthcare terminology and insurance processes gained via coursework or certification., • Associate’s or Bachelor’s degree in Social Work, Healthcare Administration, Public Health, or related field., • Training in motivational interviewing, trauma-informed care, or medical billing/coding., • Continuing education in Medicaid/Medicare eligibility, health equity, or patient advocacy., • Three-Five years’ experience in patient-facing roles within a healthcare setting. Technical Skills-Preferred • Proficiency with CRM or case management systems., • Knowledge of Medicaid/Medicare eligibility and benefits coordination., • Ability to interpret medical billing and insurance documents., • Active listening and empathetic communication., • De-escalation tactics for emotionally distressed patients., • Cultural awareness and sensitivity in communication., • Mission-Driven Advocacy – Consistently puts patient needs first., • Ego Resilience – Thrives amid adversity and changing demands., • Empathy – Provides compassionate support while ensuring professionalism., • Urgency – Balances speed and sensitivity in patient interactions., • Detail Orientation – Ensures accuracy and completeness in documentation., • Cultural Competence – Demonstrates respect and understanding of diverse experiences., • Adaptability – Successfully operates in evolving policy and procedural environments. Why Join Us? As a Patient Advocate, you’ll make a real difference—helping patients navigate complex health and insurance systems, securing critical benefits, and enabling focus on healing and well-being. Join a mission-driven, supportive team where your work matters and your growth is encouraged. Full benefits offered including Health, Dental, Vision, 401(k) with company match, STD/LTD, Life Insurance and more. Salary: $50,000+/year based on experience plus $4,000+/year bonus potential

Job Description Fast paced Medical Billing company looking for experienced Medical Billing and Insurance Collector ( >2 years). Must have knowledge of medical appeal guidelines, including Medicare. Need to be proficient with ICD-10 and coding guidelines. Good benefits such as; paid vacation, paid holidays, 401K, health benefits . Job Type: Full-time Experience: • Electronic claim filing, • Posting payments (EOB's and ERA's, • Work Rejections, • Work Denials, • Insurance Portal Follow Up, • A/R follow up and collections on outstanding AR (Insurance Aging)

Job Description Benefits/Perks • Competitive Compensation, • Great Work Environment, • Assist clients with processing insurance claims through both private insurance and Medicaid/Medicare, • Note and process all necessary forms from the insurance, • Assist patients in navigating the billing and insurance landscape, including collecting all necessary forms and signatures, • Work with doctor’s offices and hospitals to obtain charge information and billing details, • Enter all billing and payment information into the system properly and without errors, • Follow up with clients and payments, as needed, • Answer phones, assist clients with questions, take messages, and screen calls, • Maintains the highest level of confidentialityQualifications, • Strong customer service skills, • Previous experience with medical coding or billing desired, • Strong organization skills, • Excellent attention to detail

Job Description POSITION PURPOSE: The purpose of the Patient Financial Services Specialist II is to ensure that the batches and daily registration have been processed correctly. Coordination of work from the patient care areas, maintaining the work flow of documents to and from data processing and supervising closing by staff. POSITION REQUIREMENTS / QUALIFICATIONS: Education/Experience: High School Diploma or GED Equivalent. Some College Credits Preferred, Five years’ experience in Health Care. Knowledge of Medicaid / Medicare insurance, collections and setup. Must know how to post B&E’s. Licensure / Certification: Maintain current CPR certification from the American Heart Association Skills / Ability: Ability to work as a team leader and independently. Must have clerical skills, ability to type 35 WPM and have interviewing skills. Must have knowledge of math, operation of calculator; telephone etiquette, human relation skills and organizational skills. Must be computer literate. Ability to demonstrate effective oral and written communication skills. POSITION RESPONSIBILITIES (THIS IS A EXEMPT POSITION) Complete statistical data and submit daily. Plans, supervises and coordinates the work of Patient Financial Services Specialist staff and supporting clerical staff in various Departments. Assist with training of new employees and work related problems. Answers inquiries of staff as questions arise in connection with obtaining needed information. Spot check work in progress to ensure prompt work flow to and from Data Processing. Ensures that decisions are in accordance with CHI Policies. Make credit decisions regarding admission deposit in problem situations. Discuss with patient the status of their accounts and make payment arrangements. Verifies Medicare, Medicaid and all other insurance carriers when needed. Coordinates and directs balance of daily closing and ensures that all procedures and payments are posted accurately by staff. Performs cashier duties, collects patient funds for services and enters data into computer for payment received. Performs voids, deletions, corrections on payments, B&E’s and batches. Performs billing audits to ensure compliance by the PFSS. Provides instruction regarding posting in computer correctly. Verifies batches of PFSS. Provides updates and training of cashier functions. Provides reports to the Director of Finance or appropriate staff. Use appropriate and correct telephone etiquette at all times. Participates in Continuing Educational In-service and Performance Improvement Activities. Report of PFSS errors. Report of Medical Coding errors. Ensures that all B&E (billing and encounter) forms are posted by the PFSS within the same of service. Ensure batches are scanned into the Imaging system on time and accurately. Allocation of Personnel to cover staff shortages. Reports to work on time and ready to work with minimal absenteeism. Adheres to the Confidentiality Policies and Procedures / HIPAA Regulations. Performs other duties as assigned, including variable shifts if needed.

