Medical coder jobs in Florida - 385 jobs

Location Requirement: Candidates must reside in one of the following states- Florida, Alabama, or Georgia. If offered the position, will be required to come onsite in Pensacola, FL for orientation The Coder III reviews inpatient records and accurately assigns appropriate ICD-10-CM/PCS codes according to established guidelines with a 97% accuracy rate, while maintaining coding standards for productivity. This position must preserve confidentiality of health information. This position must be able to use tact and diplomacy when communicating with employees, physicians, administration, and public, under complex or emotional situations. RESPONSIBILITIES Reviews patient records and accurately assigns appropriate ICD-10-CM/PCS codes according to established guidelines. Meets Productivity Standard for Inpatient Coding: 17 charts/day. Understands appropriate assignment of MS-DRG, POA, and discharge disposition. Assists with all levels of coding including inpatient, outpatient, and psych. Works as a team member to achieve goals for the department. Assists with data integrity audits, and corrects errors as needed (invalid codes, discharge codes, etc.). Monitors backlog of un-coded records on a daily basis, reports to Manager, and adjusts work schedule accordingly. Assists in identification of potential identity errors. Ensures Coding Clinics are reviewed and applied appropriately. Maintains current knowledge/certification QUALIFICATIONS Minimum Work Experience 2 years Coding experience in a hospital setting with inpatient/MS-DRG coding Required 2 years Experience in regulatory issues related to Medicare and other third party payers as is relates to hospital coding and billing Required Licenses and Certifications Graduation from an accredited coding program Upon Hire Required Registered Health Information Administrator (RHIA_AHIMA) Upon Hire Required or Registered Health Information Technician (RHIT_AHIMA) Upon Hire Required or Certified Coding Specialist (CCS_AHIMA) Upon Hire Required or Certified Coding Associate (CCA_AHIMA) Upon Hire Required or ABOUT US Baptist Health Care is a not-for-profit health care system committed to improving the quality of life for people and communities in northwest Florida and south Alabama. The organization includesthree hospitals, four medical parks,Andrews Institute for Orthopaedic & Sports Medicine, and an extensive primary and specialty care provider network. With more than 4,000 team members, Baptist Health Care is one of the largest non-governmental employers in northwest Florida. Baptist Health Care, Inc. is an Equal Opportunity Employer. BHC maintains and enforces a policy that prohibits discrimination against any workforce members or applicants for employment because of sex, race, age, color, disability, marital status, national origin, religion, genetic information, or other category protected by federal, state or local law.

Job Title: Certified Medical Coder (AAPC) - On-Site, Downtown Orlando Are you a skilled and detail-oriented Certified Medical Coder seeking an exciting opportunity to join Quest National Services, a thriving medical billing company? We are looking for a dedicated individual to join our dynamic team at our Downtown Orlando office. If you have a passion for accuracy, teamwork, and growth opportunities, we want to hear from you! Job Description Utilize your expertise as a Certified Medical Coder to accurately assign appropriate medical codes to diagnoses, procedures, and services, ensuring compliance with all relevant coding guidelines and regulations. Review medical documentation and superbills to extract essential information required for proper coding. Work collaboratively with medical providers and billing specialists at Quest National Services to clarify coding questions, resolve discrepancies, and optimize claim accuracy. Stay updated with the latest coding guidelines, industry changes, and regulations to maintain the highest level of coding proficiency. Participate actively in team meetings at Quest National Services, offering insights and suggestions for process improvement and overall operational excellence. Embrace our team-oriented environment at Quest National Services, contributing positively to the office culture and fostering a supportive atmosphere. Qualifications AAPC certification as a Certified Professional Coder (CPC), Certified Professional Coder - Apprentice (CPC-A), or equivalent. Proven experience in medical coding and billing, with expertise in various healthcare specialties, including neurology, OB/GYN, urgent care, urology, podiatry, and nephrology. Solid understanding of healthcare EMR solutions like Kareo "Tebra," AdvancedMD, eClinicalWorks, Athena, and NextGen. Excellent knowledge of ICD-10, CPT, HCPCS Level II, and other relevant coding systems. Strong attention to detail and accuracy, with a commitment to delivering error-free coding results. Effective communication skills, both written and verbal, to collaborate with medical providers and the internal team at Quest National Services effectively. Ability to thrive in a team-oriented environment at Quest National Services and contribute positively to a supportive and collaborative office culture. Proactive attitude and willingness to adapt to changing industry standards and best practices. Additional Information At Quest National Services, we value our team members and strive to provide excellent benefits to ensure their well-being and job satisfaction. As a full-time Certified Medical Coder, you'll enjoy the following perks: Competitive salary and performance-based incentives. Comprehensive medical, dental, and vision insurance plans to keep you and your family healthy. Optional AFLAC coverage for additional financial protection. Life insurance coverage for peace of mind. Employer-matched 401k plan to help you plan for the future. Opportunities for professional growth and career advancement in our promote-from-within environment. Join our close-knit team at Quest National Services, where your contributions are valued, and your skills are appreciated. We're excited to welcome a talented Certified Medical Coder who shares our passion for excellence and teamwork. To apply, please submit your resume and a cover letter detailing your relevant experience and why you'd be a great fit for our team at Quest National Services. We look forward to meeting you and discussing the potential of a mutually rewarding partnership. Quest National Services is an equal opportunity employer and encourages candidates from diverse backgrounds to apply.

The Hospital Inpatient Coder Senior will be expected to apply extensive knowledge in assigning ICD-10- CM diagnosis and ICD-10-PCS procedure codes and Medicare Severity-Diagnosis Related Groupers (MS-DRG) for complex hospital inpatient services. Applies clinical knowledge of disease processes, physiology, pharmacology, and surgical techniques by reviewing and interpreting all clinical documentation included in an inpatient record. Abstracts data in compliance with national and regional policies. Clarifies physician documentation by utilizing a facility-established query process. Demonstrates knowledge of sequencing diagnoses and procedure codes outlined in the ICD-10-CM/ICD-10-PCS Official Coding Guidelines, Uniform Hospital Discharge Data Set, CMS guidelines, and other resources as applicable. The Hospital Inpatient Coder Senior is expected to function as a subject matter expert on the team and assist less experience team members on following operational policies. It is responsible for training and onboarding new team members and participating in special projects assigned by the Mid Revenue Cycle leadership. Responsibilities: Coding Encounter Key Performance Indicator Requirements Constraints of systems Query Knowledge Team Support Special Projects Perform other duties as assigned Credentials and Experience: High School Diploma/GED Five (5) years in hospital inpatient coding experience with ICD-10 diagnosis, procedure codes and MSDRG. Any (one) of the following certifications is required: CCS) Certified Coding Specialist (CPC) Certified Professional Coder (COC) Certified Outpatient Coding (CCS-P) Certified Coding Specialist - Physician (RHIT) Registered Health Information Technician (RHIA) Registered Health Information Administrator (CIC) Certified Inpatient Coder *Any certification not listed above, but issued from a Governing Body listed below, will be considered by the business AHIMA ************* or AAPC ************ Minimum Skills/Specialized Training Required Thorough understanding of the effect of data quality on prospective payment, utilization, and reimbursement for multiple medical specialties. Experience in coding hospital inpatient electronic medical records. Excellent communication and interpersonal skills. Experience with automated patient care and coding systems. Competence with MS Office software Extensive knowledge of American Healthcare Association ("AHA") coding clinic guidelines, ICD-10-CM and ICD-10-PCS coding guidelines, Medicare Severity Diagnosis Related Groupers ("MSDRG"), All Patient Refined Diagnosis Related Groupers ("APRDRG"), Center for Medicare & Medicaid Services ("CMS") guidelines, National Center for Healthcare Statistics ("NCHS"). Preferred Experience Preferred qualifications include: • Experience with coding oncology-related services.

