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Job Description Job Description A certified professional biller/coder (CPC) Salary 15-25 base on expertise and experience Responsibilities: · Overseeing the medical coding for all healthcare activities · Ensure that medical coding used is in compliance with all medical coding laws and regulations · Ensure that the coding used is for reimbursable expenses when necessary · Provide regular coding, Home Health coding, or hospital coding as appropriate · Communicating with patients regarding rejected claims or procedures · Interact with doctors, nurses, and office staff · Able to work during regular business hours and rarely work overtime or weekends as necessary · Responsible for entering charges in as accurate a manner as possible, which means coordinating with the doctor’s office to obtain any missing information (i.e., insurance cards, authorizations, op reports, etc.) Knowledge of correct CPT coding and ICD10 coding · CPR bills all types of insurance such as Medicare, Medicaid, HMOs, PPOs, Cigna, Aetna, Humana, Blue Cross Blue Shield etc. · Posting Payments o Post all payments to the patient’s computer record o Record deposit amounts in an Excel spreadsheet o Also includes following up on all denied claims, pended claims, returned mail, etc. o Involve writing letters to insurance companies for appeal or regarding disputed issues · Collections: Responsible for collecting all payments on the account to the best of your abilities. An aged Accounts Receivable is generated for doctor’s account on a monthly basis. Billing representatives are responsible for making sure all accounts aged over 40 days are extensively researched to prevent any further delay in payment. This includes calling insurance companies and patients, initiating payments agreements, etc. · Office Interfacing: Billing representative is required to interface with the doctor’s office in an organized and professional manner to obtain all information necessary and give guidance as needed regarding reimbursement issues. On a monthly basis (minimum) the billing representatives are often required to meet with the physician, as well as his/her staff, to resolve policy issues and discuss billing matters and collections issues. Communication with doctor’s office regarding current insurance contracts, and other change · Month End Reporting: Accounting summary reports are generated on a monthly basis using Excel. Reports need to balance other accounting records and need to be reviewed by billing representative for accuracy. Reporting of changes in the doctor’s charge patterns or income are to be discussed with management on a monthly basis. Competences: · Actual certification for medical coding · Expertise in a variety of insurance and medical coding regulations · Associate’s degree in health administration and RHIT certification · Preferred CPC or CCS-P · Excellent letter writing skills · Knowledge of o CPT and ICD10 coding o Medical terminology · Detail and critical thinking skills · Excellent communication skills · Excellent interpersonal skills · Strong knowledge in computer programs o Microsoft Office o E Clinical Works 11 version Be Prepared As Follows: · References: (Required) minimum of one (5) year experience in your field. · Employment Eligibility Documents (e.g. Permanent Resident Card, Passport – see list at: www.uscis.gov/i-9-central/acceptable-documents ) Company Descriptionhttps://www.denniscortesmd.com/index.htmlhttps://www.denniscortesmd.com/index.html

Job Description Job Description A certified professional biller/coder (CPC) Salary 15-25 base on expertise and experience Responsibilities: · Overseeing the medical coding for all healthcare activities · Ensure that medical coding used is in compliance with all medical coding laws and regulations · Ensure that the coding used is for reimbursable expenses when necessary · Provide regular coding, Home Health coding, or hospital coding as appropriate · Communicating with patients regarding rejected claims or procedures · Interact with doctors, nurses, and office staff · Able to work during regular business hours and rarely work overtime or weekends as necessary · Responsible for entering charges in as accurate a manner as possible, which means coordinating with the doctor’s office to obtain any missing information (i.e., insurance cards, authorizations, op reports, etc.) Knowledge of correct CPT coding and ICD10 coding · CPR bills all types of insurance such as Medicare, Medicaid, HMOs, PPOs, Cigna, Aetna, Humana, Blue Cross Blue Shield etc. · Posting Payments o Post all payments to the patient’s computer record o Record deposit amounts in an Excel spreadsheet o Also includes following up on all denied claims, pended claims, returned mail, etc. o Involve writing letters to insurance companies for appeal or regarding disputed issues · Collections: Responsible for collecting all payments on the account to the best of your abilities. An aged Accounts Receivable is generated for doctor’s account on a monthly basis. Billing representatives are responsible for making sure all accounts aged over 40 days are extensively researched to prevent any further delay in payment. This includes calling insurance companies