Job DescriptionBenefits: • Bonus based on performance, • Competitive salary, • Dental insurance, • Health insurance, • Paid time off, • Training & development Key Responsibilities: • Prepare and submit accurate claims and encounters to HMO plans in a timely manner., • Review encounters for accuracy and completeness before submission., • Verify patient and provider information, ensuring alignment with health plan requirements., • Resolve claim rejections or denials by researching and correcting errors promptly., • Maintain detailed records of submitted claims, payments, and outstanding balances., • Communicate with HMO plans regarding billing inquiries, discrepancies, or follow-ups., • Collaborate with internal teams to ensure documentation and coding compliance., • Monitor billing cycles to meet deadlines and avoid delays in payment., • Provide regular reports on encounter submissions, claim status, and collection progress., • Stay up to date on billing regulations, HMO plan policies, and industry best practices. Qualifications: • High school diploma or equivalent (Associates or Bachelors degree preferred)., • Minimum 2 years of medical billing experience, preferably with HMO plans., • Strong knowledge of medical coding, claims submission, and encounter processes., • Proficient in medical billing software and MS Office (Excel, Word, Outlook)., • Excellent attention to detail and accuracy., • Strong organizational and time management skills., • Ability to work independently and as part of a team., • Effective communication skills, both written and verbal.