At PsynergyHealth, we are revolutionizing healthcare staffing through technology-driven solutions. Our innovative approach spans the United States and delivers tailored staffing support to optimize workforce management-from virtual safety observers to multi-state licensed physicians (and everything in between). We focus on right-sizing workforces, improving clinical outcomes, and enhancing operational efficiencies for healthcare organizations. Job Summary We are seeking a detail-oriented Certified Medical Coder with strong experience in Revenue Cycle Management (RCM) to work with our RCM partners and physician leaders to ensure accurate medical coding, timely claim submission, and optimized reimbursement. The ideal candidate will play a key role across the full revenue cycle, from charge capture through payment posting and denial resolution, while maintaining compliance with all regulatory and payer requirements. Key Responsibilities Medical Coding & Documentation Support clinical leadership in review of provider documentation for completeness, accuracy, and compliance Ensure coding complies with federal regulations, payer guidelines, and industry standards Revenue Cycle Management (RCM) Partnership Work with our partners to manage end-to-end RCM processes including charge entry, claims submission, and follow-ups Ensure that we submit clean claims to commercial, government, and managed care payers Work with our partners to review and resolve claim rejections and denials in a timely manner Work with our executive and clinical leadership to identify root causes of denials and implement corrective actions Post payments, adjustments, and reconcile accounts as needed Monitor accounts receivable (A/R) and follow up on unpaid or underpaid claims Compliance & Quality Stay current with coding updates, payer policies, and regulatory changes Participate in coding audits and quality assurance reviews Maintain HIPAA compliance and patient confidentiality at all times Reporting & Collaboration Generate and review RCM and coding reports to identify trends and improvement opportunities Collaborate with providers, billing staff, and administrative teams to improve revenue performance Support process improvements to increase accuracy, efficiency, and collections Qualifications Required Certified Medical Coder credential (CPC, CCS, or equivalent) Strong knowledge of ICD-10-CM, CPT, and HCPCS coding Experience with Revenue Cycle Management workflows Familiarity with EHR and medical billing systems Understanding of payer policies, denials management, and compliance standards Preferred 2+ years of experience in medical coding and RCM Experience with multiple specialties (e.g., primary care, specialty practices, hospital-based coding) Knowledge of Medicare, Medicaid, and commercial payer guidelines Skills & Competencies High attention to detail and accuracy Strong analytical and problem-solving skills Effective written and verbal communication Ability to manage multiple tasks and meet deadlines Proficiency in Microsoft Office and billing/coding software Compensation & Benefits We offer a competitive compensation package including health benefits, paid time off, retirement plan, and professional development opportunities. Salary is commensurate with experience and ranges from $65,000 to $75,000 per year.

*Candidate Must come onsite one week for training in Doral, FL Our Client is seeking an experienced ASC ProFee Coder to support a newly opened surgery center with a growing case volume and current backlog. This is a contract-to-hire opportunity with immediate interviews. Schedule Monday-Friday, 8:00 AM-5:00 PM EST No weekends Flexibility for appointments as needed Coding Scope ASC Professional Fee & Facility coding Specialties include: Anesthesiology General Surgery ENT Orthopedics Ophthalmology Gynecology Urgent Care Cardiology No GI coding required Systems Epic IMO EncoderPro Onsite Requirement One-time onsite visit in Doral, FL (5 days) for equipment pickup and orientation Client covers hotel and gas; candidate responsible for transportation Requirements Must reside in Florida Must have experience coding for an Ambulatory Surgical Center Ability to fully abstract from paper charts/books if needed AAPC or AHIMA certification required Strong communication skills for a remote environment Bilingual (Spanish/English) a plus, not required Role Details Contract-to-hire Pay rate: up to $32/hr Accuracy standard: 95-100% Client-provided equipment Start date: ASAP Interview: Virtual (Teams), interviewing immediately

