Trabajos medical coder en Miami, FLCrear alertas

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 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 SUMMARY: Part Time Billing Specialist performs diagnosis and procedural coding to individual patient health information for data retrieval, analysis, and claims processing. DUTIES AND RESPONSIBILITIES: • Reviews the patient ‘s medical record for accurate and complete documentation prior to coding., • Works closely with the physician coordinator regarding discrepancies found in patient’s record prior to claim submission, • Codes for assigned physicians, locations, and/or departments from review of medical record documentation., • Applies knowledge of current coding and billing requirements to assure claims are submitted correctly, • Brings identified concerns and trends to the manager/team lead for resolution., • Reviews coding and billing worklists and resolves claim rejections., • Enters patient demographic information and verifies patient insurance coverage QUALIFICATIONS: • Working knowledge of CPT and ICD10 coding, • Medical coding certification preferred but not required, • Minimum 2 years’ experience in medical billing and coding, • Excellent attention to detail and follow up, • Knowledgeable of payer rules and requirements for both coding and eligibility checking, • High school diploma or general education degree, • Computer skills required: Efficient data entry skills for both speed and accuracy 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 Job Title: Medical Billing & Coding Specialist Company: Pinnacle Wound Management Employment Type: Full-Time Location: This is an on-site location in Miami, FL 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 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.