Job Description POSITION PURPOSE: This is a limited technical position in the collection and preparation of specimens for laboratory testing and performance of approved waive Tests. Duties performed follow standardized lab practices and procedures under the supervision of a Licensed Medical Technologist or the Lab Supervisor. Also, duties will include revenue collection including cash handing, ensure that the Billing and Encounter Forms are processed correctly. Coordination of work from the patient care areas, maintaining the work flow of documents to and from data Processing. POSITION REQUIREMENTS / QUALIFICATIONS: Education/Experience: Graduate from a standard high school or GED equivalent. Appropriate clinical lab techniques in an accredited training institution. Six (6) months phlebotomy experience preferred. Certified Lab Assistant or Certified Phlebotomist. ICD 9 Coding experience preferred. Experience in Patient Financial Services. Knowledge of Medicaid / Medicare, Kid Care, other Health Insurance, sliding fee scale and financial setup preferred. Licensure / Certification: Applicable and/or available License as Laboratory Technician, Certified Laboratory Assistant, Phlebotomist, Medical Assistant or Certified Nursing Assistant from the State of Florida. CPR certification. Skills / Ability: Basic computer knowledge, phlebotomy skills, and knowledge of cashiering functions. Ability to relate to diverse ethnic population. Must have clerical skills, ability to type 20 – 30 wpm. Ability to demonstrate effective oral and written communication skills. Bi-lingual preferred. POSITION RESPONSIBILITIES (THIS IS A NON-EXEMPT POSITION) Performs blood drawing and processing duties or occasionally reference as part of a team collects blood from infants and adults by micro and macro techniques for complete counts or component. Must have the skills needed to obtain blood from difficult veins using both the syringe and vacutainer. Instructs patients in the proper preparation and collection of timed specimen. Prepares blood samples for a large volume of routine chemistry tests, including listing of specimens, examining samples, to see if blood is ready for testing, checking the condition of serums and placing blood in tubes for processing. Performs waive lab procedures, e.g. pregnancy test and urine dipstick. Post laboratory billing and payments into Intergy computer. Accurately identifies the assigned lab based on HMO contract. Order and stock supplies and issues supplies, as needed to the other units and centers. Sorts and files correspondence, lab reports or other documentation as applicable. Answers telephone, relay messages to staff, and distributes memorandums. Monitors all lab request and documents receipt of results as applicable. Assist the providers in locating results. Maintains work log and appointment schedules for laboratory services. Dispenses medical appliances to patients as directed, and give proper specimen collection instructions. Where applicable participate in appropriate Continuing Education, In-service Training, Performance Improvement Activities and/or maintain current licensure and/or certification. Keeping alert of emergency needs of patients waiting for services. Attend departmental and institutional meetings as required. Maintains laboratory work areas clean and orderly. Demonstrates a respectful manner towards patients, physicians and co-workers. Greets patients in a courteous manner, responds to patients with empathy and positive interpersonal skills. Responsible for knowing and adhering to Departmental and Institutional Policies and Procedures. Maintains a cooperative working relationship with all members of the Laboratory Department. Assist with orientation of new personnel and phlebotomy training reviews for existing personnel. Maintain current CPR certification. Understands and participates in the principles of the Quality Management Program. PFSS POSITION DUTIES: Register or update client, in Intergy as per guidelines by Community Health of South Florida. Researches files for previous enrollment in CHI computer system before creating a new medical record number. Registers patients requiring laboratory tests on the computer to include generating a route slip, collects fees for such test and generates receipts. Checks for valid patient fee classification, Medicare, Medicaid other funded programs and sliding fee scale. Performs financial screening on active clients who have requested services from Community Health of South Florida, Inc. Performs cashier duties: pre-collection, A/R and enters data into computer for payment received. Attempt collection of past due debts as clients request services from CHI. Check-out clients upon receiving Laboratory services and issue walk-away bill. Post procedures, collect additional funds when checking out clients after receiving services. Review and balance daily batches for posting locations, allocating correct procedure, accounts posted to zero insurance, etc. Submit daily batches to assigned supervisor or designee. Submit cash and copies of daily batches to the Supervisor for deposit. Complete statistical data and submit daily. Verifies, Medicare, Medicaid and all other insurance carriers. Performs daily balance closing and ensures that all procedures and payments are posted accurately. Use appropriate and correct telephone etiquette at all times. Completes & Post all B&E (billing and encounter) forms within the same day of service. Presents a clean, neat appearance according to CHI guidelines. Reports to work on time and ready to work with minimal absenteeism. Adheres to Confidentiality Policies and Procedures / HIPAA Regulations. Performs a minimum of 80% of work assignments. Performs other duties as assigned.

