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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 Position Purpose: The Revenue Cycle Specialist role is to provide support to the organization to address all revenue cycle management needs. This includes identifying trends that would impact revenue, work on patient claims, follow up on denial and rejection related issues, and work on special projects as needed. Position Requirements / Qualifications: Education/Experience: High School Graduate or GED required. At least two (2) years’ work experience in a healthcare front office setting. CPC certification preferred. Knowledge of Medicaid / Medicare insurance, collections, and Explanation of Benefits (EOB). Must have experience in healthcare Billing and Revenue Cycle operational workflow. Licensure / Certification: Maintain current CPR certification from the American Heart Association. Skills / Ability: Ability to work as a team member. Must have clerical skills. Must have knowledge of math, operation of calculator, telephone etiquette, human relation skills and organizational skills. Must be computer literate. Demonstrate effective oral and written communication skills. Familiar with Managed Care Contracts, Medical Terminology, ICD-10, and CPT Codes. Knowledge of collections processes and procedure. POSITION RESPONSIBLITIES (THIS IS A NON-EXEMPT POSITION) • Responsible for identifying, analyzing, and managing Process Improvement projects in the Revenue Cycle area., • Responsible for working the Billing Work Queue impacting revenue for timely review and claims submission (Front/Back Office functions)., • Monitor patient account details for billing related issues., • Reporting claims status to clients on a regular basis to ensure accurate communication between departments within a healthcare organization., • Knowledge of payer guidelines and policies., • Identify and communicate with Director of Patient Access/Office Managers of the front office trends impacting claims rejection/denials for training opportunities., • Provide support to RCM Manager, Coder, Site Office Managers and CBO Vendor in order to expedite claims payments., • Coordinating with other departments to ensure that billing cycles are completed efficiently., • Work the monthly and cumulative missing encounter report by validating open encounters are truly missing and working with the clinicians to ensure that they complete documentation and close encounter., • Access and navigating through various payer portals for claims reconsideration and processing., • Follow up on unpaid claims, appeals of denied claims and post payments/adjustments accordingly., • Review the closed encounters that appear on the missing encounter report to validate a charge filed in Transaction Inquiry., • Supports manager/supervisor in identification of potential loss revenue related to trends in charge entry, billing, coding, or contracting practices that are related to charge capture., • Utilize the coding resources to understand procedures that are denied., • Identify and communicate global payer issues with RCM, Managed Care and Back Office Vendor to generate evidence-based appeals for claims processing reconsiderations., • Understand Managed Care Contracts and various aspects of patient access to maximize claims reimbursement., • Monitor and review monthly Chronic Care Management invoices for Medicare reimbursement., • Responsible for receiving, tracking, and entering hospital encounters into Epic for billing reimbursement., • Export claims data from EHR into RCM Vendor portal for charge posting and billing., • Follow up with all outstanding AR projects as directed by RCM Manager., • Review the Provider Flow fax portal for correspondence communication and distribution., • Complete and submit Quest Diagnostic missing billing details for processing., • Establishes and maintains good interpersonal relationships with clients and staff., • Participates in the RCM monthly meeting with vendor., • Export claims data from EHR into RCM Vendor portal for charge posting and billing., • Follow up with all outstanding AR projects as directed by RCM Manager., • Maintains open communication using appropriate chain of command regarding departmental issues.

