• Perform internal quality reviews for inpatient and outpatient coding across multiple Health Information Management Service Centers (HSCs). • Audit medical records to ensure coding accuracy, completeness, and compliance with MS-DRG and national standards. • Provide feedback, coaching, and documentation support to coders to improve performance and maintain consistency. • Participate in special review projects and policy-driven audit initiatives. • Maintain productivity and accuracy rates of at least 95%. • Keep coding knowledge current by reviewing official data quality standards, coding guidelines, and policy updates. • Support adherence to internal and external compliance requirements for data and reimbursement accuracy.

Role Description We are seeking a detail-oriented and adaptable Medical Billing & Coding Specialist to support the administrative and revenue cycle operations of a growing healthcare practice. This role is ideal for someone with strong experience in medical billing, coding, and healthcare documentation, particularly within a primary care setting. The successful candidate will play an important role in ensuring accurate coding, reimbursement optimization, and overall financial health of the practice. As the clinic continues to grow, we are looking for someone who is flexible, proactive, and willing to take on new responsibilities as operational needs evolve. The ideal candidate thrives in a dynamic healthcare environment, maintains a high level of accuracy, and is committed to supporting both patients and providers through efficient administrative processes. Responsibilities - Medical Coding: - Assign and review appropriate diagnosis and procedure codes - Ensure coding accuracy and compliance with payer requirements - Support providers with documentation-related coding questions - Assist in maintaining coding standards and best practices - Insurance & Revenue Cycle Support: - Verify insurance information and patient eligibility - Assist with claim corrections, resubmissions, and appeals when necessary - Help optimize reimbursement and reduce claim denials - Maintain compliance with healthcare billing and coding regulations - Administrative & Operational Support: - Support general healthcare administrative workflows as needed - Assist with documentation and record management - Adapt to changing responsibilities as the clinic continues to grow - Collaborate with providers and team members to improve operational efficiency Top 3 Priorities - Medical Coding Accuracy: Ensure diagnosis and procedure codes are assigned accurately and consistently while maintaining compliance with industry standards and documentation requirements. - Clinical Documentation Integrity: Maintain complete, organized, and accurate clinical records that support coding accuracy, provider documentation, and quality patient care. - Adaptability & Practice Support: Provide flexible support across coding and administrative functions while helping a growing healthcare practice operate efficiently. Qualifications - Previous experience in medical billing and coding is required - Strong understanding of ICD-10, CPT, and HCPCS coding systems - Experience reviewing clinical documentation and assigning accurate diagnosis and procedure codes - Ability to identify coding discrepancies, documentation gaps, and compliance concerns - Strong understanding of healthcare reimbursement processes and claims management - Experience working with insurance companies and payer guidelines - Strong attention to detail and commitment to accuracy - Prior experience working with primary care practices is strongly preferred - Familiarity with family medicine, internal medicine, preventive care, chronic disease management, and routine outpatient visits - Understanding of Evaluation and Management (E/M) coding guidelines and documentation requirements - Ability to review medical records and ensure documentation supports coding decisions - Familiarity with healthcare compliance standards and coding best practices - Experience collaborating with providers to improve documentation quality - Strong computer proficiency and ability to learn new systems quickly - Excellent organizational and time-management skills - Ability to manage multiple priorities in a fast-paced environment - Comfortable adapting to changing workflows and responsibilities - Excellent written and verbal English communication skills - Ability to communicate professionally with providers, clinical staff, and administrative team members - Strong problem-solving, analytical, and critical-thinking skills Ideal Candidate Profile - Detail-oriented and highly accurate - Adaptable and flexible in a growing practice environment - Reliable, accountable, and self-motivated - Organized and process-driven - Comfortable working independently while collaborating with a team - Proactive in identifying opportunities for improvement - Committed to maintaining confidentiality and compliance standards - Eager to learn, grow, and contribute to the long-term success of the practice Requirements - Must be proficient in speaking and writing English very clearly - Must have relevant work experience - Be able to submit an NBI clearance and/or Local Police Clearance background check before onboarding [mandatory] - Must be available for video meetings with your camera on (when needed) Technical Requirements - Device: Reliable laptop or desktop computer. - Internet: High-speed connection (minimum 25 Mbps). - Audio: Noise-canceling headset. - Video: Webcam for virtual meetings. - Workspace: Quiet, professional environment. Benefits - Dedicated HR & Contractor Support Team: Access to world-class support for questions, guidance, contract matters, and client communication. - Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks. - HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients. - Top 1% VA Performance Training: Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention. - Client-Approved U.S. Holidays: Contractors may take U.S. holidays off according to the client’s needs and schedule. - Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client. Paid time off is optional and only if offered by the client. - Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best. - Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on your performance.