Job Description Come grow with us! Medrina has been voted one of the fastest growing companies and 92% of our employees feel we are a Great Place To Work! This is a remote full-time position offering a starting annual salary of $115,000 plus up to 10% annual bonus, and a monthly $100 internet and cell phone allowance. Spanish language fluency is required. Although this is a remote role, candidates must reside between Palm Beach and Miami, FL area and will travel to local locations in this area a few times per month. This is a great opportunity for a bi-lingual Director of Nursing to join our team for this remote role utilizing their skills and advancing their career with clinical operations! This role comes with a robust benefits package including immediate/day one health/dental/vision insurance, company funded life insurance, and 15 days of vacation, 7 paid holidays and 5 sick days and more. As well as eligibility for 401(k) with a company match after 6 months of service. Job Summary: The Director of Clinical Operations will be a part of our national team of operations leaders and oversee clinical operations for a specified region and participates in the development, planning, and operations for a multi-physician practice to fulfill programmatic directions and goals as well as traveling to conduct Provider introductions, customer relationship building meetings, and training. This role ensures a smooth on-boarding credentialing, training, and start of new Providers and their implementation into Skilled Nursing Facilities and other healthcare settings. The Director of Clinical Operations supervises each individual account to ensure success for all parties as well as collaborating with the client building’s administrative teams to ensure consistent, efficient, and compliant operational performance. This role also collaborates to ensure continual efficient and compliant operational performance of the Providers and buildings. You will be called upon to directly interface with our customers. This will include Physicians, Physician Extenders, Skilled Nursing Facility department heads, and other healthcare setting leaders. The Director will be asked to participate in analyzing operational and clinical performance both for client facilities and medical providers. This is a remote role, but travel is expected locally to meet facility leaders, and conduct provider introductions, onboarding and training. The Director of Clinical Operations reports to the Senior Vice President of Clinical Operations. Essential Duties and Responsibilities: • Medrina Programs Implementation:, • In collaboration with Business Development, clinical leadership and other teams, implements existing operations processes, workflows, best practices and protocols for the new client buildings., • Oversees the operational integration of various and/or new Medrina programs into Skilled Nursing Facilities (SNFs) and other healthcare settings., • Coordinates administrative functions and assists in planning and supporting the program development as well as monitors programs and assists in developing strategies for adaptation to market changes., • Assists in data collection for preparation of reporting related to and forecasting., • Ensures efficient and compliant operational performance of the department and programs. Strives to streamline operations and effectively apply new concepts and techniques for positive outcomes. Identifies and implements technology to improve operations., • Collaborates and has consistent communication with multiple departments within the organization., • Participates in monitoring and evaluating a program’s inception and performance and routinely monitors performance for volumes, referrals, and trends., • Establishes and maintains a working relationship with physician staff with respect to their compliance and performance related to billing, coding, and regulatory agency standards., • Assists in initiatives that will develop relationships with ACO/MCOs in needed markets under the direction of the Vice President of Clinical Operations and Chief Medical Officer., • Assists in implementing new programs, protocols, and methods to track quality metrics and will make adjustments as needed., • Other responsibilities as assigned. 2. Facility Relations and Performance: • Establishes and maintains a strong working relationship with key personnel in partnering Skilled Nursing Facilities to ensure program growth and ensure the program is making positive impact on the Skilled Nursing Facility., • Serves as the point of contact between SNFs, healthcare facilities, and medical providers to ensure smooth implementation of Medrina programs., • Serves as a point of contact between Skilled Nursing Facilities’ clinical staff and the physicians to ensure quality and satisfaction., • Maintains strong relationships with key administrative and clinical personnel in partnering facilities to ensure continuous program growth and success., • Works directly with facility administrative and clinical leadership, and providers to monitor the success of Medrina programs and improve patient outcomes., • Monitors facilities performance ensuring that Medrina protocols are followed, and quality standards are met., • Collaborates with Medrina Business Development and Recruitment teams in ensuring smooth operations related transitions. 3. Provider Relations and Performance: • In collaboration with Human Resources, monitors and ensures providers complete mandatory state and federal new hire and annual training., • Monitors providers’ performance ensuring that Medrina protocols are followed, and quality standards are met., • Alerts and collaborates with clinical leadership and clinical training teams to improve providers’ (Physicians’ and Advance Practice Providers) performance, if necessary., • Addresses insufficient provider performance in collaboration with clinical and operational leadership and Human Resources teams in accordance with company performance management policies., • Approves providers schedule changes and time off requests utilizing company systems., • Reviews and approves appropriate employee expense reports and ensures staff follow the correct procedures for continuing education and other expenses., • Prepares and conducts providers annual performance reviews utilizing company system incorporating facility feedback, clinical and operations leadership and feedback, • Reviews and ensure Physicians’ and APPs’ supervision and practice state requirements compliance and facilitates revisions with Credentialing and Legal teams. 4. Operational Performance and Compliance Leadership: • Maintains compliance with all regulatory and accrediting institutions and monitor program components relative to criteria determined by regulatory agencies and also internally by the organization (i.e, billing, credentialing, training, facility visits requirement & etc). Ensures compliance with Medicare and other regulatory requirements, including reporting and documentation standards., • Coordinates activities related to growth objectives, data planning, developing goals and objectives, and desired outcomes of programs and serves as a liaison with Administration in planning, developing, implementing, and evaluating operational and clinical performance., • Keep abreast of all billing, coding, and compliance related issues as they apply to the practice and assist in staff education in regard to these changes., • Reviews and approves requests for release of information to agencies and members of the public as required by law., • Coordinates and acts as project manager with planning and supporting program development as well as monitors programs, provides progress updates, and assists in developing strategies for adaptation to market changes., • Participates in initiatives that will develop relationships with ACO/MCOs in needed markets under the direction of the Senior Vice President of Clinical Operations and Chief Clinical and Medical Officers., • Leads efforts to streamline the operations and implement technological improvements where appropriate to improve operational efficiency., • Fosters a culture of continuous improvement, collaboration, and innovation within the team. 5. Quality and Metrics Tracking: • Assists in data collection for preparation of reporting related to and forecasting., • Assists in developing and maintaining objectives and policies and procedures to ensure the efficient operation of the department., • Regularly reviews program data and trends to identify areas for improvement in clinical performance and operational processes., • Spanish language fluency., • Cannot be excluded from participation in any state or federal programs such as Medicare or Medicaid., • Must have 2 years of leadership and administration experience preferably in the Skilled Nursing Facility or Hospital Rehabilitation healthcare setting (such as Director of Nursing)., • Minimum of 5 years of experience and understanding of care coordination and Medicare as well as with Medicare and Medicaid billing and reimbursement policies and proven record of leading team(s) to operational success., • Proficiency with HIPAA and PHI compliant practices., • Proficient in healthcare management software (EMR, HMR) and Microsoft Office Suite (Excel, Word, Outlook), • Must be a detail-oriented, organized decision maker with the ability to work both independently and within a team structure., • Must be able to analyze situations and make appropriate decisions based on information provided., • Must be able to prioritize tasks to determine which should be given priority at a specific time., • Must be able to accept responsibility with a task and ensure completion from start to end., • Practice excellent verbal and written communication skills in remote setting and present in a professional manner to various stakeholders., • Must be a self-starter who is disciplined, detail-oriented, organized, and able to prioritize tasks in a fast-paced environment., • This is a remote, work from home position which handles sensitive, confidential, and financial information. Work must be performed in a secure setting., • Must have the ability to join virtual online meetings as required both with video and voicework environment, requiring reliable internet and telephone service., • Travel for on-site visits and company meetings., • Ability to sit, stand, and walk for extended periods. Frequently required to talk or hear

