Medical coder jobs in Hialeah, FL - 241 jobs

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).

Do you love to care for patients in a warm and welcoming environment? Gastro Health is currently looking for an enthusiastic full-time Coding Specialist to join our team! Gastro Health is a great place to work and advance in your career. You'll find a collaborative team of coworkers and providers, as well as consistent hours - and we enjoy paid holidays per year plus paid time off. In this role, the you will work closely with Manager, Coding Operations and management team. The Team Lead will ensure that the company core values are being met. Job Description Drop claims for office, hospital, nutrition, pathology, biologics, imaging, pediatricians, anesthesia, and endoscopy center for accurate processing by payers Review medical documentation from EMR and hospital systems for accurate coding and billing to insurance companies Apply current billing and coding guidelines Evaluate that charges provided by the physicians support the level being billed based on the documentation Prepare claims with necessary fields for processing, such as linking authorizations to charges, code blood work, and assigning appropriate modifiers as needed Provide feedback to office managers and physicians regarding clinical documentation to ensure compliance with coding guidelines and reimbursement reporting requirements Manage claims for auditing purposes, including placing them on hold and billing once the process is complete Email office managers and physicians where updates are needed to operative reports Minimum Requirements High School Diploma or GED equivalent Must have CPC or equivalent certification Extensive knowledge of patient registration, coding, billing, regulatory requirements, billing compliance, business operations, financial systems and financial reporting. Certified coder AAPC or AHIMA Excellent communication skills both verbal and written. Able to analyze data and quickly identify process-based issues for remediation. Maintains confidentiality in all matters that include Patient Health Information and employee data. Hands-on participation in process/workflow design including team member involvement across the department. Intermediate experience with Microsoft Excel and Office products is required. Target Oriented and Coding team resolution mindset Prior experience collaborating with a remote team is highly preferred. Gastro Health is the largest gastroenterology multi-specialty group in the country. We are over 300 physicians strong with over 100 locations throughout the nation, including Florida, Alabama, Ohio, Maryland, Washington, Virginia, and Massachusetts. We employ the finest gastroenterologists, pediatric gastroenterologists, colorectal surgeons, and allied health professionals. Gastro Health is always looking for talented individuals who share our mission to provide outstanding medical care and an exceptional healthcare experience. This position offers a great work/life balance! We are growing rapidly and support internal advancement We offer competitive compensation 401(k) retirement plans Profit-Sharing Dental insurance Health insurance Life insurance Paid time off Vision insurance Disability insurance Pet insurance We offer a comprehensive benefits package to our eligible employees, which includes: Cigna healthcare, dental, vision, life insurance, 401k, profit-sharing, short & long-term disability, HSA, FSA, and PTO plus 7 paid holidays. Gastro Health is proud to be an Equal Opportunity Employer. We do not discriminate based on race, color, gender, disability, protected veteran, military status, religion, age, creed, national origin, gender identity, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We thank you for your interest in joining our growing Gastro Health team!

Mindlance is a national recruiting company which partners with many of the leading employers across the country. Feel free to check us out at ************************* Job Description Business Medical Coder Visa GC/Citizen Location 5775 Blue Lagoon Dr. Miami, FL 33126 Division Healthcare Contract 3 Months Qualifications Role · Review of denial on adjudicated claim that is classified as a code edit denial. · Request and review supporting documentation (medical records) when needed. · Once review is complete contact provider by phone to provide rationale as to whether we will overturn (pay) the denial or if it is upheld. Qualifications · CPC, CRC.CCS-P Coding Certification · CPC-A with coding experience · Knowledge/experience of CPT, ICD-9, and ICD-10 coding · Comfortable with making outbound calls to provider offices If you are available and interested then please reply me with your “Chronological Resume” and call me on **************. Additional Information Thanks & Regards, Ranadheer Murari | Team Recruitment | Mindlance, Inc. | W: ************ *************************