Role Description We are seeking a highly analytical and detail-oriented Denials Specialist to join our team. This role is responsible for managing and resolving denied claims through in-depth investigation, payer communication, and cross-functional collaboration. Unlike traditional denial roles, this position requires strong critical thinking skills, as claims are processed outside of standard CPT billing and heavily managed through Excel-based workflows. The ideal candidate is proactive, tech-savvy, and skilled in building relationships with payer contacts to drive successful claim resolution. Key Responsibilities - Review and analyze denied claims by accessing payer and claims portals (e.g., Athena and payer-specific systems) - Identify root causes of denials, including copays, deductibles, coding issues, or service discrepancies - Categorize denied and unpaid claims into appropriate buckets based on denial reason - Collaborate with internal Revenue Cycle Specialists to research, correct, and resolve claim issues - Resubmit corrected claims to payers in a timely and accurate manner - Maintain detailed tracking and reporting of denials using Excel and Google Sheets - Communicate directly with payer representatives to resolve issues and prevent future denials - Continuously identify trends and opportunities to improve denial resolution processes Qualifications - Minimum 6 months to 3 years of denials management experience within a provider-side environment - Proven ability to independently investigate and resolve claim denials end-to-end - Experience using payer portals to review denial reasons, pull reports, and resubmit claims - Strong analytical and critical thinking skills; able to diagnose issues and determine solutions - Advanced proficiency in Excel and/or Google Sheets (sorting, filtering, formulas required; pivot tables and VLOOKUP preferred) - Comfortable working on a Mac operating system with dual monitors - Excellent communication and relationship-building skills, particularly with external payer contacts - Highly organized with the ability to manage multiple priorities Requirements - Fully remote position (exclusions apply) - Must maintain a HIPAA-compliant workspace, including: - Private, secure work environment - No other individuals present during working hours - Secure internet connection - Equipment Requirements (employee-provided): - Dual monitors - Mac-compatible wireless keyboard and mouse Schedule - Training Period (Approx. 4 Weeks): - Part-time hours - Start time: 8:00 AM MST - Schedule may adjust based on performance - Post-Training: - Full-time hours - Schedule must fall between 7:00 AM – 5:00 PM MST - No overtime permitted Compensation - $22/hour for candidates with 6 months experience - Up to $25/hour for candidates with up to 3 years of experience Location Restrictions Candidates must reside in eligible states. We are unable to hire in the following locations: - Alaska - Arkansas - Delaware - Hawaii - Maine - Mississippi - New Mexico - Oklahoma - Puerto Rico - South Dakota - Vermont - Wisconsin Employment Type Open-ended contract What Sets This Role Apart This is not a traditional denials role. Success in this position requires: - Deep analytical thinking beyond surface-level claim review - Strong collaboration across internal and external stakeholders - Comfort working in non-traditional billing structures with data-heavy workflows Pay and Benefits The pay range for this position is $22.00 - $25.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: - Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Jul 3, 2026.

Role Description The University of Miami/UHealth Department Health Information Management has an exciting opportunity for a full-time Outpatient Coder 3 to work in Miami, FL. Under the general direction of the Outpatient Coding Manager, the Outpatient Coder 3 reviews documentation in the electronic medical record (EMR) and assigns and sequences ICD-10-CM diagnosis codes and CPT procedure codes in accordance with national coding guidelines. The primary focus of this role is to capture all encounter specific diagnoses and procedure codes for accurate reimbursement, data collection, and research purposes. - Review, analyze, and interpret the entire electronic medical record (EMR) to identify all diagnoses and procedures documented during a patient’s admission. - Reviews documentation and reaches out to physicians for additional information when information for proper coding is missing or incomplete. - Assigns codes to outpatient records for use in reimbursement and data collection. - Complies with policies and procedures and maintains confidential patient records. - Reports unusual circumstances, risk factors, errors, and discrepancies to management. - Consistently maintain coding accuracy and productivity standards of ≥ 95%. - Adheres to University and unit-level policies and procedures and safeguards University assets. Qualifications - High School Diploma or equivalent. - Minimum 5 years of current ICD-10 and CPT outpatient coding experience required. - Certified Professional Coder (CPC), Certified Coding Specialist (CCS), CIRCC OR Registered Health Information Technician (RHIT). - Skill in completing assignments accurately and with attention to detail. - Understanding of and adherence to the Health Insurance Portability and Accountability Act (HIPAA). - Commitment to the University of Miami Health System policies and procedures. - Must stay up to date with continuing education requirements to maintain credentials. - Ability to work independently and/or in a collaborative environment. - Background in use of encoder, computer assisted coding, and EMR software applications. - Efficient communication skills (interpersonal, verbal, and written). - Strong organizational and analytical skills. - Demonstrate critical thinking skills, and ability to interpret, assess, and evaluate provider documentation. - Proficient with Microsoft Office applications. - Ability to sit for long periods of time. - Capable of working in a 100% remote environment with little supervision, while also staying focused on assignment tasks. - Any appropriate combination of relevant education, experience and/or certifications may be considered. Benefits - Competitive salaries. - Comprehensive benefits package including medical, dental, tuition remission, and more.