Job Description TAVERNIER HEALTH CENTER POSITION PURPOSE: The purpose of the Patient Financial Services Specialist is to ensure that the Billing and Encounter Forms are processed correctly. Coordination of work from the patient care areas, maintaining the work flow of documents to and from Data Processing. POSITION REQUIREMENTS / QUALIFICATIONS: Education/Experience: A minimum of High School Diploma or GED Equivalent. ICD 9 Coding experience preferred. Experience with Patient Services. Must have knowledge of Medicaid / Medicare Insurance, collection and setup. Licensure / Certification: Maintain current CPR certification from the American Heart Association. Skills / Ability: Ability to work as a team member. Must have clerical skills, ability to type 20 - 30 wpm and have interviewing skills. Must have knowledge of math, operation of calculator; telephone etiquette, human relation skills and organizational skills. Must be computer literate. Ability to demonstrate effective oral and written communication skills. POSITION RESPONSIBILITIES (THIS IS A NON-EXEMPT POSITION) Register new client on Intergy as per guidelines issued by Community Health of So. Florida. Researches files for previous enrollment in CHI computer system before creating a new medical record number. Re-new or update existing clients profiles as per guidelines issued by Community Health of South Florida. Performs financial screening on active clients who have requested services from Community Health of South Florida, Inc. Attempt collection o Completes assigned task in a timely manner.f past due debts as clients request services from CHI. Check-in clients for needed medical services. Check-out clients upon receiving medical services. Process of patient payments. Review and balance out daily batches. Submit daily journal to assigned supervisor. Submit cash and copies of daily batches to the Accounting Department for deposit. Complete statistical data and submit daily. Reviews Quality Care Guidelines/Patient Reminder print-out to identify overdue items e.g. Advance Directives, Learning Needs Assessment, Depression Screening, etc. Identifies patients who have not executed an Advance Directive and provide them with the Advance Directive form to read. Identifies patients who need a Learning Needs Assessment and gives them the form to complete. Identifies patients due for Depression Screening and provide them with a PHQ-9 form in the appropriate language to complete. Gives all new patients a New Patient History form to complete before Nursing Staff calls the patient. Attaches a completed new patient lab request form to the encounter form of every new patient. Consistently informs patients that their Provider wants them to read or complete the appropriate forms or education material while waiting to see the Provider. Verifies Medicare, Medicaid and all other insurance carriers. Performs daily balance closing and ensures that all procedures and payments are posted accurately. Performs cashier duties, collect patient funds for services and enters data into computer for payment received. Train new employees on all functions of Patient Services (i.e. registration, cashiering, posting of B&E’s and Payments). Use appropriate and correct telephone etiquette at all times. Participates in Continuing Educational In-services and Performance Improvement Activities. Reports to work on time and ready to work with minimal absenteeism. Completes & Post all B&E (billing and encounter) forms within the same of service. Adheres to the Confidentiality Policies and Procedures / HIPAA Regulations. Performs other duties as assigned, including variable shifts if needed. WE ARE AN EQUAL OPPORTUNITY EMPLOYER