Details Lakeland Regional Health is a leading medical center located in Central Florida. With a legacy spanning over a century, we have been dedicated to serving our community with excellence in healthcare. As the only Level 2 Trauma center for Polk, Highlands, and Hardee counties, and the second busiest Emergency Department in the US, we are committed to providing high-quality care to our diverse patient population. Our facility is licensed for 892 beds and handles over 200,000 emergency room visits annually, along with 49,000 inpatient admissions, 21,000 surgical cases, 4,000 births, and 101,000 outpatient visits. Lakeland Regional Health is currently seeking motivated individuals to join our team in various entry-level positions. Whether you're starting your career in healthcare or seeking new opportunities to make a difference, we have roles available across our primary and specialty clinics, urgent care centers, and upcoming standalone Emergency Department. With over 7,000 employees, Lakeland Regional Health offers a supportive work environment where you can thrive and grow professionally. Active - Benefit Eligible and Accrues Time Off Work Hours per Biweekly Pay Period: 80.00 Shift: Flexible Hours and/or Flexible Schedule Location: 210 South Florida Avenue Lakeland, FL Pay Rate: Min $19.37 Mid $24.22 Position Summary Under the direction of the Coding and Clinical Documentation Improvement Manager, reviews clinical documentation and diagnostic results, as appropriate, to extract data and apply appropriate ICD-10-CM, CPT, and/or HCPCS codes and modifiers to outpatient encounters for reimbursement and statistical purposes. Communicates with physicians, Physician Advisor or other hospital team members as needed to obtain optimal documentation to meet coding and compliance standards. Abstracts clinical and demographic information in ICD-10 CM, CPT, and HCPCS codes and modifiers into the computerized patient abstract. Participates in ongoing continued education to assure knowledge and compliance with annual changes. Position Responsibilities People At The Heart Of All That We Do Fosters an inclusive and engaged environment through teamwork and collaboration. Ensures patients and families have the best possible experiences across the continuum of care. Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created. Safety And Performance Improvement Behaves in a mindful manner focused on self, patient, visitor, and team safety. Demonstrates accountability and commitment to quality work. Participates actively in process improvement and adoption of standard work. Stewardship Demonstrates responsible use of LRH's resources including people, finances, equipment and facilities. Knows and adheres to organizational and department policies and procedures. Standard Work Duties: Coder II - Outpatient Assigns and sequences diagnostic and procedural codes using appropriate classification systems utilizing official coding guidelines. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding Abstracts and enters coded data as well as correct surgeon, anesthesiologist and procedure date. Assures appropriate information such as pathology and operative reports are present in the medical record prior to final coding for coding accuracy and appropriate APC assignment. Maintains appropriate level of coding and abstracting productivity and quality for outpatient diagnostic, Emergency Department, Family Health Center, ambulatory surgeries, observations, and other recurring services as per established minimum per hour requirement. Demonstrates competence in coding and abstracting requirements by maintaining less than 5% error rate for all ICD-10-CM and/or PCS, CPT, and HCPCS codes and modifiers. Continuously reviews changes in coding rules and regulations including in Coding Clinic, CPT Assistant, CMS, and other payer guidelines. Prioritizes coding functions as directed by the Manager, and organizes job functions and work assignments to efficiently complete tasks within the established time frames. Demonstrates knowledge of all equipment and systems/technology necessary to complete duties and responsibilities. Works collaboratively with the Discharge Not Final Billed (DNFB) clerks to prioritize workload daily. Reviews appropriate outpatient work queues daily to address coding reviews, edits and corrections. Reviews appropriate outpatient work queues daily to address coding reviews, edits and corrections. Competencies & Skills Essential: Computer Experience, especially with computerized encoder products and computer-assisted coding applications. Requires critical thinking skills, organizational skills, written and verbal communication skills, decisive judgment, and the ability to work with minimal supervision. Knowledge of anatomy and physiology, pharmacology, and medical terminology. Qualifications & Experience Essential: High School or Equivalent Nonessential: Associate Degree Essential: High School diploma with Associate Degree from accredited HIM program or certificate in coding from an accredited college. Other information: Certifications Essential: CCS Certifications Preferred: Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA). Experience Essential: 2-5 years acute care hospital outpatient coding experience within the past five years, or 5-7 year's experience in a multi-disciplinary clinic including surgeries and/or Emergency Department coding.

Founded in 1920, Akerman is recognized as one of the nation's premier law firms, with more than 700 lawyers across the United States. Akerman LLP is seeking a Records Coordinator for its Tampa office. Under the direction from department management, The Records Coordinator will be responsible for the handling of Active and Inactive physical and electronic records for their office in accordance with firm policies and procedures. This is a full-time, in office position. JOB DUTIES AND RESPONSIBILITIES: Processing of client/matter and firm administrative records in accordance with established policies and procedures. Maintain central file room in an organized manner; regularly audit file room to ensure active records are properly stored and/or scanned into iManage, Work with Attorneys and Legal Administrative Assistants, retrieving, delivering scanning records stored onsite and offsite. Assist with the closing of inactive matters and the disposition of expired records. Assist with the analysis and disposition of eligible expired physical and electronic administrative and client/matter records, confirming all firm and Outside Counsel Guidelines are reviewed and complied with. Provide weekly status reports to the Records Manager and Director. Assist department management with departing attorneys, collecting physical files for scanning, handling the transfer of both physical and electronic records in accordance with departmental procedures. Attend departmental and team meetings, participate in knowledge-building activities, training webinars. Assist with office cleanup projects, special scanning projects in other office locations, as needed. QUALIFICATIONS AND EXPERIENCE: Knowledge of Records Management principles, Records Retention principles & processes; Knowledge of AI Tools (Microsoft Co-Pilot, Vincent AI or other AI tools) Minimum of 3 years Legal Records Management experience or related college degree. Strong computer and database skills; data analysis (previous experience utilizing legal-specific Records Management software applications (iManage Records Manager, LegalKey, for example); Imaging/Scanning experience a plus. Strong verbal and written communications skills. Problem solver and a team player; Able to lift boxes weighing approximately 35-50 lbs. Available to travel to other office locations to work on special projects as needed. We offer an excellent compensation and benefits package. To apply, please submit your resume and salary requirements. EOE #LI-PT1 Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

The vibrant Village of Key Biscayne, incorporated on June 18, 1991, is in the center 1.25 square miles of a four-mile-long, two-mile-wide barrier island between the Atlantic Ocean and Biscayne Bay. The island is connected via a scenic causeway and bridges to the City of Miami, only seven miles away. Key Biscayne is a thriving residential community of more than 14,800 residents. Together with our residents, we are advancing our safe and secure village; thriving and vibrant community and local marketplace; engaging and active programs and public spaces; accessible, connected, and mobile transportation system; and resilient and sustainable environment and infrastructure. The Village of Key Biscayne is seeking a Records and Agenda Coordinator. The Records and Agenda Coordinator of the Village Clerk's Office provides highly skilled administrative support and provides assistance in discharging the duties and overall management of the Village Clerk's Office. This position exercises independent judgment in performing special functions under the supervision of the Village Clerk. Work emphasizes daily administrative work, departmental IT initiatives, working with the Village Clerk on emerging technologies and Agenda and Records Management strategies. Work may include customer service functions and interaction with the public and administrative support assignments for the Village Clerk. Essential Duties and Responsibilities Records Management Coordinate the processing and fulfillment of public records requests in compliance with Florida law. Assist the Village Clerk with the management, retention, scanning, and indexing of permanent public records as part of the Village's records management program. Maintain multiple systems including lobbyist registrations, advisory board memberships, contracts, resolutions, and ordinances. File and organize official documents for the Village Council and the Office of the Village Clerk according to departmental procedures. Council & Meeting Support Assist in the preparation, posting, and distribution of Village Council electronic agenda packets and required legal notices. Prepare the Council Chamber and other meeting venues for Village Council meetings. Attend official meetings to record and transcribe minutes as assigned by the Village Clerk. Coordinate Council travel arrangements, including airline reservations, hotel accommodations, transportation, and conference registrations. Administrative Support Prepare a variety of documents such as correspondence, memoranda, forms, tables, and reports with accuracy and completeness. Process invoices, checks, and assist with monitoring and preparing the Village Clerk and Council budgets. Customer Service & Other Duties Provide excellent customer service in person and by phone, responding to inquiries and concerns or directing them to the appropriate department. Perform other related duties as assigned by the Village Clerk. Minimum Qualifications & Requirements Education & Experience Bachelor's degree in public administration or a related field from an accredited college or university. Four (4) years of experience performing high-level administrative, clerical, or secretarial work. Previous experience in a Municipal or County Clerk's Office is preferred. Knowledge, Skills & Abilities Strong computer proficiency, including Microsoft Office Suite (Word, Excel, Outlook, etc.). Knowledge of automated agenda preparation software and public records management systems. Familiarity with municipal government operations, services, and responsibilities of the Clerk's Office. Knowledge of the rules and regulations governing the conduct of Village Council meetings, including Florida Sunshine Law, Florida public records law, and principles/practices of public agency record keeping. Typing speed of at least 50 wpm. Capable of transcription, summary minute preparation, and accurate recordkeeping. Strong organization and time management skills. Communicate clearly, tactfully, and effectively in English, both orally and in writing; excellent grammar and writing skills required. Ability to communicate in Spanish is a plus. Read, update, analyze, and maintain various records and files with accuracy. Quickly learn and apply various electronic document conversion processes and the Village's records management systems. Operate standard office equipment (computers, printers, copiers, scanners, telephones, etc.). Work independently, exercise discretion and judgment, and maintain confidentiality and professionalism. Manage multiple recurring deadlines where accuracy and attention to detail are critical. Provide flexibility to accommodate occasional evening work. Certifications & Other Requirements Notary Public of the State of Florida, or ability to obtain within three (3) months of employment. Records Management Certification preferred. Must be legally authorized to work in the United States. Must possess a valid Florida Driver's License. Must successfully complete a background investigation, including a national criminal history check. Requirements may be waived by the Village Clerk. These job functions should not be construed as a complete statement of all duties; additional job-related tasks may be required. Must be a non-smoker. SALARY RANGE: $58,649 - $95,892 POSITION TYPE: Full-Time / Non-Exempt APPLICATION PROCESS: Interested and qualified applicants should submit cover letter, resume to: Juan C. Gutierrez, Human Resources Director, Village of Key Biscayne via E-mail: ************************** Village of Key Biscayne is an Equal Opportunity Employer and a Drug/Smoke Free Workplace Qualified applicants are considered for employment and treated without regard to race, color, religion, sex, disability, marital, or veteran status (except if eligible for veterans' preference).