We are seeking a motivated Entry -Level Medical Coder / Billing Assistant to join the administrative team. This position offers a great pathway into the healthcare field for individuals interested in medical billing and coding. Hybrid work is possible after the training period. Key Responsibilities Code medical procedures accurately for billing and insurance claims. Prepare financial reports and submit claims to insurance companies or patients. Enter and maintain patient data in administrative and billing systems. Track outstanding claims and follow up on unpaid accounts. Communicate with patients to discuss balances and develop payment plans. Maintain confidentiality and comply with HIPAA and all healthcare regulations. Qualifications High school diploma or equivalent required; healthcare coursework a plus. MediClear or equivalent HIPAA compliance credential required. Strong communication, organization, and time -management skills. Ability to remain professional and calm while working with patients and insurance representatives. Basic computer proficiency and familiarity with billing software or EMR systems preferred. Why Join Us Excellent opportunity for those starting a career in healthcare administration. Supportive, team -oriented work environment. Comprehensive benefits and advancement potential within a growing healthcare organization.

Medical 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

Scope: Seeking inpatient coder with 2+ years of experience in acute care setting coding medical and surgical cases for multiple specialties as well as trauma cases. Coders work in a WQ and take the next case on the list, facility sees standard acute care specialties such as cardiology, orthopedics, neurology, neurosurgery, ID, pulmonary, OB/GYN, pediatrics, neonatal, etc. Experience with Cerner and 3M 360 CAC required. Schedule can be flexible within reason after training. For initial training will need to be available between 8a and 4p Eastern Time for up to a week. This project estimated to be 6 months. Summary/Objective Under limited supervision the Coder Inpatient reviews medical records and performs coding on all diagnoses, procedures, and DRG. The Coder Inpatient uses the most accurate codes for reimbursement purposes, research, epidemiology, statistical analysis outcomes, financial and strategic planning, evaluation of quality of care, and communication to support the patient's treatment. The Coder Inpatient will be charged with maintaining the confidentiality of patient records and procedures. Essential Job Functions Responsible for abstracting, coding, sequencing and interpreting the clinical information from inpatient, outpatient, emergency department, pro fee and clinical medical records. Responsible for the assignment of correct principal diagnoses, secondary diagnoses and principal procedure and secondary procedure codes with attention to accurate sequencing. Utilizes technical coding principals and DRG/APC reimbursement expertise to assign appropriate codes. Abstracts and codes pertinent medical data into multiple software programs and/or encoders. Follows official coding guidelines to review and analyze health records. Maintains compliance with both external regulatory and accreditation requirements, and with State and Federal regulations. Extracts pertinent data from the patient's health record, and determines appropriate coding for reports and billing documents. Identifies codes for reporting medical services, procedures performed by physicians. Enters codes into various computer systems dependent upon the various clients. Track and document productivity in specified systems, maintain productivity levels as defined by the client. Maintain 95% quality rating Perform duties in compliance with Company's policies and procedures, including but not limited to those related to HIPAA and compliance. Key Success Indicators/Attributes Ability to prioritize and multi-task in a fast-paced, changing environment. Demonstrate ability to work in all work types and specialties. Demonstrate ability to self-motivate, set goals, and meet deadlines. Demonstrate leadership, mentoring, and interpersonal skills. Demonstrate excellent presentation, verbal and written communication skills. Ability to develop and maintain relationships with key business partners by building personal credibility and trust. Maintain courteous and professional working relationships with employees at all levels of the organization. Demonstrate excellent analytical, critical thinking and problem solving skills. Skill in operating a personal computer and utilizing a variety of software applications. Knowledge of coding convention and rules established by the AHIMA, American Medical Association (AMA), the American Hospital Association (AHA) and the Center for Medicare and Medicaid (CMS), for assignment of diagnostic and surgical procedural codes. Knowledge of JCAHO, coding compliance and HIPAA HITECH standards affecting medical records and the impact on reimbursement and accreditation. Supervisory Responsibility No Work Environment This job operates in a remote home office environment. This role routinely uses standard office equipment such as computers and phones. 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. While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; and talk or hear. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus. Position Type/Expected Hours of Work This is a full-time or part-time position. Days and hours of work are generally Monday through Friday, 8:00 a.m. to 5 p.m. This position occasionally requires long hours and weekend work. Required Education and Experience Successful completion of an AAPC or AHIMA-approved Coding Certificate Program and a minimum of two to four years of current production coding experience in acute care. Preferred Education and Experience N/A Additional Eligibility Qualifications Must have the following certificates and/or licenses: CPC, COC, CIC, RHIA, RHIT, CCS, and/or CCS-P. Security Access Requirements In addition to the specific security access required by the employee's client engagement, the employee will have access to the Omega systems set forth in the "Standard Field Employee" profile. AAP/EEO Statement Omega is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status. Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Employee may perform other duties as assigned * 2 + years coding in an acute care setting for medical and surgical cases for multiple specialties * Cerner and 3M 360 CAC experience * Able to maintain 95% coding accuracy * Able to reach 2 CPH productivity in 4 weeks and maintain after * Good verbal and written communication skills * Ok with short term project