and patients, initiating payments agreements, etc. · Office Interfacing: Billing representative is required to interface with the doctor’s office in an organized and professional manner to obtain all information necessary and give guidance as needed regarding reimbursement issues. On a monthly basis (minimum) the billing representatives are often required to meet with the physician, as well as his/her staff, to resolve policy issues and discuss billing matters and collections issues. Communication with doctor’s office regarding current insurance contracts, and other change · Month End Reporting: Accounting summary reports are generated on a monthly basis using Excel. Reports need to balance other accounting records and need to be reviewed by billing representative for accuracy. Reporting of changes in the doctor’s charge patterns or income are to be discussed with management on a monthly basis. Competences: · Actual certification for medical coding · Expertise in a variety of insurance and medical coding regulations · Associate’s degree in health administration and RHIT certification · Preferred CPC or CCS-P · Excellent letter writing skills · Knowledge of o CPT and ICD10 coding o Medical terminology · Detail and critical thinking skills · Excellent communication skills · Excellent interpersonal skills · Strong knowledge in computer programs o Microsoft Office o E Clinical Works 11 version Be Prepared As Follows: · References: (Required) minimum of one (5) year experience in your field. · Employment Eligibility Documents (e.g. Permanent Resident Card, Passport – see list at: www.uscis.gov/i-9-central/acceptable-documents ) Company Descriptionhttps://www.denniscortesmd.com/index.htmlhttps://www.denniscortesmd.com/index.html

Job DescriptionBenefits: • 401(k), • Dental insurance, • Health insurance, • Paid time off, • Vision insurance We are seeking a detail-oriented and knowledgeable Medical Biller to join our company, and liaise with the outside billing department. The ideal candidate will be responsible for managing billing processes, ensuring accurate coding and submission of claims and payment follow-up. This role is crucial in facilitating the financial operations of our centers while ensuring compliance with healthcare regulations. Requirements/Responsibilities: 5 years of Surgical Center (ASC) billing experience is absolutely required MUST be available to work on site Strong knowledge of outpatient surgical procedures in a multi-specialty ASC preferred Experience with Automobile Insurance, Major Medical/Commercial Insurance and Lien Cases EMR systems: 3 years (Required) Medical coding: 3 years Proficient in English Responsibilities • Review unbilled cases and identify missed revenue opportunities., • Assist in reducing AR days related to coding or billing errors or lack of follow-up., • Monitor billing accuracy and reimbursement reconciliation., • Contact attorney offices for lien case payments after reductions been done, • Collections (Monitoring insurance claims by running appropriate reports and communicate with the appropriate people/departments resolve claims that are not paid in a timely manner)., • Handle escalated billing-related inquiries., • Follow up on claims using various systems, such as practice management, EHR, and clearinghouse., • Prepare monthly audit reports with findings and corrective recommendations., • Audit current procedures to monitor and improve the efficiency of billing and collections operations, • Must work well with outside billing services or third-party billers Required Skills • Proficiency in medical coding (ICD-10, ICD-9) and familiarity with DRG systems., • Excellent attention to detail with strong organizational skills., • Ability to communicate effectively in English, • Problem-solving skills to address billing issues efficiently and effectively.

\n JOB DESCRIPTION\n\n\n Provides investigative support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates and resolves instances of health care fraud and abuse investigations of medical providers using informational tips from member benefits and medical records following review of post-payment claims. \n\n\n Essential Job Duties\n\n\n • Independently re-evaluates medical claims and associated records by applying knowledge of advanced coding, all relevant and applicable Federal and State regulatory requirements, and Molina policies.\n, • Reviews post-pay claims against corresponding medical records to determine accuracy of claims payments. \n, • Manages documents and prioritizes caseloads to ensure timely turnaround. \n, • Ensures adherence to applicable state/federal/internal policies, Current Procedural Terminology (CPT) guidelines and provider contract requirements.\n, • Devises clinical summary post-review.\n, • Communicates and participates in meetings related to cases.\n, • Completes medical review to facilitate referral to law enforcement or payment recovery. \n, • Supports investigation work as necessary and required by the regulatory agency.\n\n\n Job Requirements\n\n\n, • At least 2 years CPT coding experience in a surgical, hospital and/or clinic setting, or equivalent combination of relevant education and experience.