OUR CLIENT is a contracting and data management services organization dedicated to primary care physicians throughout Florida IN THIS ROLE YOU are responsible to assist in the development, undertaking and maintenance of a long term comprehensive, clinical coding audit program for inpatient and outpatient activity. To develop and Implement policies to support the clinical coding audit function Receive, review and communicate findings on patient billing coding related complaints. Identify training needs through the audit program of work and liaise with the clinical coding training manager and audit manager to provide the necessary training identified Conduct routine, risk based, proactive or reactive compliance reviews of procedural and diagnosis coding/billing and medical record documentation performed by clinical service providers Prepare reports as required relative to these monitoring and review activities. Work with coding/billing associates to assure compliance on coding, billing, monitoring and review activities. Monitor, communicate and conduct educational sessions regarding additions and/or revisions to coding and documentation rules and regulations. TO SUCCEED IN THIS ROLE, YOU HAVE: High School diploma required, Associate Degree preferred; Must be a certified professional coder; Minimum five years hands-on experience in physician coding

Job DescriptionDescription: Medical Biller - Join Our Team at WeEvolve, LLC About Us: At WeEvolve, LLC, we're more than just a provider of Applied Behavior Analysis (ABA) therapy-we're a team dedicated to improving lives. We offer in-home, onsite, and community-based ABA therapy across Palm Beach County and the Treasure Coast, delivering the highest quality care to individuals and families. With a strong clinical foundation and a passion for what we do, we aim to evolve with science and foster positive outcomes one relationship at a time. We're looking for an organized, detail-oriented, and dedicated Medical Biller to join our team and help us continue to provide exceptional care. If you're ready to be part of a forward-thinking company where you can make an impact, we'd love to hear from you! Website: ******************* Your Role: As a Medical Biller at WeEvolve, LLC, you will be a key player in ensuring the efficient and accurate processing of billing and claims. Your main responsibility will be to manage the billing process for Medicaid and Private Insurance providers, ensuring timely and error-free submissions. This is an in-person role based in our Boca Raton office, with regular working hours Monday through Friday, from 8:30 AM to 5:00 PM (30-minute lunch break). What You'll Do: Billing & Documentation: Ensure the accuracy and completeness of billing information for both Medicaid and private insurance claims. Create, process, and track all billing documentation. Collaborate & Resolve Issues: Work closely with insurance companies and other team members to resolve billing and credentialing issues in a timely manner. Maintain Patient Files: Organize and maintain accurate patient files, ensuring compliance with privacy regulations (HIPAA). Other Duties: Support additional administrative and clerical tasks as assigned, contributing to the smooth operation of the billing and credentialing departments. Key Competencies: Analytical Thinking: Ability to analyze data, identify problems, and develop appropriate solutions. Detail-Oriented: Precision and attention to detail are key in maintaining billing accuracy and compliance. Organization: Ability to manage multiple tasks efficiently while maintaining an organized and systematic workflow. Time Management: Meet deadlines and ensure tasks are completed within the required time frame. Ethical Conduct & Integrity: Maintain high standards of ethics and confidentiality, adhering to HIPAA regulations. Reliability & Accountability: Dependability in performing tasks and taking responsibility for outcomes. Clear Communication: Strong verbal and written communication skills are essential to interacting with colleagues, providers, and insurance companies. Work Environment: This role is based in our professional office environment in Boca Raton, FL, and will regularly use standard office equipment (computers, phones, photocopiers, fax machines). Physical Demands: The role requires regular talking and hearing, occasional standing and walking, and the ability to handle office equipment. Minimum Qualifications: Preferred Education: Associate's degree or equivalent experience. Experience: Minimum of 2 years in an administrative or clerical role (preferably in medical billing or insurance). Skills: Proficiency in Microsoft Office, especially Excel and Word. Strong follow-up and organizational skills. Medical Terminology: Familiarity with medical terminology is a plus. Communication: Fluent in English (Spanish is a plus). Excellent written and verbal communication skills. Confidentiality & HIPAA: Ability to maintain confidentiality and ensure compliance with HIPAA regulations. Attention to Detail: Extremely detail-oriented with the ability to handle multiple tasks without supervision. Why WeEvolve? Growth & Impact: We are a company that evolves with the science of ABA therapy, so you'll have the opportunity to grow and contribute to something meaningful. Inclusive Environment: WeEvolve, LLC is an Equal Opportunity Employer, committed to providing equal employment opportunities to all individuals regardless of age, race, color, creed, religion, national origin, disability, gender, sexual orientation, or veteran status. If you're an organized, diligent individual with a passion for helping others and an eye for detail, we want to hear from you! Join a company that's making a real impact on the lives of families across Broward, Palm Beach and the Treasure Coast. Requirements:

Full-time Description Medical Biller - Join Our Team at WeEvolve, LLC About Us: At WeEvolve, LLC, we're more than just a provider of Applied Behavior Analysis (ABA) therapy-we're a team dedicated to improving lives. We offer in-home, onsite, and community-based ABA therapy across Palm Beach County and the Treasure Coast, delivering the highest quality care to individuals and families. With a strong clinical foundation and a passion for what we do, we aim to evolve with science and foster positive outcomes one relationship at a time. We're looking for an organized, detail-oriented, and dedicated Medical Biller to join our team and help us continue to provide exceptional care. If you're ready to be part of a forward-thinking company where you can make an impact, we'd love to hear from you! Website: ******************* Your Role: As a Medical Biller at WeEvolve, LLC, you will be a key player in ensuring the efficient and accurate processing of billing and claims. Your main responsibility will be to manage the billing process for Medicaid and Private Insurance providers, ensuring timely and error-free submissions. This is an in-person role based in our Boca Raton office, with regular working hours Monday through Friday, from 8:30 AM to 5:00 PM (30-minute lunch break). What You'll Do: Billing & Documentation: Ensure the accuracy and completeness of billing information for both Medicaid and private insurance claims. Create, process, and track all billing documentation. Collaborate & Resolve Issues: Work closely with insurance companies and other team members to resolve billing and credentialing issues in a timely manner. Maintain Patient Files: Organize and maintain accurate patient files, ensuring compliance with privacy regulations (HIPAA). Other Duties: Support additional administrative and clerical tasks as assigned, contributing to the smooth operation of the billing and credentialing departments. Key Competencies: Analytical Thinking: Ability to analyze data, identify problems, and develop appropriate solutions. Detail-Oriented: Precision and attention to detail are key in maintaining billing accuracy and compliance. Organization: Ability to manage multiple tasks efficiently while maintaining an organized and systematic workflow. Time Management: Meet deadlines and ensure tasks are completed within the required time frame. Ethical Conduct & Integrity: Maintain high standards of ethics and confidentiality, adhering to HIPAA regulations. Reliability & Accountability: Dependability in performing tasks and taking responsibility for outcomes. Clear Communication: Strong verbal and written communication skills are essential to interacting with colleagues, providers, and insurance companies. Work Environment: This role is based in our professional office environment in Boca Raton, FL, and will regularly use standard office equipment (computers, phones, photocopiers, fax machines). Physical Demands: The role requires regular talking and hearing, occasional standing and walking, and the ability to handle office equipment. Minimum Qualifications: Preferred Education: Associate's degree or equivalent experience. Experience: Minimum of 2 years in an administrative or clerical role (preferably in medical billing or insurance). Skills: Proficiency in Microsoft Office, especially Excel and Word. Strong follow-up and organizational skills. Medical Terminology: Familiarity with medical terminology is a plus. Communication: Fluent in English (Spanish is a plus). Excellent written and verbal communication skills. Confidentiality & HIPAA: Ability to maintain confidentiality and ensure compliance with HIPAA regulations. Attention to Detail: Extremely detail-oriented with the ability to handle multiple tasks without supervision. Why WeEvolve? Growth & Impact: We are a company that evolves with the science of ABA therapy, so you'll have the opportunity to grow and contribute to something meaningful. Inclusive Environment: WeEvolve, LLC is an Equal Opportunity Employer, committed to providing equal employment opportunities to all individuals regardless of age, race, color, creed, religion, national origin, disability, gender, sexual orientation, or veteran status. If you're an organized, diligent individual with a passion for helping others and an eye for detail, we want to hear from you! Join a company that's making a real impact on the lives of families across Broward, Palm Beach and the Treasure Coast.

Are you an experienced Certified Coder with Managed Care experience looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the position for you! Job Description Job Title: Medical Coding Auditor Position Summary: As the Medical Coding Auditor, you would be responsible for reviewing medical and behavioral health care medical records, coding, abstracting, and analyzing inpatient and outpatient medical records. Hours for this Position: Monday-Friday 8:00am-5:00pm Advantages of this Opportunity: Pay $20-$30 per hour, negotiable based on experience Work for a Fortune 500 company who pride themselves on partnership, integrity, teamwork, and accountability Be a part of a team who serves the full spectrum of member needs Weekly deposit options Great benefits offered More Insight of Daily Responsibilities: Verify and validate authorization of services Coordinate coding and payment issues Conduct reviews of medical records/documents supporting claims for medical/behavioral services Identify coding errors, inconsistencies, or abnormal billing patterns Qualifications What We Look For: CCA, CCS, CCS-P, CPC, or CPC-H certification 5+ years of experience in managed care and/or behavioral health care Additional Information Want More Information? Interested in hearing more about this great opportunity? Reach out to Amanda Hammer at 407-636-7030 ext. 201 for immediate consideration. HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! The greatest compliment to our business is a referral. If you know of someone looking for a new opportunity, please pass along my contact information!

JOB AD: Medical Records Clerk Aspen Medical has an exciting opportunity for MRCs to partner with us in providing quality medical care to patients within a transitional setting. MRCs, alongside fellow team members, will be fully entrusted to ensure that the utmost competent care and safety is consistently delivered with compassion to the patient population. The medical teams will be located within a secure medical facility, where such services include, but are not limited to the following: Medical Screening (New Arrivals) Comprehensive Screening Sick Call 24-Hour Emergency Medical and Mental Health Treatment Women's Medical Care Aspen Medical will provide additional EMS, Diagnostic and Laboratory, and other ancillary services. All clinic service delivery services will be provided in accordance with US clinical standards and compliance measures. Citizenship: *All Aspen Medical staff must be US citizens or Green Card holders. Sponsorship will not be available . Requirements: Education: High School diploma or General Educational Development (GED) equivalency. Basic medical terminology required Certification: Registered Health Information Technician (RHIT) or Registered Health Information Administrator American Heart Association certification in Basic Life Support (BLS) Experience: A minimum of one year of recent, relevant, related experience Language Proficiency: Fluency in Spanish is highly desired but not required Core Duties: Initiates and maintains medical records in accordance with prescribed directives Files military forms documenting patient care into the official medical record Searches for missing paperwork or records; requests information pertaining to patient treatment to place in the medical record Prepares reports regarding record statistics as necessary. Participates in records review as part of the facility's quality assurance program and in accordance with Exhibit 5, Version 1.0 (4 Oct 22) accreditation standards Retires medical records in accordance with regulatory guidelines. *Pay rate details and associated work schedules will be outlined during the interview phase. Aspen Medical is committed to a diverse and inclusive workplace. We are an equal opportunity employer, and Aspen Medical does not discriminate based on race, national origin, gender, gender identity, sexual orientation, protected veteran status, disability, age, or other legally protected status. For individuals with disabilities who would like to request accommodation, please contact [email protected]. By joining Aspen Medical, you will join a responsive mission-driven organization where you will be a vital member of a small, dynamic team supported by a large international corporation.