Outpatient coder with 2 + years of experience in coding outpatient recurring/series account concentrating on wound clinic, infusion clinic, trauma clinic, but physical therapy, occupational therapy, speech pathology, and anticoagulation clinics will also be part of the mix Epic and 3M 360 experience is required. Schedule is 8 hours Mon - Fri with 75% of shift between client's regular business hours of 8am and 5pm CST. 2 + years of experience in coding outpatient recurring/series accounts Epic Experience 3M 360 Experience Able to work M-F with the majority of the shift between 8a-4p CST Able to pick up new workflows and technology easily Able to ramp up productivity in 4 weeks Maintain 95% accuracy in all coding Good written and verbal communication

The Medical Coder II position performs adequate coding services to the organization for achievement of reimbursement and compliance with correct coding guidelines. This individual requires skills in the sequencing of diagnosis/procedure codes to optimize reimbursement. ESSENTIAL DUTIES AND RESPONSIBILITIES Responsible for the evaluation of medical documentation for proper assignment of ICD10-CM/CPT-4 codes and the preparation of claims. Seeks clinical documentation and makes coding recommendations to physicians based on their overall medical observation and documentation of medical records. Provide Physician training on MRA/HEDIS coding and medical documentation guidelines. Ensures medical records for accuracy and completion through pre audit and post audit processes to adequately code for all services to achieve reimbursement in accordance with correct coding guidelines. Completion of 30 medical record abstracts daily and provides coding recommendations to physicians. Provides PCP MRA/HEDIS coding support, education, and training. Monitor coding changes to ensure most current information is available. Assists with chart reviews/audits performed by health plans. Looks for new problem areas, trends, etc. Works HCC/HEDIS Care Gap Reports. Expected to maintain up to date coding innovations that can improve their workflow. Maintenance, reconciliation, and completion of PCP coding recommendations-Level 1 claims that have been corrected by physician. Other duties as assigned. EXPERIENCE AND REQUIRED SKILLS High School Diploma or equivalent required. CPC & ICD10 Certification required. Minimum of 3 years of medical coding experience with acquired progressive responsibility preferred. Proficient in official coding guidelines, ICD-10CM, CPT-4 and HCPCS. Strong organizational skills and high attention to detail. Strong collaboration and relationship building skills. Required to have a command of the English language and be proficient with grammar, spelling and verbal skills to communicate with patients, providers, and staff in written and oral communication. Must be proficient be proficient in Microsoft Office and knowledge with computers, scanners, etc. Experience with Patient Financial Systems and Electronic Medical Records. Good communication skills. Ability to learn new tasks and concepts. Bilingual English/Spanish preferred. IMC Health provides equal employment opportunity to all applicants and employees. No person is to be discriminated against in any aspect of the employment relationship due to race, religion, color, sex, age, national origin, disability status, genetics, citizenship status, marital status, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