Job Description Job Summary The Billing Manager is responsible for managing all activities of the Billing Department within the Revenue Cycle, with a strong emphasis on collections, reducing accounts receivable (A/R), and ensuring compliance with HIPAA guidelines and company policies. This role also focuses heavily on team development and process improvement to meet departmental goals and performance standards. Essential Duties and Responsibilities • Oversee day-to-day operations of the billing team, including workflow management, staffing, training, and disciplinary actions., • Coordinate billing needs and onboarding processes for newly acquired centers and DeNovo facilities., • Monitor payment trends; evaluate and implement changes to billing and collections strategies to improve cash flow., • Ensure HIPAA compliance across all billing activities and implement regulatory updates in a timely manner., • Work with Payers to resolve complex billing or reimbursement issues beyond standard provider support., • Collaborate with Operations to ensure alignment and communication of billing requirements across facilities., • Ensure timely month-end close processes and reporting from the billing department., • Monitor and optimize the patient account to staff ratio., • Escalate reimbursement or payment issues to the VP of RCM proactively., • Contribute to and monitor adherence to the departmental budget., • Stay up-to-date with industry trends, Federal guidelines, and payer policy changes impacting reimbursement operations., • Oversee and continuously improve billing processes and systems for both internal and external stakeholders., • Develop and implement training programs to ensure staff proficiency in compliance, billing regulations, and policy adherence., • Conduct staff evaluations, set performance goals, and manage individual development plans., • Maintain knowledge and compliance with company handbooks, safety, and security policies., • Promote professional development through leadership coaching, mentorship, and regular performance audits., • Foster collaboration across the organization to improve efficiency and outcomes., • Serve as a communication bridge between executive leadership and frontline billing staff., • Bachelor’s degree in Healthcare Administration, Business, or related field (preferred)., • Minimum 5 years of medical billing experience, including 3+ years in a supervisory or management role, ideally in a dialysis behavioral health setting., • In-depth knowledge of medical billing codes (ICD-10, CPT, HCPCS) and Federal regulations relevant to dialysis and/or Behavioral Health, • Proficiency in billing and EMR systems and financial reporting tools., • Professional certification preferred: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Professional Biller (CPB)., • Proven leadership skills with experience managing and developing high-performing teams., • Exceptional organizational, analytical, and problem-solving capabilities., • Experience with federal ESRD Prospective Payment System (PPS) or behavioral health reimbursement models., • Familiarity with dialysis or behavioral health terminology and physician billing protocols., • Ability to interpret complex payer policy changes and translate them into operational strategies.

Job Description Position Summary: Medical Record Coder is responsible for timely review of patient records in order to identify an appropriate selection of ICD-10-CM/PCS codes that will accurately reflect the reason for admission, extent of care received, and level of severity of illness. Coder is further responsible for insuring that all data elements required for federal and state reporting are collected and included in the patient's demographic record. Accounts for each Inpatient and Outpatient records in order that all are coded. Enters coded data into computer to facilitate the billing process. Position Qualification: • Preferred: 2-3 years Inpatient coding experience preferred., • EDUCATION: RHIA, RHIT, CCS preferred or completion of ICD-10/PCS 4 coding programs., • TRAINING: Orientation and training under supervision of Director and Coding Manager until competency is observed., • ABILITIES AND SKILLS: Requires eye hand coordination with good manual dexterity. Must be able to look at computer CRT most of the day and must be computer knowledgeable. Must have excellent command of the English language, both oral and written. Must be organized. Requires frequent but limited contact with physicians. LICENSE AND/OR CERTIFICATION: RHIA, RHIT, or CCS preferred.