Hybrid-Sunrise, Florida The Medical Coding Auditor conducts audits to provide investigative support related to potential fraud, waste, abuse and/or overpayment. Through post payment medical records review, the Medical Coding Auditor ensures appropriate coding on claims paid and maintains compliance documentation of any fraud, waste or abuse identified based on coding guidelines and regulatory and contract requirements. Essential Duties and Responsibilities: Performs post payment medical record review audits of claims payments to identify potential fraud, waste, abuse and/or overpayment. Completes and maintains detailed documentation of audits including but not limited to coding guidelines reviewed, medical necessity documentation, decision methodology, and monetary discrepancies identified. Coordinates overpayment recoveries with the Fraud Investigative Unit Manager. Responsible for assisting the Fraud Investigative Unit Manager with potential fraud, waste or abuse investigations requiring medical coding expertise, participating in external audit requests, and special projects as needed. Coordinates, conducts, and documents audits as needed for investigative purposes. Prepares written reports or trending data related to findings and facilitates timely turnaround of audit results. Prepares written summaries of audit results for purposes of reporting potential fraud, waste, abuse and/or overpayment. Retrieves and compiles data across multiple information systems and provides needed information for internal and external customers in a timely manner. Identifies potential provider fraud through review of claims data, complaint referrals, and application of rules, healthcare coding practices, and fraud detection software. Reviews provider billing practices to investigate claims data and compliance with State and Federal laws. Analyzes provider data and identifies erroneous or questionable billing practices. Interprets state and federal policies, Florida Medicaid, Children's Health Insurance Program, and contract requirements. Determines and calculates overpayment/underpayment, appropriately documents and participates in steps to remediate. Determines priorities and method of completing daily workload to ensure that all responsibilities are carried out in a timely manner. Performs all other duties as assigned. This job description in no way states or implies that these are the only duties performed by the employee occupying this position. Employees will be required to perform any other job-related duties assigned by their supervisor or management. Qualifications: Medical Coder certification from accredited source (e.g. American Health Information Management Association, American Academy of Professional Coders or Practice Management Institute) must have. Prior experience in Medicaid claims role and/or post payment medical coding auditor role preferred. Knowledge of Medicaid rules, claims processing, medical terminology and coding principles and practices. Knowledge of auditing, investigation, and research. Knowledge of word processing software, spreadsheet software, and internet software. Manage time efficiently and follow through on duties to completion. Skills and Abilities: Written and verbal communication skills. Ability to organize and prioritize work with minimum supervision. Detail oriented. Ability to perform math calculations. Analytical and critical thinking skills. Ability to operate personal computer and general office equipment as necessary to complete essential functions, including using spreadsheets, word processing, database, email, internet, and other computer programs. Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions. Work Schedule: Community Care Plan is currently following a hybrid work schedule. The company reserves the right to change the work schedules based on the company needs. 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. While performing the duties of this job, the employee is regularly required to sit, use hands, reach with hands and arms, and talk or hear. The employee is frequently required to stand, walk, and sit. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee may occasionally lift and/or move up to 15 pounds. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job. The environment includes work inside/outside the office, travel to other offices, as well as domestic, travel. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. We are an equal opportunity employer who recruits, employs, trains, compensates and promotes regardless of age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees unique. We are committed to fostering, cultivating and preserving a culture of diversity, equity and inclusion. Background Screening Notice: In compliance with Florida law, candidates selected for this position must complete a Level 2 background screening through the Florida Care Provider Background Screening Clearinghouse. The Clearinghouse is a statewide system managed by the Agency for Health Care Administration (AHCA) and is designed to help protect children, seniors, and other vulnerable populations while streamlining the screening process for employers and applicants. Additional information is available at: ???? h********************************

Part-time Description Medical Coder (Certified) ! Lake Butler Hospital is a critical access hospital in North Florida providing 24-hour emergency services, inpatient hospitalization, swing bed program, rehabilitation services, outpatient laboratory, and outpatient radiology (X-ray, ultrasound, and CT scan) services to Union County and the surrounding counties. We are devoted to providing all members of our community with premier-quality health care in a compassionate and inviting environment. We are seeking a knowledgeable and experienced Health Information Management (HIM) Medical Coder to join our team! This is a Part-Time position. Initial responsibilities are on-site but remote work is possible after successfully demonstrating proficiency in the specifics for our facility. Job Summary: This position assigns accurate CPT codes from medical records for billing purposes. Also tasked to ensure proper documentation for charge capture and to remain current with industry guidelines. The successful candidate will have demonstrated ICD-10-CM proficiency, and have a demonstrated understanding of the CPT guidelines for separate procedures, bundling and add-on-codes. Must also be comfortable reviewing, resolving and preventing coding denials. More job responsibilities are provided in the full job description. Applicants must have Inpatient and Outpatient Hospital experience and experience in Rural Health Clinics. THIS IS NOT A REMOTE POSITION! Coder, HIM, Medical Billing, Medical Coder, Patient Accounts, Medical Records, Healthcare Union County, Lake Butler, Bradford County, Starke, Baker County, Macclenny, Glen Saint Mary, Columbia County, Fort White, Alachua County, Alachua, High Springs, Gainesville, Clay County, Keystone Requirements Education: High school graduate or equivalent. Current certification in ICD-9/CPT-4 coding and ICD-10CM/PCS Experience: At least 2-years of progressive in-patient and out-patient medical coding work. Experience in Rural Health Clinics. Skills: Proficient in Microsoft Office Suite with strong computer skills; Excellent written and oral communication skills. Knowledge: Working knowledge of Health Information Management required. Thorough knowledge of ICD-9/CPT-4 and ICD-10 CM/PCS coding sets. Abilities: Ability to operate office equipment (fax, copier, computer). Equipment Used for Job: Computer, copier, facsimile machine.