At Medusind we take immense pride in offering superior, cost-effective solutions covering the whole spectrum of tasks and processes to the healthcare industry. A significant factor is that our workforce comes with a rich domain expertise and robust compliance norms. Our four-prong approach of an excellent management team coupled with detailed eye for processes, experienced manpower, and cutting edge technology helps us deliver superior, cost effective services to our clients across the globe. Job Description SUMMARY: This position is a member of a team that is responsible for coding review, coding education, and charge entry. The goal of the team is to ensure correct coding, timely charge entry, billing compliance, and to provide on-going coding education to providers and staff. RESPONSIBILITIES: Stays up-to-date on coding rules and CPT/ICD/HCPCS codes. Stays up-to-date on 3rd party payer rules and integrates those rules into daily work. Review for accuracy all charge slips submitted by the Medusind clients and hospital departments. Make corrections based on the medical documentation. Assist the department manager with collecting data for trends to help develop training plans for clients and providers. Assist billing office in addressing billing concerns from the Collections team as necessary. Perform random audits on charts. Data entry of the charges in a timely and accurate fashion. Perform other duties as assigned. Participate in continuing education sessions. Foster and maintain excellent relationships with Medusind clients. Qualifications KNOWLEDGE, SKILLS, AND ABILITIES: Minimum of five years experience working with CPT, ICD-10 and HCPCS codes. A strong understanding of coding requirements. Must either possess a CPC certification or a CCS certification. 1 year Radiology, Neurology and Medicare Part B coding experience. Knowledge of computer applications and Microsoft Office processing. Additional Information All your information will be kept confidential according to EEO guidelines.

Job Description Medical Record Coder is responsible for timely review of patient records in order to identify an appropriate selection of ICD-9-CM/CPT codes that will accurately reflect the reason for admission, extent of care received, and level of severity of illness. Coder is further responsible for insuring that all data elements required for federal and state reporting are collected and included in the patient's demographic record. Accounts for each Inpatient and Outpatient records in order that all are coded. Enters coded data into computer to facilitate the billing process. Position Qualification: Preferred: 2-3 years Inpatient coding experience preferred. EDUCATION: RHIA, RHIT, CCS preferred or completion of ICD-9/CPT 4 coding programs. TRAINING: Orientation and training under supervision of Director and Coding Manager until competency is observed. ABILITIES AND SKILLS: Requires eye hand coordination with good manual dexterity. Must be able to look at computer CRT most of the day and must be computer knowledgeable. Must have excellent command of the English language, both oral and written. Must be organized. Requires frequent but limited contact with physicians. EXPERIENCE: 2-3 years coding experience preferred. Licenses/Certifications: LICENSE AND/OR CERTIFICATION: RHIA, RHIT, or CCS preferred.

Entry level position intended to support the achievement of the goals of the organization and execute essential functions under the close supervision of the Senior MRA/HEDIS Specialist and/or Director of MRA; Identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories. Verify and ensure the accuracy, completeness, specificity and appropriateness of diagnosis codes based on services rendered. Review medical record information to identify all appropriate coding based on CMS HCC categories. Complete appropriate paperwork/documentation/system entry regarding claim/encounter information. Support and participate in process and quality improvement initiatives. PRINCIPLE RESPONSIBILITIES: Review medical record information to identify all appropriate coding based on CMS HCC categories Complete appropriate paperwork/documentation/system entry regarding claim/encounter information Monitor coding changes to unsure that most current information is available Review and prepare charts for affiliates or medical centers Work HCC suspect reports and submit to the Director for review Accurately coding and submitting encounters on a timely basis after supervisor review Due to the nature of this position, it is understood that coding requirements are expected to change; therefore, participation in affiliated classes and individual efforts to maintain current knowledge of these changes is required KEY COMPETENCIES: Builds Trust: Consistently models and inspires high levels of integrity, lives up to commitments and takes responsibility for the impact of one's actions. Pursues Excellence: Seeks out learning, strives to develop and expand personally, and continuously helps others upgrade their capability to contribute to the managed careplan. Executes for Results: Effectively leverages resources to create exceptional outcomes, embraces changes and constructively resolves barriers and constraints. Collaborates: Engages others by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that places the insurance plan and medical center overall success first. EXPERIENCE/SKILL REQUIREMENTS/EDUCATION: At least one of the following: One (1) year prior medical coding and/or billing experience, or Two (2) years prior medical assistant experience, or CPC, CPC-A or CCS-P, CRC Coding Certification, or Pending completion of externship for coding certification Familiar with Microsoft Word and Excel Familiarity with primary care medical charts Strong organization and process management skills Strong collaboration and relationship building skills High attention to detail Excellent written and verbal communication skills Ability to learn new tasks and concepts Healthy Partners 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.