Job Description • Reviews all medical/surgical billings for reasonable and necessary charges. Examines coding of operative reports, procedures, and multiple and complicated surgeries., • Performs hospital length of stay reviews to determine reasonable and necessary care, and appropriateness of stay. Recommends appropriate payments of dispute of billing, as necessary., • Provides second review of bills on which providers question the appropriateness of payments authorized., • Evaluates claims referred for medical management and makes recommendations for follow-up, further investigation or documentation as necessary., • Trains and assists claims staff on quality health care cost containment and utilization reviews.Company DescriptionLeading specialty benefits management company in Puerto Rico and South Florida. Our innovative care management model integrates the needs of providers, payors and members to ensure the delivery of high quality, cost effective care while realizing substantial millions of dollars savings that keep the cost of healthcare down. We are building a model for managing care delivery that embodies traditional values, promises reliability, and embraces flexibility and technology. Through our experience in the healthcare industry, the company aims to improve healthcare outcomes, achieve cost savings and serve as a single point of contact to move into value-based care.Leading specialty benefits management company in Puerto Rico and South Florida. Our innovative care management model integrates the needs of providers, payors and members to ensure the delivery of high quality, cost effective care while realizing substantial millions of dollars savings that keep the cost of healthcare down.\r\n\r\nWe are building a model for managing care delivery that embodies traditional values, promises reliability, and embraces flexibility and technology. Through our experience in the healthcare industry, the company aims to improve healthcare outcomes, achieve cost savings and serve as a single point of contact to move into value-based care.

Job Description Our busy, private allergy practice is seeking Front Desk personnel. As a Medical Front Desk your responsibilities typically involve a variety of administrative tasks. Here's a detailed job description: Administrative Duties: • Patient Scheduling: Schedule patient appointments, testing, and follow-up visits, ensuring efficient use of time slots and coordination with other staff members. You will also be responsible for responding to patient inquiries via phone and email and providing exceptional customer service to ensure a positive patient experience., • Patient Registration: Greet patients, collecting and entering demographic and insurance information, and update electronic medical records (EMRs) accurately., • Insurance Verification & Billing/Coding: Collecting, verifying insurance eligibility via supported website or phone, entering appropriate insurance information into EMR. Assist with billing processes, including coding procedures and services accurately to ensure proper reimbursement., • Referral & Prior Authorization Management: Obtain referrals and/or authorizations for office visits and related testing/procedures and assist patients with insurance-related inquiries., • Copay & Balance Collections: Collecting appropriate copays and balances from patients at the time of service via Point of Service Systems. Contacting patients with outstanding balances to collect payment. Ensuring proper cash balancing on a daily basis. Creating Estimate of Services based on scheduled visit and patient specific benefits., • Medical Records Management: Maintain organized and up-to-date medical records, including filing, scanning, and retrieving documents as needed., • Patient Contact & Communication: Utilize a multi-line phone system to answer a varying volume of incoming calls, take messages for all departments, and make appropriate outbound calls to schedule, confirm, and/or reschedule patient appointments. Facilitate communication between patients, physicians, and other healthcare providers, both in person and over the phone., • Supply Management: Monitor inventory levels of office supplies, restock as needed, and coordinate supply orders with the leadership team., • Education: High school diploma or equivalent., • Experience: Prior experience in a medical office setting, especially in specialty or allergy clinics, is preferred., • Skills: Excellent customer service, strong communication and interpersonal skills, attention to detail, ability to multitask, proficiency in EMR systems. AAP/EEO Statement In order to provide equal employment and advancement opportunities to all individuals, employment decisions at will be based on qualifications and job-related abilities. We do not discriminate in employment opportunities or practices on the basis of race, color, religion, sex, national origin, age, disability, ancestry, sexual orientation, marital status, gender identity or any other characteristic protected by law. We will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in undue hardship.