Job DescriptionSalary: $17hr - $19hr About us Integrity Medical Group provides a full range of medical services. We diagnose, treat, and repair bones, joints, and connective tissue involved with muscle and tendons. We provide care and treatment plans where our patients can enjoy an active lifestyle and be proactive for good health. The Medical Records Specialist position assists the office with processing medical records. The Medical Records Specialist compiles, maintains, copies, retrieves, and tracks medical records with accuracy and close attention to detail. Our practice is high volume, so the ability to work in a fast-paced environment while multitasking is a must! Experience Preferred: 6 months of experience processing medical records working in a medical office setting. Performance Indicators: Demonstrate a strong attention to detail Completes medical records requests thoroughly, efficiently, and with minimal errors Demonstrates ownership of work and accountability Critical problem-solving skills required; proactive in all aspects Demonstrates skills in accuracy and multitasking while working to impact progress within the daily workload and adhere to internal deadlines. Demonstrates a high comfort level in working with large volumes of data. Maintains confidentiality when managing patient data (HIPAA Guidelines) Professionally communicates with patients via phone or email. Knowledge of medical terminology. Must be a team player and able to demonstrate positive communication skills Responsibilities Compile and maintain medical files for individual patients. Scan paper charts into the EMR system. Review and process requests for medical record information. Obtain medical records from other physicians offices or hospitals. Release records to physicians offices, attorneys, patients, and insurance companies in accordance with state and HIPAA policies. Benefits: Dental insurance Disability insurance Health insurance Life insurance Paid time off Vision insurance Schedule: 8-hour shift Day shift Monday to Friday Ability to commute/relocate: Winter Park 32879: Reliably commute or planning to relocate before starting work (Preferred) Application Question(s): Do you have experience in a medical office? Do you have experience using eClinicalWorks? Are you bilingual, and if so, which language do you speak fluently? Education Required: High school diploma/GED. Preferred: Completion billing Employment practices will not be influenced or affected by an applicants or employees race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status, or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.

Lead Medical Records & Referrals Coordinator oversee the administrative duties and operational efficiency of the Medical Records & Referrals department. They are responsible for processes and procedures that support medical records, referrals, data management, and resolving patient complaints. This is NOT a remote position. Key Responsibilities Maintains a transparent, effective relationship with the Regional Director of Operations and Medical Records & Referrals Manager by supporting the organization's activities Completes timely and accurate data entry Oversees the department in the absence of the Manager Provides excellent customer service to patients, staff, partners, and visitors Contributes and enhances the positive image of the medical records & referrals department Assists patients and partners with referral processing, medical records requests, and other related inquiries Ensures and maintains an efficient departmental workflow Remains non-judgmental when engaging with patients Monitors critical data for analysis and report generation Ensures medical records are available to practitioners and clinical personnel upon request Knowledge of medical terminology Knowledge of insurance verification procedures Knowledge of True Health's processes to navigate patients appropriately Scans and import patient data to the electronic medical record Coordinate the staff in assisting providers in obtaining authorizations, for appointments, consultations, procedures, etc. Monitors received requests for summaries of medical care given to our patients by private physicians or medical facilities, keep a record of all correspondence, and provide follow-up as needed Monitors and coordinates follow-up on patients who do not keep their appointments for specialists Track all patient referrals to ensure report was received scanned and imported in a timely manner Monitors rules and regulations, and policies and procedures, ensuring compliance with processes Responsible for documenting all steps taken to properly process a referral Tracks reports on turnaround time for processing Orange County referrals in a timely manner Directs staff in notifying the provider and patient if additional tests are needed before a referral can be completed Research patient medical records and respond to insurance and other correspondence Supports staff development via the completion of 1:1 sessions Participates in the recruitment and retention of staff Maintains open lines of communication Resolves complaints and inquiries regarding medical records and referrals Maintains an adequate and constant supply of printed medical release forms and materials to be used by all medical departments; process necessary authorizations and referrals, and acknowledges receipt and adequate recordkeeping of all authorizations and referrals Delegates and oversees the preparation of data necessary for all requested patient charts by hospitals, attorneys, etc., including making copies and arranging delivery of such documents Responsible for processing assigned referrals within 72 hours Oversee the accuracy of file records; attach reports of consultation and diagnostic procedures (x-ray, laboratory, consultations, etc.) Functions as primary True Health medical records and referrals contact for internal and external inquiries and develop and maintain positive working relationships Monitor documents scanned within the EMR system and all medical records received via mail within 72 hours Conducts site visits monthly with medical records and referrals staff Attends internal and external meetings Contributes to achievement of organizational goals Travel as necessary using personal vehicle (must maintain current auto insurance at own expense) Other responsibilities as assigned Essential Functions Problem Solving Customer Service Verbal Communication Written Communication Planning/Organizing Adaptability Initiative Administration/Operations Managerial Skills Professional Judgement Minimum Qualifications Education: Associate's degree or higher from an accredited college or university Preferred High School Diploma, GED, or equivalent work experience, Required Experience: Proficiency in Microsoft Office (Ex. Word, Excel, Outlook, PowerPoint), Required Epic experience, Preferred Minimum of 1 year of customer service experience, Preferred Typing 40wpm Bilingual in English and Spanish or Creole, Preferred Licenses or Certifications: N/A Criminal Background Clearance: True Health is a Health Center Program grantee under 42 U.S.C. 254b, a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n), and partners with agencies that require criminal background checks. True Health has established policies and procedures that may influence the overall employment process, hiring, and “just cause” for the termination of employees. An employee's career could be shortened if there is a violation of any policies and procedures. Prohibited criminal behavior is defined in Florida Statute (F.S.) 408.809. Any employee arrested for any offense outlined in the F.S.408.809 will be immediately suspended and remain suspended until the charges are disposed of in court. The employee will be terminated for an arrest or convict of any violation listed above. DRUG/ALCOHOL SCREENINGS A post-offer drug and alcohol screen is a requirement for employment. Failure to successfully pass the drug/alcohol screen will be cause for the offer to be rescinded. Employees are subject to random drug/alcohol screenings throughout the duration of their employment with True Health. If an employee fails to pass the drug/alcohol screening, then this shall become grounds for discipline up to and including immediate termination. WORK ENVIRONMENT The employee will be working in an outpatient healthcare setting. The employee is subject to prolonged periods of sitting at a desk and working on a computer. The employee is subject to perform repetitive hand and wrist motions. The employee is frequently required to stand, walk, talk, and hear. The employee is occasionally required to use hands to handle or feel objects, reach with hands and arms, stoop, kneel, crouch, and move or lift up to twenty-five (25) pounds. The employee is required to use close vision, peripheral vision, depth perception, and adjust focus. A reasonable accommodation may be provided to enable individuals with disabilities to perform the essential functions. WORKING CONDITIONS The employee will work as the needs of the operation require. Normal work days and hours are Monday through Thursday, 8am - 6pm and Fridays, 8am - 12pm; however, there will be times when the employee will need to come in or work on “off hours” or “off days” to meet the needs of the position. CORE COMPETENCIES Mission-Focused: Commits to and embraces True Health's mission to enable access to care for uninsured and underinsured individuals. Relationship-Oriented: Understands that people come before process and is essential in cultivating and managing relationships toward a common goal. Collaborator: Understands the roles and contributions of all sectors of the organization and can mobilize resources (financial and human) through meaningful engagement. Results-Driven: Dedicated to shared and measurable goals for the common good; creating, resourcing, scaling, and leveraging strategies and innovations for broad investment and community impact. Brand Steward: Steward of True Health's brand and understands his/her role in growing and protecting the reputation and results of the greater organization. Visionary: Confronts the complex realities of the environment and simultaneously maintains faith in a different and better future, providing purpose, direction, and motivation. Team-Builder: Fosters commitment, trust, and collaboration among internal and external stakeholders. Business Acumen: Possesses a high-level of broad business and management skills and contributes to generating financial support for the organization. Network-Oriented: Values the power of networks; strives to leverage True Health's breadth of community presence, relationships, and strategy. SELECTION GUIDELINES The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