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

At Claremedica, exceptional is the standard. Driven by our purpose to enhance the lives of the seniors in the communities where we have the privilege to work, live, and play, the Claremedica team is comprised of the brightest and best in their fields of expertise. From clinical excellence to unparalleled administrative support and beyond, we're working together to help seniors live happier, healthier, fuller lives. That kind of teamwork and passion for excelling can only exist in a workplace that fosters employees' growth and wellness and where their full potential and value are realized. At Claremedica, we're excited about great people like you. We're even more excited to support you with the resources, training, benefits, competitive compensation, and more to help you thrive and succeed in our communities. Opportunity awaits - welcome to Claremedica. ESSENTIAL FUNCTIONS The Manager of Medical Records and Referrals oversees the integrity, accuracy, and confidentiality of patient health records and referral processes while supporting efficient utilization of healthcare services. This role ensures compliance with HIPAA and other regulatory requirements, leads coordination of medical documentation and referrals and works closely with clinical teams to promote timely, appropriate, and cost-effective care. DUTIES AND RESPONSIBILITIES Oversee the management, storage, and retrieval of electronic and paper medical records. Supervise referral workflows to ensure timely processing of incoming and outgoing referrals. Support utilization review activities, including ensuring referrals and services meet medical necessity requirements. Collaborate with providers and care teams to facilitate accurate clinical documentation and care coordination. Ensure strict adherence to HIPAA regulations and internal confidentiality policies. Develop and enforce protocols for health information documentation, record retention, utilization review, and release of information. Monitor workflow, utilization trends, and performance metrics for medical records and referral operations. Train and mentor staff on best practices for documentation, referral processing, and utilization procedures. Serve as the point of contact for audits, surveys, and compliance reviews related to medical records, referrals, and utilization. Implement and optimize use of electronic medical record (EMR) systems. Identify areas for process improvement and lead initiatives to enhance efficiency, accuracy, and appropriateness of care. Maintain knowledge of relevant laws, standards, and technology related to health information management and utilization. SUPERVISORY RESPONSIBILITIES This position does have supervisory responsibilities. WORKING CONDITIONS General office working conditions. 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 accommodation may be made to enable individuals with disabilities to perform the essential function. While performing the duties of this job, the employee will be required to stand, walk, sit, use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs, balance; stoop, kneel, crouch or crawl; talk or hear. The employee must occasionally lift and or move up to 15 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust your focus. Manual dexterity is required to use desktop computers and peripherals. WORK ENVIRONMENT The work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of his 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. TRAVEL Local travel between care centers may be required for coverage. SAFETY HAZARD OF THE JOB Minimal Hazards Qualifications QUALIFICATIONS/REQUIREMENTS Associate's or Bachelor's degree in Nursing, Health Information Management, Healthcare Administration, or related field required. 3-5 years of experience in medical records management, referrals coordination, utilization review, or health information systems. At least 2 years in a supervisory or management role preferred. Strong knowledge of HIPAA and regulatory requirements related to medical records, utilization review, and referrals. Proficiency with EMR systems (e.g., eClinicalWorks, Epic, or similar). Excellent organizational, analytical, and communication skills. Ability to guide teams, resolve workflow issues, and maintain strong coordination with clinical staff. High attention to detail and strong problem-solving ability. Bilingual in English and Spanish preferred.

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********************************

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********************************