Medical Records Collector is a team member with several years experience in working collaboratively with outreaching to providers in order to pursue medical records via phone call, fax, mail, electronic medical record system retrieval and direct onsite pick up, for the HEDIS projects. Assists the

Those with strong interest in clinical research and medical education are encouraged to apply. Mount Sinai Medical Centers Award Winning Cancer Center is seeking a board eligible/board certified Hematologist Oncologist to join our distinguished team. Respond to medical and oncologic emergencies in c

HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service. Screens members using Molina policies and processes, assisting clinical Case Management staff as they i

The Holy Cross Medical Group (HCMG) and Holy Cross Hospital have an excellent full-time employment opportunity for a Board Certified or Board Eligible, Fellowship Trained Hematology/Oncology physician to join a practice located in Fort Lauderdale, Florida. This is an exciting opportunity for an exce

HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service. Screens members using Molina policies and processes, assisting clinical Case Management staff as they i

Medical, Dental, Vision, Life Insurance, and FSA accounts. Memorial Cancer Institute (MCI), a key part of Memorial Healthcare System, is seeking a Board Eligible/Board Certified Hematologist/Medical Oncologist to join its specialized team of experts delivering outstanding cancer care. Based in our H

Contacts physician offices according to department guidelines to request missing information from authorization requests or for additional information as requested medical directors. Provides computer entries of authorization request/provider inquiries, such as eligibility and benefits verification,

The Columbia University Division of Cardiology at Mount Sinai Medical Center in Miami Beach, Florida is seeking a board-certified Clinical Cardiologist to join our full-time academic faculty. Those with a strong interest in clinical research and medical education are encouraged to apply.

Certified Medical Assistant (CMA).

The Columbia University Division of Urology at Mount Sinai Medical center currently consists of 10 full-time faculty members organized around a 5-year residency training program with two residents per year. Mount Sinai is an accredited urology residency program and all faculty are required to be act

The Medical Biller compiles amounts owed to medical facility and maintains order, invoice, and payments records. Assists patients, insurance companies, and laboratories with inquiries regarding billing issues. Submits completed batches to appropriate billing offices daily.

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 advanc

Five years of legal billing/receivables experience and in-depth knowledge of accounting principles and billing software; advanced experience in e-billing. This position will entail a wide range of duties including being responsible for the effective hands-on coordination and management of the e-bill

Ensure billing is distributed and returned during the billing cycle. Ardurra is seeking a Project Billing Specialist to join our team in Miami, FL!. Ensure billing of all contract terms.

Location: Aventura Hospital and Medical Center. Communications skills, medical and anatomical skills, mechanical aptitude.

Resolves edits in charge review/charge router work queues to ensure complaint billing based on medical documentation - for Physician Billing. The Billing Specialist is responsible for resolving claim edits for payors using the knowledge of the appropriate billing form and billing guidelines as well

Experience with hourly and lump sum billing. Maintaining billing folders for assigned projects with all the appropriate documents including proposals, expenses, third party consultant invoices, and monthly client invoices. Reviewing proposals/contracts in order to calculate billings correctly.

The ideal candidate will have over 7 years of experience in medical billing and collections, with a strong background in Coding, Pre-Authorization, Workers Comp Claims, and Insurance Certification. Position Summary We are seeking an experienced, team player and detail-oriented Medical Biller and Col

We are seeking a Grant Billing Manager to oversee all aspects of grant billing, compliance, and financial reporting. Develop billing schedules, systems, and resolve discrepancies. You will collaborate with program and fiscal staff, resolve billing issues, and support audits while ensuring compliance