\n, • Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Professional Medical Auditor (CPMA), or American Academy of Professional Coders (AAPC) certified\n, • Critical-thinking, problem-solving and analytical skills. \n, • Ability to prioritize and manage multiple tasks.\n, • Ability to work in a team setting.\n, • Strong verbal/written communication skills, and presentation skills.\n, • Microsoft Office suite (including Excel), and applicable software program(s) proficiency.\n, • In some states, 5 years of experience working in a fraud, waste and abuse (FWA)/special investigations unit (SIU)/fraud investigations role may be required (dependent on state/contractual requirements). \n, • Knowledge of investigative and law enforcement procedures with emphasis on fraud investigations.\n, • Knowledge of Managed Care and the Medicaid, Medicare, and Marketplace programs.\n, • Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems.\n, • Ability to research and interpret regulatory requirements.\n\n\n Preferred Qualifications\n\n\n, • Certified Professional Compliance Officer (CPCO). \n, • Certified Fraud Examiner (CFE) and/or Accredited Health Care Fraud Investigator (AHFI). \n, • Experience working in group health insurance, particularly within claims processing or operations. \n, • Working knowledge of local, state and federal laws and regulations pertaining to health insurance, investigations and legal processes (commercial insurance, Medicare, Medicare Advantage, Medicare Part D, Medicaid, Tricare, Pharmacy, etc.). \n, • Experience with claims processing systems. \n, • Ability to use Microsoft Excel/Access platforms working with large quantities of data. \n, • Ability to answer questions, identify trends and patterns, and present findings. \n\n\n #PJCorp\n\n\n #LI-AC1\n\n\n To all current Molina employees. If you are interested in applying for this position, please apply through the Internal Job Board. \n \n \n Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V\n Pay Range: $21.82 - $42.55 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

As a Medical Assistant, you'll have the support you need to reach your career goals. From best-in-class learning and development programs, a commitment to promoting from within, and a competitive salary and benefits package, you'll have opportunities to not only expand your career, but your life. Commitment to continuous development and promoting from within means your career path is limitless. Medical Assistants who join a DHG practice work with licensed doctors, supporting the clinical needs of your practice's patients and doctors. Not only can you maximize your career potential, but you can make a real difference in the lives of our patients. Pembroke Pines Office: 10081 Pines Blvd, Suite D, Pembroke Pines, FL 33024 About DHG Fast paced multi-specialty medical centers spanning throughout Dade and Broward County Florida • Ekg, • Phlebotomy, • Taking vitals, • Assisting physicians in room with patients, • Knowledge of HEDIS measures (2-3 years experience), • Returning patient phone calls, • Making appointments, • Understanding of referrals processes, • Calling in prescriptions, • Insurance verification/Internal verification systems and multiple payer websites including Availity, • Must be able to work independently, • Have experience with Electronic Medical Records (EMR), • Prior experience or knowledge of muti-specialized practices (Internal Medicine and Cardiology), • Strong organizational skills, • Knowledge of Microsoft Office and proficient in general computer processes, • Experience as a coder and transcriber (Preferred) + 2-3 Years of experience required + High School Diploma or equivalent

Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: Responsible for auditing coded inpatient or outpatient medical records applying ICD-10 CM/PCS and/or CPT-4. Reviews Ambulatory Payment Classification (APC), Medicare Severity Diagnosis Related Groups (MSDRG) and All Patients Refined Diagnosis Related Groups (APRDRG) assignment and queries following official coding guidelines and regulatory requirements. Provides training and education based on audit results and any regulatory changes that effect Federal, State and American Health Information Management Association (AHIMA) guidelines. Responsibilities: Maintains thorough knowledge of ICD-10CM/PCS, and CPT coding principles and guidelines; possesses substantial knowledge of MSDRG, APRDRG, APC, and Enhanced Ambulatory Patient Groups (EAPG) classification systems and query guidelines for compliant provider documentation.Conducts and reports on electronic medical record audits to verify ICD-10CM/PCS, CPT and APC, MSDRG, and APRDRG coding and grouping accuracy. Serves as an expert resource for all coding staff. Assists with developing specific departmental goals, standards, and objectives which directly support the strategic plan and vision of the organization.Works closely with inpatient and outpatient coding managers to analyze and resolve claim denials that are rejected by edits from the Revenue Cycle Department. Reviews and responds to all external coding denial audits using ICD-10CM/PCS, CPT and APC, MSDRG, and APRDRG audits.Performs all other duties as assigned.Coordinates, develops, and implements coder intern education and