Description: NO WEEKENDS, NO EVENINGS, NO HOLIDAYS We offer competitive pay as well as PTO, Holiday pay, and comprehensive benefits package! Benefits: · Health insurance · Dental insurance · Vision insurance · Life Insurance · Pet Insurance · Health savings account · Paid sick time · Paid time off · Paid holidays · Profit sharing · Retirement plan GENERAL SUMMARY The Coder Certified is responsible for successfully and efficiently coding all cases to the highest level of accuracy to ensure maximum reimbursement. The Coder Certified will ensure quality and productivity standards are met. The Coder Certified will ensure accurate coding of documentation to include diagnoses, procedures, and modifiers with adherence to established coding guidelines for both government and third-party payers. They work with the Coding Supervisor to escalate coding issues and prevent untimely claim submission and denials. Requirements: ESSENTIAL JOB FUNCTION/COMPETENCIES The responsibilities and duties described in this job description are intended to provide a general overview of the position. Duties may vary depending on the specific needs of the affiliate or location you are working at and/or state requirements. Responsibilities include but are not limited to: Reviews chart documentation for accuracy and completeness, identify inconsistencies in chart documentation, and work with appropriate staff and Coding Supervisor to resolve issues. Communicates with Claims Resolution Specialists and Business Office staff when necessary to resolve errors and clarify issues. Demonstrates and use in-depth knowledge of CPT, HCPCS, modifiers, diagnosis codes, insurance coverage plans, medical terminology, and anatomy and physiology. Works collaboratively with providers to obtain complete documentation to support coding. Stays accountable to quality and productivity standards, and monitor compliance with policies and procedures. Identifies process opportunity trends and recommend ways to improve efficiencies. Responsible for maintaining current knowledge of coding guidelines and relevant state and federal regulations. Ensures adherence to third party and governmental regulations relating to coding, documentation, compliance, and reimbursement. Participates in special projects, personal development training, and cross training as instructed. Informs Coding Supervisor of trends, inconsistencies, discrepancies, or payer changes for immediate resolution. Works in conjunction with peers and functional areas of the Coding and Revenue Integrity department for the betterment of completing tasks and the company overall. Performs other position related duties as assigned. Employees shall adhere to high standards of ethical conduct and will comply with and assist in complying with all applicable laws and regulations. This will include and not be limited to following the Solaris Health Code of Conduct and all Solaris Health and Affiliated Practice policies and procedures; maintaining the confidentiality of patients' protected health information in compliance with the Health Insurance Portability and Accountability Act (HIPAA); immediately reporting any suspected concerns and/or violations to a supervisor and/or the Compliance Department; and the timely completion the Annual Compliance Training. CERTIFICATIONS, LICENSURES OR REGISTRY REQUIREMENTS CPC, CCS-P, CMRS or AAPC required. KNOWLEDGE | SKILLS | ABILITIES Demonstrates an understanding of business operations and how individual actions contribute to overall performance. Excellent customer service, verbal, and written communication skills. Knowledge of medical terminology, CPT and ICD coding, and the full revenue cycle process. Familiarity with Electronic Health Record (EHR) systems and Microsoft Office applications. Understanding of Medicare, Medicaid, managed care, and third-party payer guidelines. Knowledge of governmental regulations and healthcare compliance requirements. Strong analytical and problem-solving skills with the ability to draw conclusions and make recommendations. Ability to handle multiple tasks and manage competing deadlines with a high level of accuracy and attention to detail. Capable of developing reports and creating professional presentations. Well-organized and able to maintain confidentiality in handling sensitive information. Self-motivated with a focus on maintaining productivity and efficiency. Ability to work independently and collaboratively across teams and departments. Ability to recognize coding issues and prevent untimely claim submission and denials. EDUCATION REQUIREMENTS High School Diploma or equivalent required. EXPERIENCE REQUIREMENTS At least 3 years experience to successfully perform this job. Entry level Medical Billing and Coding Terminology preferred. Experience in Urology or physician practice environment preferred. REQUIRED TRAVEL N/A PHYSICAL DEMANDS Carrying Weight Frequency 1-25 lbs. Frequent from 34% to 66% 26-50 lbs. Occasionally from 2% to 33% Pushing/Pulling Frequency 1-25 lbs. Seldom, up to 2% 100 + lbs. Seldom, up to 2% Lifting - Height, Weight Frequency Floor to Chest, 1 -25 lbs. Occasional: from 2% to 33%

Miami, FL Onsite / Hybrid options available Full-Time | Contract or Contract-to-Hire TempExperts is seeking an experienced Medical Biller & Coder to support a busy healthcare organization in the Miami area. This role plays a critical part in ensuring accurate coding, timely billing, and efficient reimbursement across multiple payers. The ideal candidate is detail-oriented, organized, and comfortable working in a fast-paced medical environment. Responsibilities Review, code, and submit medical claims using ICD-10, CPT, and HCPCS codes. Ensure accurate and timely billing for physician and/or facility services. Verify insurance coverage, eligibility, and benefits. Resolve claim rejections and denials through follow-up and appeals. Post payments, adjustments, and reconcile EOBs. Maintain compliance with HIPAA and payer regulations. Communicate with insurance carriers, providers, and internal teams as needed. Qualifications 2+ years of experience in medical billing and coding. Strong knowledge of ICD-10, CPT, and HCPCS coding. Experience working with Medicare, Medicaid, and commercial payers. Familiarity with EHR/EMR and medical billing systems. High attention to detail and strong organizational skills. CPC, CCS, or related certification preferred (not required). What's Great About This Opportunity: Stable, long-term opportunity with growth potential. Collaborative and supportive healthcare team. Competitive pay based on experience. Exposure to multiple payers and specialties. Consistent schedule with work-life balance. Pay: Competitive and based on experience