Job Description At Palm Medical Centers (PMC) our patients have the peace of mind knowing that their health and well-being are our primary concerns. We give our health plan clients the confidence that their members are well taken care of. With more than 24,000 at-risk members, we provide primary care and other services to seniors and families in our medical centers that are comfortable, convenient and staffed with caring professionals. Our activity and wellness facilities are filled with health plan members who know us for our distinct events and programs that cater to the communities we serve. Every day, we deliver on our promise to bring value based, quality healthcare to our patients. Overview PMC is looking for a CDI/Certified Professional Coder who will demonstrate deep knowledge in Medical Risk Adjustment, HEDIS, CNS Coding guidelines, billing standards and regulations. A teamwork person who will deliver a high standard of quality of work to drive improved business performance. Duties and Responsibilities • Conduct workflows in Coding and Quality processes, medical record completion and department projects for accuracy in medical record documentation as needed., • Ensures proper code selection for compliance with ICD-10-CM Official Guidelines for Coding and Reporting., • Educates physicians on proper documentation and compliance standards., • Reviews medical record to include consultations (inpatient and outpatient) and hospital discharge summaries to ensure continuity of care and continued coding for accurate risk adjustment., • Performs pre-post audits to ensure medical record completeness, consistency, and compliance., • Works collaboratively with medical and supporting staff to follow-up on documentation needs to support the diagnosis and quality measures based on patient age and chronic conditions., • Uses only pre-approved source documents as validation for recommendations on documentation that meets the technical specifications in support of a measure., • Develops and maintains professional skills and knowledge through training programs including education sessions for ICD-10-CM and CPT codes., • Demonstrates a thorough understanding of Coding Guidelines., • Demonstrates understanding of company policies which impact Coding functions and takes ownership for compliance for own area of responsibility., • Collaborates with Supervisor as necessary to clarify and verify information. Reports opportunities identified in concurrent and retrospective clinical documentation to support quality, regulatory compliance, and effective coding., • Participates in department meetings. Consistently demonstrates awareness and willingness to fulfill Service Excellence Commitments., • Works collaboratively with team members, other departments, and clinical staff consistent with the Mission and Vision of the company., • Willingly performs similar or related tasks as assigned., • Assists in teaching any office staff and/or providers in proper documentation and coding guidelines as necessary., • Reports any issues to Quality, Compliance and Operations as necessary., • Accurately enters all identified and validated procedures codes in claims into the practice’s EMR., • Assists in all RAPS submission projects as they occur if needed., • Certified Professional Coder (CPC) through AAPC or AHIMA., • 2 years of experience as Certified Professional Coder at minimum., • Proficient in assigning ICD-10-CM codes according to provider documentation level to comply with federal regulations and insurance requirements., • Computer skills, Word, Excel, HER., • Ability to travel to medical centers if needed and/or work remotely., • Excellent verbal and written communication skills., • Excellent customer service skills., • Excellent organizational skills and attention to detail., • Ability to effectively present information in one-on-one situations to providers, office staff, insurance companies, and other employees., • To perform this job successfully, an individual must have knowledge of Microsoft Word, Excel, Internet software, Email software, and insurance web sites., • Strong sense of business ethics., • Prolonged periods of sitting at a desk and working on a computer., • While performing the duties of this job the employee is regularly required to sit, use hands and arms, talk and hear., • Health insurance, • Dental Insurance, • Vision insurance, • Life insurance, • 401(k), • 8 hour shift, • Day shift Palm Medical Centers is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. Palm Medical Centers makes hiring decisions based solely on qualifications, merit, and business needs at the time. Powered by JazzHR jPASsBB6xC