training. Training will align with AHIMA standards of ethical coding and official coding guidelines. Provides feedback based on audit results and tracks coder intern progression throughout the program.Maintains strict adherence to patient confidentiality according to MHS standards and regulatory requirements.Holds educational sessions for coding specialists, documentation specialists, and physicians. Acts as a liaison for electronic physician query process. Utilizes coding audit results to tailor education to increase coding accuracy. Assists the coding staff to format compliant queries and assesses for compliance with AHIMA query standards. Reports results of coding and query compliance audits to management. Competencies: ACCOUNTABILITY, ACCURACY, CUSTOMER SERVICE, EFFECTIVE COMMUNICATION, HUMAN ANATOMY, MEDICAL CODING, MEDICAL TERMINOLOGY (3), RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR Education and Certification Requirements: Accredited Program: Health Information Management (Required)Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA), Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA), Registered Health Information Technician (RHIT) - State of Florida (FL) Additional Job Information: Complexity of Work: Requires critical thinking, decisive judgment, effective written and verbal communication skills. Demonstrates effective time management skills, professional responsibility and fosters teamwork. Able to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Ability to accurately assign and sequence ICD-10-CM/PCS and CPT codes to principal diagnosis and procedures, complications and co-morbid conditions to complex inpatient or outpatient encounters such as observation, outpatient surgery and interventional radiology. Provides guidance to other departmental staff in identifying and resolving coding issues or errors. Proficient in basic computer skills including Microsoft Office applications and utilizing a computerized encoder and electronic medical record systems.Required Work Experience: For inpatient coding auditor, three (3) years of inpatient coding experience. For outpatient coding auditor, three (3) years of outpatient coding experience.Other Information: For Hospital Coding: Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS).For Physician Coding: CPC Certified Professional Coder, HCC - Hierarchical Condition Category Coder, CRC Certified Risk Adjustment Coder, or CPMA Certified Professional Medical Auditor.Additional Credential Info: Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS). For Physician Coding: CPC Certified Professional Coder, HCC - Hierarchical Condition Category Coder, CRC Certified Risk Adjustment Coder, or CPMA Certified Professional Medical Auditor. Working Conditions and Physical Requirements: • Bending and Stooping = 40%, • Climbing = 0%, • Keyboard Entry = 60%, • Kneeling = 40%, • Lifting/Carrying Patients 35 Pounds or Greater = 0%, • Lifting or Carrying 0 - 25 lbs Non-Patient = 40%, • Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 0%, • Lifting or Carrying > 75 lbs Non-Patient = 0%, • Pushing or Pulling 0 - 25 lbs Non-Patient = 40%, • Pushing or Pulling 26 - 75 lbs Non-Patient = 0%, • Pushing or Pulling > 75 lbs Non-Patient = 0%, • Reaching = 40%, • Repetitive Movement Foot/Leg = 0%, • Repetitive Movement Hand/Arm = 60%, • Running = 0%, • Sitting = 60%, • Squatting = 20%, • Standing = 60%, • Walking = 60%, • Audible Speech = 60%, • Hearing Acuity = 60%, • Smelling Acuity = 0%, • Taste Discrimination = 0%, • Depth Perception = 60%, • Distinguish Color = 60%, • Seeing - Far = 60%, • Seeing - Near = 60%, • Bio hazardous Waste = 0%, • Biological Hazards - Respiratory = 0%, • Biological Hazards - Skin or Ingestion = 0%, • Blood and/or Bodily Fluids = 0%, • Communicable Diseases and/or Pathogens = 0%, • Asbestos = 0%, • Cytotoxic Chemicals = 0%, • Dust = 0%, • Gas/Vapors/Fumes = 0%, • Hazardous Chemicals = 0%, • Hazardous Medication = 0%, • Latex = 0%, • Computer Monitor = 60%, • Domestic Animals = 0%, • Extreme Heat/Cold = 0%, • Fire Risk = 0%, • Hazardous Noise = 0%, • Heating Devices = 0%, • Hypoxia = 0%, • Laser/High Intensity Lights = 0%, • Magnetic Fields = 0%, • Moving Mechanical Parts = 0%, • Needles/Sharp Objects = 0%, • Potential Electric Shock = 60%, • Potential for Physical Assault = 0%, • Radiation = 0%, • Sudden Decompression During Flights = 0%, • Unprotected Heights = 0%, • Wet or Slippery Surfaces = 0% Shift: Primarily for office workers - not eligible for shift differential Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification. Wages shown on independent job boards reflect market averages, not specific to any employer. We encourage candidates to talk to their Memorial Healthcare System recruiter to discuss actual pay rates, during the hiring process. Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity. Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, gender identity or expression, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law. We are proud to offer Veterans Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program. Employment is subject to post offer, pre-placement assessment, including drug testing. If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, 8am-5pm) or email _