Hybrid-Sunrise, Florida The Medical Coding Auditor conducts audits to provide investigative support related to potential fraud, waste, abuse and/or overpayment. Through post payment medical records review, the Medical Coding Auditor ensures appropriate coding on claims paid and maintains compliance documentation of any fraud, waste or abuse identified based on coding guidelines and regulatory and contract requirements. Essential Duties and Responsibilities: Performs post payment medical record review audits of claims payments to identify potential fraud, waste, abuse and/or overpayment. Completes and maintains detailed documentation of audits including but not limited to coding guidelines reviewed, medical necessity documentation, decision methodology, and monetary discrepancies identified. Coordinates overpayment recoveries with the Fraud Investigative Unit Manager. Responsible for assisting the Fraud Investigative Unit Manager with potential fraud, waste or abuse investigations requiring medical coding expertise, participating in external audit requests, and special projects as needed. Coordinates, conducts, and documents audits as needed for investigative purposes. Prepares written reports or trending data related to findings and facilitates timely turnaround of audit results. Prepares written summaries of audit results for purposes of reporting potential fraud, waste, abuse and/or overpayment. Retrieves and compiles data across multiple information systems and provides needed information for internal and external customers in a timely manner. Identifies potential provider fraud through review of claims data, complaint referrals, and application of rules, healthcare coding practices, and fraud detection software. Reviews provider billing practices to investigate claims data and compliance with State and Federal laws. Analyzes provider data and identifies erroneous or questionable billing practices. Interprets state and federal policies, Florida Medicaid, Children's Health Insurance Program, and contract requirements. Determines and calculates overpayment/underpayment, appropriately documents and participates in steps to remediate. Determines priorities and method of completing daily workload to ensure that all responsibilities are carried out in a timely manner. Performs all other duties as assigned. This job description in no way states or implies that these are the only duties performed by the employee occupying this position. Employees will be required to perform any other job-related duties assigned by their supervisor or management. Qualifications: Medical Coder certification from accredited source (e.g. American Health Information Management Association, American Academy of Professional Coders or Practice Management Institute) must have. Candidates with relevant work experience may be eligible for company-sponsored certification or licensure. Prior experience in Medicaid claims role and/or post payment medical coding auditor role preferred. Knowledge of Medicaid rules, claims processing, medical terminology and coding principles and practices. Knowledge of auditing, investigation, and research. Knowledge of word processing software, spreadsheet software, and internet software. Manage time efficiently and follow through on duties to completion. Skills and Abilities: Written and verbal communication skills. Ability to organize and prioritize work with minimum supervision. Detail oriented. Ability to perform math calculations. Analytical and critical thinking skills. Ability to operate personal computer and general office equipment as necessary to complete essential functions, including using spreadsheets, word processing, database, email, internet, and other computer programs. Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions. Work Schedule: Community Care Plan is currently following a hybrid work schedule. The company reserves the right to change the work schedules based on the company needs. 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. While performing the duties of this job, the employee is regularly required to sit, use hands, reach with hands and arms, and talk or hear. The employee is frequently required to stand, walk, and sit. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee may occasionally lift and/or move up to 15 pounds. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job. The environment includes work inside/outside the office, travel to other offices, as well as domestic, travel. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. We are an equal opportunity employer who recruits, employs, trains, compensates and promotes regardless of age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees unique. We are committed to fostering, cultivating and preserving a culture of diversity, equity and inclusion. Background Screening Notice: In compliance with Florida law, candidates selected for this position must complete a Level 2 background screening through the Florida Care Provider Background Screening Clearinghouse. The Clearinghouse is a statewide system managed by the Agency for Health Care Administration (AHCA) and is designed to help protect children, seniors, and other vulnerable populations while streamlining the screening process for employers and applicants. Additional information is available at: ???? h********************************

Full-time Description Medical Coder (Certified) !! Lake Butler Hospital is a critical access hospital in North Florida providing 24-hour emergency services, inpatient hospitalization, swing bed program, rehabilitation services, outpatient laboratory, and outpatient radiology (X-ray, ultrasound, and CT scan) services to Union County and the surrounding counties. We are devoted to providing all members of our community with premier-quality health care in a compassionate and inviting environment. We are seeking a knowledgeable and experienced Health Information Management (HIM) Medical Coder to join our team! This is a Full-Time position. Initial responsibilities are on-site but remote work is possible after successfully demonstrating proficiency in the specifics for our facility. For full-time employees, we offer medical benefits, paid time off, 401k after one year of service, discounts at Willow Cafe, and more! Job Summary: This position assigns accurate CPT codes from medical records for billing purposes. Also tasked to ensure proper documentation for charge capture and to remain current with industry guidelines. The successful candidate will have demonstrated ICD-10-CM proficiency, and have a demonstrated understanding of the CPT guidelines for separate procedures, bundling and add-on-codes. Must also be comfortable reviewing, resolving and preventing coding denials. More job responsibilities are provided in the full job description. Applicants must have Inpatient and Outpatient Hospital experience and experience in Rural Health Clinics. THIS IS NOT A REMOTE POSITION!! Coder, HIM, Medical Billing, Medical Coder, Patient Accounts, Medical Records, Healthcare Union County, Lake Butler, Bradford County, Starke, Baker County, Macclenny, Glen Saint Mary, Columbia County, Fort White, Alachua County, Alachua, High Springs, Gainesville, Clay County, Keystone Requirements Education: High school graduate or equivalent. Current certification in ICD-9/CPT-4 coding and ICD-10CM/PCS Experience: At least 2-years of progressive in-patient and out-patient medical coding work. Experience in Rural Health Clinics. Skills: Proficient in Microsoft Office Suite with strong computer skills; Excellent written and oral communication skills. Knowledge: Working knowledge of Health Information Management required. Thorough knowledge of ICD-9/CPT-4 and ICD-10 CM/PCS coding sets. Abilities: Ability to operate office equipment (fax, copier, computer). Equipment Used for Job: Computer, copier, facsimile machine.