Job DescriptionGet to Know Rivia Mind At Rivia Mind, we believe great mental health care begins with a human connection. Where We Are: We are a psychiatrist-owned mental health practice rooted in New York City, serving individuals across New York, New Jersey, Connecticut, Florida, and Massachusetts through both virtual and hybrid appointments. How We Support: With a 360°ree; view of each individual, we provide compassionate, science-based care that honors the full complexity of a person's biology, psychology, and life circumstances. We go beyond symptom management with an interdisciplinary care model grounded in collaboration, personalization, and delivered with warmth, respect, and clinical integrity. We bring a high-touch, human-centered approach to every aspect of care, from clinical treatment to operational coordination. Click Here to learn more about our services. Thrive Together: 🌟 Our shared North Star unites us to provide the best patient experience. At Rivia Mind, we cultivate a collegial culture rooted in: • A foundation of shared values and reciprocal support, • A mindset of curiosity, learning, and growth Job Summary Under the direct supervision of the Revenue Cycle Supervisor, the Revenue Cycle Coordinator serves as a key support role within the billing department. This position contributes to claim processing, denial resolution, insurance follow-up, and patient invoicing. It also plays a critical role in handling communication across billing channels, including emails, phone calls, and chat messages, with an emphasis on timely and professional follow-through. The Coordinator leverages prior billing experience to help maintain accuracy, efficiency, and responsiveness across all core revenue cycle functions. Application Window: Until February 9th Anticipated Start Date: April, 2026 Job Responsibilities & Qualifications Responsibility Composition Claim Processing & Follow-Up – 40% • Submitting, reviewing, and following up on claims to ensure timely payment and resolution.Denials & Rejections – 20%, • Investigating denied claims, updating claim statuses, and collaborating with supervisors or payers for appeal/resubmission.Account Management – 15%, • Reviewing patient accounts, reconciling balances, managing invoicing, and payment plans.Provider & Patient Communication – 15%, • Communicating with providers for clarification on billing details; responding to patients' questions around balances or billing errors.Reporting, Internal Projects, & Documentation – 10%, • Prepare, review, and transmit claims using billing software in an accurate and timely manner, • Document billing-related interactions and resolutions in alignment with department SOPs and compliance requirements., • Support insurance eligibility troubleshooting by flagging inconsistencies or missing information for resolution, • Follow up on denied or rejected claims, including supporting the collections process in accordance with department standards, • Support patient invoice procedures, including billing inquiries and basic account clarification, • Review and validate claims for completeness, coding accuracy (CPT/ICD-10), and payer-specific rules before submission, • Monitor claims for timely filing deadlines and escalate any risks to the Revenue Cycle Supervisor, • Effectively utilize the EMR system (IntakeQ) and other platforms to support claim, payment, and patient account workflows, • Investigate billing discrepancies and errors, and assist with resolution of denied claims when appropriate, • Check each insurance payment for accuracy and compliance with contracted rates; call payers to address discrepancies if necessary, • Flag potential secondary insurance coverage for further review or follow-up, • Escalate complex denial trends, unresolved claim issues, or recurring payer discrepancies to the Senior Revenue Cycle Specialist or Supervisor, • Collaborate with the Revenue Cycle Supervisor and Specialists to provide support as needed (e.g., special projects, ad-hoc reports, process improvements), • Collaborate cross-functionally with other operational teams to support efficient billing workflows and issue resolution, • Assist with specialty focus areas (e.g., mailed correspondence, provider coordination) as needed to maintain workflow continuity, • Provide responsive support to patients, providers, and internal departments by managing billing-related phone calls, emails, and chat inquiries; ensure timely and accurate resolution in line with department standards, • Maintain clear, empathetic, and professional communication with patients and providers regarding billing concerns to uphold patient trust and care continuity., • Maintain compliance with HIPAA, insurance billing guidelines, and all internal processes, • Adhere to department Standard Operating Procedures (SOPs) and contribute to continuous improvement efforts, • Promote a collaborative work culture that supports growth, teamwork, and continuous learning, • Expected to contribute to weekly claims submission and denial resolution goals as set by the Revenue Cycle Supervisor Education: • Required: High school diploma or GED, • Three (3) or more years of experience in medical billing, including claim submission and insurance follow-up, • Experience in remote healthcare customer service or patient support, including phone-based communication, • Competent understanding and interpretation of Explanation of Benefits (EOBs), • Knowledge of EMR/EHR platforms (e.g., IntakeQ), • Data entry experience with strong attention to detail, • Knowledge of insurance guidelines, including HMO/PPO, in-network/out-of-network (IN/OON) benefits, and Medicare rules, • Proficiency with Google Suite and the ability to navigate multiple platforms (e.g., Salesforce, EMRs), • Intermediate computer skills and solid technical aptitude, • Behavioral health billing experience, • One (1) or more years of telehealth billing and coding experience Benefits That Support You, Personally and Professionally At Rivia Mind, we know that providing exceptional care starts with caring for our team. That's why we offer a comprehensive, thoughtfully designed benefits package that supports your health, financial wellness, growth, and overall well-being—so you can thrive in work and life. • 3 weeks of front-loaded PTO + 9 paid holidays, • Annual office closure (Dec 25–Jan 1), • Annual Impact Days for volunteering or professional development, • 401(k) with employer match, • Referral bonus potential, • Annual Flexible Benefit Reimbursement, • Medical, dental, and vision insurance — with EAP and additional wellness programs, • Voluntary benefits, HSA, DCA, FSA (based on plan), transit & parking options Compensation Determination: The pay range listed reflects the minimum and maximum base salary for this role, determined through an internal compensation assessment that considers similar labor markets to our practice across the United States. Actual compensation is influenced by compensable factors such as location, role responsibilities, required skills, relevant experience, qualifications, role level, and applicable credentials. It is uncommon for an individual to be hired at or near the top of the posted range. In addition to base salary, total compensation may include bonuses, commissions, or other incentives depending on the role. Location Eligibility: At this time, we are only able to consider applicants whose primary residence is in one of the following states within the United States of America: Connecticut, Florida, Massachusetts, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Texas. Because this is not a solely on-site role, your primary residence must remain in one of these approved states. Please note that residing outside of these states—even temporarily—may result in employment eligibility issues, tax implications, or other regulatory concerns. If your location changes or you're based elsewhere, we encourage you to stay connected for future openings. Equal Opportunity Employer: Rivia Mind is an Equal Employment Opportunity Employer. It is the policy of Rivia Mind to provide equal employment opportunities without regard to race, color, ancestry, religion, sex, gender identity or expression, pregnancy, age, ethnic or national origin, immigration or citizenship status, hair, weight, height, disability, marital status, veteran status, sexual orientation, genetic information/GINA, political affiliation or activity, or any other protected characteristic under applicable law. It is also the policy of Rivia Mind that qualified individuals with disabilities receive equal opportunity regarding job application procedures, hiring, and all aspects of the employment process. Rivia Mind is committed to the full inclusion of all qualified individuals. Consistent with the Americans with Disabilities Act (ADA) and applicable state and local laws, it is the policy of Rivia Mind to provide reasonable accommodations when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, pre-employment testing, to otherwise participate in the selection process, to perform the essential job functions, and/or to receive other benefits and privileges of employment, please contact us directly. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Applicants must be authorized to work in the United States. We are unable to sponsor work visas at this time. This is in accordance with applicable federal, state, and local laws, including Title VII of the Civil Rights Act, the Americans with Disabilities Act, the Age Discrimination in Employment Act, and the Genetic Information Nondiscrimination Act. If you need assistance or accommodation due to a disability during the application process, please contact our Talent Acquisition team at .

