Medical coding jobs in Miami, Florida - Page 2Create job alerts

Job Description SUMMARY: Full 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 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 DescriptionTTF is recruiting for DRG Auditors who have worked in Inpatient Revenue Integrity to work remotely for a company based out of the Southwest. We are seeking individuals with experience in CDI with either CCDS, CCS, or RHIT certifications. This is a full-time, direct-hire role, where you can work anywhere in the United States. The starting salary is $46-$52/hour and comes with full benefits. Qualified candidates must have: • CCDS, CCS, RHIT certifications, • Five years acute care coding experience TTF is a healthcare search and staffing company that partners with hospitals, physician groups, TPA's, medical management companies, pharmaceutical and pharmacy benefit plan organizations, surgery centers, DME/home health, consulting companies, and all other healthcare fields. The TTF Coding and HIM Division partners with healthcare organizations nationwide to match top talent in the Coding and HIM industry with organizations that want to hire the best talent. We place Remote Coders, Coding Managers, Coding Directors, and ICD10 Certified Trainers on a contract and direct-hire basis. Our goal is to offer outstanding opportunities to talented coders and coding professionals with RHIT, RHIA, CCS, CPC, and other coding certifications. #IND1

Job Description POSITION SUMMARY This position will investigate allegations of potential healthcare fraud and abuse activity. Assist in planning, organizing, and executing claims investigations or audits that identify, evaluate and measure potential healthcare fraud and abuse ESSENTIAL DUTIES & RESPONSIBILITIES • Conduct investigations of potential waste, abuse, and fraud, • Document activity on each case and refer issues to the appropriate party., • Perform data mining and analysis to detect aberrancies and outliers in claims., • Develop new queries and reports to detect potential waste, abuse, and fraud., • Provide case updates on progress of investigations and coordinate with Health Plans on recommendations and further actions and/or resolutions., • Assist with complex allegations of healthcare fraud., • Prepare summary and/or detailed reports on investigative findings for referral to Federal and State agencies., • Complete various special projects and audits To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. • Bachelor’s degree in business, Criminal Justice, Healthcare, related field or equivalent experience., • 1+ years of experience in medical claims investigation, auditing, and analysis within a Managed Care Environment, with a focus on detecting potential fraud, waste and abuse., • Knowledge of medical coding and terminology., • Advanced Proficiency in Microsoft Excel, Data Analysis and Fraud Detection. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. • The noise level in the work environment is usually moderate., • Fast-paced office environment., • Highly regulated environment., • Time frames to handle issues are in accordance with CMS and NCQA as well as internal time frames. PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The employee must be able to frequently lift up to 10 pounds and occasionally lift and/or move up to 25 pounds. While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to stand and walk. The employee is occasionally required to use hands to finger, handle, or feel; reach with hands and arms; climb or balance and stoop, kneel, crouch, or crawl. Specific vision abilities required for this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. PERFORMANCE MEASUREMENTS • 3-5 Monthly evaluations, • Compliance with Department Call Metrics/ Company Regulations, • Attendance/Punctuality, • Safety and Security Solis Health Plans 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. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Job Description Clinical Data Abstractor - Oncology - Part Time United States Join Our Team as a Clinical Data Abstractor at Carta Healthcare! Company: Carta Healthcare Inc. Position: Flexible Schedule Clinical Data Abstractor Location: 100% Remote (Non-Benefit Position) Are you experienced in clinical data abstraction? Carta Healthcare Inc. is seeking talented individuals to join our growing team as Part-Time Clinical Data Abstractors! Position Overview: Join our team at Carta Healthcare, where we offer opportunities for experienced clinical data abstractors. We offer a flexible work schedule that allows for a balanced work-life experience. About Us: At Carta Healthcare, we are revolutionizing the way healthcare data is managed and used with innovative software solutions. Position Overview: As a Part-Time Clinical Data Abstractor, you will be responsible for abstracting and coding patient information from medical records to meet the requirements of various target registries. What We're Looking For: • Current Oncology Data Specialist (ODS) certification, • Minimum of 3 years of recent clinical data abstraction experience in a hospital setting (or equivalent), • Proficiency with EMR systems and multiple cancer registry software applications, • Familiarity with reporting requirements for ACS CoC, NPCR and SEER, • Maintain a 98% or higher IRR score, • Previous remote work experience preferred, • Available for a minimum of 60 abstraction hours monthlyWhy Join Us?, • Flexible part-time hours non-benefit -W2 employee, • Hourly rate $34-$38, • 100% remote, • Laptop provided for Carta abstraction In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification form upon hire. All applicants are required to reside within the continental United States. Carta Healthcare is dedicated to building a diverse and inclusive company because we serve health systems across the country; we've seen how our product and impact are strengthened the more we reflect that diversity. In addition, we have found and strongly believe that diverse teams are higher-performing, and we embrace the varied perspectives that our team members share with each other. As such, we are an Equal Opportunity Employer. #LI-Remote #BI-Remote

Job Description The Billing Specialist will be responsible for accurately preparing, submitting, and tracking claims and encounters to HMO health plans in compliance with industry regulations and plan requirements. This role plays a critical part in ensuring timely reimbursements and maintaining the financial health of the organization. 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 (Associate’s or Bachelor’s 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 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 DescriptionMedical Coder – Wound Care (Long-Term Care) About Us Pinnacle Wound Management is a physician-led wound care provider dedicated to improving healing outcomes for patients in skilled nursing and long-term care facilities. We partner with facilities to deliver advanced wound care at the bedside, supported by thorough documentation, EMR integration, and compliance with payer guidelines. We are seeking a Medical Coder with wound care experience to join our team. This role is critical in ensuring timely, accurate coding and billing for patient encounters and cellular tissue product usage across multiple facilities. Key Responsibilities * Accurately review and code wound care services performed in long-term care and post-acute settings, ensuring compliance with ICD-10, CPT, HCPCS, and payer requirements * Code independently without reliance on a provider superbill, using clinical notes and documentation as the source of truth * Release daily coding batches to support timely revenue cycle processing * Code red-label (cellular tissue) products and ensure proper documentation of lot numbers and graft application details * Assist and work closely with the billing team to correct coding errors and resolve claim rejections/denials * Generate detailed coding reports and batch logs for submission to the Director of Operations * Collaborate with the billing and operations teams to reconcile coding discrepancies and ensure compliance * Monitor payer and CMS updates impacting wound care coding, documentation, and compliance * Maintain coding accuracy, productivity standards, and adherence to compliance regulations Qualifications * Certification strongly preferred: CPC (Certified Professional Coder), CCS, or equivalent * Minimum 2 years of experience in medical coding; wound care or long-term care experience highly preferred * Strong knowledge of ICD-10, CPT, and HCPCS coding guidelines * Ability to code directly from clinical notes/documentation without superbill support * Experience coding cellular tissue/red-label products a plus * Proficient in generating coding reports, logs, and error correction documentation * Detail-oriented with excellent organizational skills and ability to manage coding batches daily * Comfortable working independently with minimal supervision What We Offer * Competitive compensation package * Opportunity to specialize in wound care and advanced procedures in the long-term care space * Supportive team environment focused on compliance and patient-centered outcomes

Job Description 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.