Responsible for the release of information function of the practice by responding to requests of patients, physicians, hospital staff and guests for health information while preserving the confidentiality of patient's protected health information for BHMG facilities. Responsible for all medical records functions for the practice. Functions as main telephone operator for the practice. Works as a team to meet physician practice goals Estimated pay range for this position is $16.00 - $18.30 / hour depending on experience. Degrees: * High School Diploma, Certificate, GED, training or experience required. Additional Qualifications: * Knowledge of medical terminology, clinical chart format and computer skills. * Ability to work in a highly-focused customer service oriented setting with high volume telephone experience. * Excellent communication skills both written and verbal must be attentive to fine details and be a high volume performer with exceptional organizational skills. * Requires typing of 25 wpm and passing a filing test.

Position is fully onsite Monday - Friday, with local travel to medical offices , candidates should have reliable transportation. Mileage for work travel will be reimbursed.Location: 9250 NW 36th St, Miami, FL 33178 Bilingual in English & Spanish Full benefits package offered on the first day of the month following the date of hire including: Medical, Dental, Vision, 401K plan with a 100% company match! Our health plan membership has grown exponentially from 8,950 to over 15,000 members in the last year! Join our winning Solis Team! Position Summary: This position is responsible for coordinating the acquisition of medical records from doctor's offices and hospitals. The coordinator will prepare record requests, conduct outreach, facilitate delivery or retrieval of medical records, validate required information is present in the record and curate the record in a standardized record repository which you will help manage. The Medical Record Coordinator will access internal and external record systems and communicate directly with healthcare professionals to complete assignments. The coordinator will support medical record acquisition for a variety of health plan operations, including risk adjustment and HEDIS/Quality. The position will report to the Director of Risk Adjustment. This is an excellent opportunity for a motivated individual seeking career growth and mentorship in the healthcare industry. You will learn clinical, organizational and health plan operations best practices from industry experts. Essential Functions and Duties: - Responsible for formulating, implementing and executing all medical record program processes, requests, workflows and policies as requested by management in a courteous and efficient manner, including offering a proactive approach to suggestions and recommendations - Prepare medical record request documentation promptly, accurately and completely - Responsible for acquiring medical records from internal and external sources - Outreach to internal and external partners regarding medical record requests, and ensure communications are secure and confidential - Ability to visit medical offices to acquire medical records - Review of medical records acquired and confirm retrieval of required information for assigned members - Resolve retrieval issues - Coordinate with other teams as appropriate, including Risk Adjustment, HEDIS/Quality, Provider Relations, Information Technology, Utilization Management and Care Management - Access and manage Medical Records repository - Develop, monitor and report performance for improvement activities - Escalate issues regarding medical record retrieval to manager as appropriate - Adhere to professional standards, office policies & procedures, federal, state and local regulations - Additional duties as assigned Minimum Job Requirements: - High School graduate or GED equivalent; college degree preferred - Minimum two-years of experience working in a health plan or medical clinic environment supporting medical record management - Willing to travel locally to provider offices Skills and Abilities: - Adhere to company privacy policies and maintain medical information confidentiality - Attention to detail and quick learner - Comfortable learning new technology platforms, specifically electronic medical records, natural language processing and artificial intelligence platforms - Comfortable working on a laptop and Microsoft office suite - Excellent verbal, written communication and interpersonal skills - Courteous and comfortable working in a professional setting - Excellent organizational skills, problem solving, ability to multitask and stay focused in a fast-paced environment Preferred qualifications: · 2+ years of college, in pursuance of a Bachelor's or Associate's degree in Health Care Required Languages: Bilingual English & Spanish