Job Description Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS) , and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $67,813 - $89,004 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: • Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential CMS audits and medical record retrieval efforts., • Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, as well as compliance with Risk adjustment production standards., • Participate in CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits., • Develop relationships with key individuals to foster an increased understanding of the Risk Adjustment process., • Support in the identification of document improvement opportunities for provider education in both MA and ACA line of business., • Identify process improvements to enhance medical encounter review efficiency., • Compliance with all applicable laws and regulations, • Bachelor's degree in a relevant field of study or commensurate work experience., • Certified professional coder (CPC), • Certified Risk Adjustment Coder (CRC) or similar certification At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team () to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

Job DescriptionAbout Us We are a fast-growing, innovative medical billing company committed to transforming the healthcare revenue cycle through technology, transparency, and top-tier customer service. Our team is passionate about simplifying the complexities of medical billing so healthcare providers can focus on what matters most—patient 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) Bachelor’s degree in Healthcare Administration, Business, or related field (Master’s 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 We are seeking a Claims Examiner to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: The Claims Examiner plays a critical role in the health care and social assistance industry by thoroughly reviewing and evaluating insurance claims to ensure accuracy, compliance, and appropriateness of payments. This position involves analyzing medical documentation, policy details, and billing information to determine the validity of claims and identify any discrepancies or potential fraud. The Examiner collaborates with healthcare providers, insurance agents, and internal teams to resolve claim issues and facilitate timely reimbursement. By maintaining up-to-date knowledge of healthcare regulations and insurance policies, the Examiner helps protect the organization from financial loss and supports the delivery of fair and efficient claims processing. Ultimately, this role contributes to the integrity and sustainability of the healthcare insurance system by ensuring claims are processed accurately and ethically. Minimum Qualifications: • High school diploma or GED, • Minimum of 2 years experience in claims examination, medical billing, or healthcare insurance processing., • Strong understanding of medical terminology, insurance policies, and healthcare billing codes (e.g., ICD-10, CPT)., • Associate’s degree or Bachelor's degree in health administration, healthcare management, or a related discipline., • Certification such as Certified Professional Coder (CPC) or Certified Claims Professional (CCP)., • Experience working within the health care and social assistance industry or with government healthcare programs., • Review and analyze health insurance claims for completeness, accuracy, and compliance with policy terms and regulatory requirements., • Verify medical codes, treatment documentation, and billing information to ensure services are properly covered and billed., • Investigate and resolve claim discrepancies by communicating with providers, members, and internal departments., • Identify and escalate potential fraudulent claims or billing errors to compliance or legal teams., • Maintain detailed records of claim evaluations and stay current with healthcare laws and industry standards to support audits and improve processing workflows.

Job DescriptionBenefits: • 401(k), • Company parties, • Dental insurance, • Health insurance Requirements and/or Responsibilities as a Charge Poster Specialist: Enthusiastic, success-driven business professional with exceptional organizational skills and the ability to develop and maintain business relationships with physician offices Able to exercise independent judgment and take action on it. Ability to interpret diagnostic and procedural phrases used by healthcare providers into coded form by locating such codes utilizing the coding manuals or software. In-depth knowledge of CPT, ICD-10, and HCPCS coding.

Job Description Hi, we're Oscar. We're hiring a Senior Analyst, Special Investigations Unit Clinical Investigator to join our SIU. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The Senior Analyst, SIU Clinical Investigator detects and audits aberrant billing patterns within claims and clinical documentation, using forensic clinical expertise to protect the integrity of healthcare spend. You will perform comprehensive pre-payment and post-payment reviews of medical records to ensure billed services align with established clinical guidelines, CMS regulations, and contractual obligations. Beyond individual claim accuracy, you will analyze provider behavior to identify schemes such as record cloning, upcoding, and unbundling that may be invisible to automated systems. As a clinical subject matter expert, you will act to translate audit findings into relevant education. You will facilitate professional discussions with colleagues and providers to correct billing behaviors and promote long-term compliance. You will partner with clinical and non-clinical investigators to build evidentiary files for potential recovery, legal action, or referrals to appropriate outside agencies. You will report into the Investigations Manager, SIU. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $64,832 - $85,092 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: • Identify and conduct clinical audits into suspected FWA with high autonomy, • Document findings, to include formal reports, graphs, audit logs, and other supporting documentation., • Metrics to align with unit goals., • Participate in the development and presentation of FWA-related education for Oscar teams, • Compliance with all applicable laws and regulations, • Active, unrestricted Registered Nurse (RN) license, • 3+ years of direct patient care clinical experience. Case Management experience a bonus., • 2+ years of experience in Medical Review, Utilization Management, or Clinical Documentation Improvement, featuring demonstrated expertise in the forensic application of complex clinical guidelines (e.g., MCG, CMS, and specialty-specific professional organizations) to multifaceted medical records., • Bachelor of Science in Nursing (BSN), Associate Degree in Nursing (ADN) with a Bachelor of Science in Health Administration, Clinical Informatics, or a related Medical Science field, or Associate Degree in Nursing (ADN) with 5+ years of specialized clinical audit experience., • Experience working in health insurance with competency regarding claims processing, billing, reimbursement, or provider contracting., • Experience delivering feedback or education to providers/physicians in a professional, non-confrontational, and persuasive manner., • Identifying trends, for example "cloned documentation" or change in billing habits of a provider., • Experience with HIPAA, data privacy, and/or data security processes At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team () to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

Find your next job here! Will train the right candidate! Average salaries from $20 - $37/Hr, full time and part time shifts available now! Hiring for: Medical Coder.

Proficiency in medical terminology, coding systems and medical billing procedures. Under the direction of the Business Office Director, the Medical Insurance Biller II is responsible for the timely and accuracy submission of hospital medical claims. Certified Medical Coder preferred.

Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care certifications. Experience demonstrating knowledge of ICD-10, Curren

Job DescriptionJob Description: Candidate must have minimum of 1 year experience as Medical Charge Poster (coder); Need to be proficient with ICD-10 and coding guidelines. Good benefits; paid vacation, paid holidays, medical insurance, 401K with employer contribution, flexible morning start time. CPC preferred. Professionally rewarding environment due to exposure to several PM/EMR systems (eCW, Kareo, Care Cloud, Meditouch, Intergy, and more) and various specialties. Requirements and/or Responsibilities as a Charge Poster Specialist: · Enthusiastic, success-driven business professional with exceptional organizational skills and the ability to develop and maintain business relationships with physician offices · Able to exercise independent judgment and take action on it. · Ability to interpret diagnostic and procedural phrases used by healthcare providers into coded form by locating such codes utilizing the coding manuals or software. · In-depth knowledge of CPT, ICD-10, and HCPCS coding.