453 Risk Adjustment Coder jobs in Hialeah,FL

Investigator, Special Investigative Unit Coding-Miami Florida

Molina Healthcare

Miami Gardens, FL 33056

$21.82-$42.55/hr

~ 19 min Onsite

At least 2 years CPT coding experience in a surgical, hospital and/or clinic setting, or equivalent combination of relevant education and experience.
Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Professional Medical Auditor (CPMA), or American Academy of Professional Coders (AAPC) certified
Critical-thinking, problem-solving and analytical skills.
Ability to prioritize and manage multiple tasks.
Ability to work in a team setting.
Strong verbal/written communication skills, and presentation skills.
Microsoft Office suite (including Excel), and applicable software program(s) proficiency.
In some states, 5 years of experience working in a fraud, waste and abuse (FWA)/special investigations unit (SIU)/fraud investigations role may be required (dependent on state/contractual requirements).
Knowledge of investigative and law enforcement procedures with emphasis on fraud investigations.
Knowledge of Managed Care and the Medicaid, Medicare, and Marketplace programs.
Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems.
Ability to research and interpret regulatory requirements.

SmartExplore AI is experimental.

New, Posted 22 hours ago

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CIB - Finance Product Control Vice President

Santander Holdings USA

Miami, FL 33131

~ 21 min Onsite

Bachelor's Degree: Accounting, Finance, Business Administration or equivalent field. - Required.
3+ Years Accounting, Finance, Business Administration or similar field within the Banking or Financial Services Industry - Required.
Advanced accounting practices and procedures, including US GAAP/IFRS and regulatory reporting standards.
Ability to lead, influence and direct peers, subordinates and management.
Ability to make effective decision making on complex matters.
Ability to convey a sense or urgency and drive.
Ability to multi-task and meet strict deadlines.
Ability to handle conflict resolution with other groups (e.g. business units) outside of Corporate Accounting to ensure appropriate accounting guidance is followed.
Ability to adjust to new developments/changing circumstances.
Ability to interact with senior level management; experience interfacing with multiple levels of the organizational structure.
Ability to maintain and report on confidential information in an appropriate manner.
Strong interpersonal, supervisory, and customer service skills required.
Strong attention to details and can analyze information quickly.
Self-directed, self-motivated and demonstrated experience providing ideas and solutions to further business understanding.
Excellent written and oral communication skills.
Excellent analytical, organizational and project management skills.
Results oriented; ability to work efficiently and meet strict reporting deadlines.
CPA : (Certified Public Accountant) - Desirable
Frequent minimal physical effort such as sitting, standing and walking is required for this role. Depending on location, occasional moving and lifting light equipment and/or furniture may be required.

SmartExplore AI is experimental.

New, Posted 5 hours ago

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Quality Control/Finish Plumber

Pioneer 2000 Enterprises

Hialeah, FL

$30-$36/hr

OnsiteFlexible ScheduleHealth Insurance

High school diploma or equivalent
Minimum of 4 years of experience in plumbing with a focus on quality control and finishing
Proven Plumbing Experience: Extensive experience as a plumber, with a solid understanding of plumbing systems, installations, and troubleshooting
Knowledge of Plumbing Codes: Familiarity with local, state, and national plumbing codes, regulations, and safety standards
Certification in plumbing (e.g., Journeyman or Master Plumber) is a plus
Physical Stamina: Ability to work in physically demanding environments, including bending, kneeling, and lifting

SmartExplore AI is experimental.

New, Posted 22 hours ago

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CIB - Finance Product Control Vice President

Santander Holdings USA

Miami, FL 33133

~ 21 min Onsite

Bachelor's Degree: Accounting, Finance, Business Administration or equivalent field. - Required.
3+ Years Accounting, Finance, Business Administration or similar field within the Banking or Financial Services Industry - Required.
Advanced accounting practices and procedures, including US GAAP/IFRS and regulatory reporting standards.
Ability to lead, influence and direct peers, subordinates and management.
Ability to make effective decision making on complex matters.
Ability to convey a sense or urgency and drive.
Ability to multi-task and meet strict deadlines.
Ability to handle conflict resolution with other groups (e.g. business units) outside of Corporate Accounting to ensure appropriate accounting guidance is followed.
Ability to adjust to new developments/changing circumstances.
Ability to interact with senior level management; experience interfacing with multiple levels of the organizational structure.
Ability to maintain and report on confidential information in an appropriate manner.
Strong interpersonal, supervisory, and customer service skills required.
Strong attention to details and can analyze information quickly.
Self-directed, self-motivated and demonstrated experience providing ideas and solutions to further business understanding.
Excellent written and oral communication skills.
Excellent analytical, organizational and project management skills.
Results oriented; ability to work efficiently and meet strict reporting deadlines.
CPA : (Certified Public Accountant) - Desirable
Frequent minimal physical effort such as sitting, standing and walking is required for this role. Depending on location, occasional moving and lifting light equipment and/or furniture may be required.

SmartExplore AI is experimental.

New, Posted 2 hours ago

Easy Apply

Property Director

CROWN RESIDENTIAL LLC

Miami Beach, FL 33141

~ 27 min Onsite

High school diploma or equivalent

SmartExplore AI is experimental.

New, Posted 1 hour ago

Fire Alarm Installation Technician

Pye Barker

Miami, FL 33172

Bilingual Preferred

New, Posted 1 day ago

Easy Apply

RETAIL SALES AND MERCHANDISING ASSOCIATE

Micro Center

Miami, FL 33131

~ 21 min OnsiteFlexible ScheduleEducation AssistanceHealth InsurancePaid Time OffRetirement Benefit

Physical requirements: lift up to 50 lbs., stand for prolonged periods of time

SmartExplore AI is experimental.

New, Posted 18 hours ago

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Senior Health Economics Analyst

ChenMed

Miami, FL 33169

~ 21 min Onsite

Minimum of four (4) years of related experience
Spoken and written fluency in English
This job requires use and exercise of independent judgment
Bachelor's degree: experience may substitute for education on a year-for-year basis above the minimum experience required

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Customer Solutions Representative $17/hr + Commission

Alorica

Hialeah, FL 33012

$17/hr

OnsiteUrgently HiringEducation AssistanceHealth InsurancePaid Time OffRetirement Benefit

High school diploma or GED
Strong computer navigational skills
Solid business and sales knowledge.
Conversational, patient, and confident, with a positive attitude.
Ability to build rapport quickly, overcome objections, and be persuasive to finalize the sale.
Must not be on any corrective action or performance plans
Must have held your current position for 6+ months
Must have relevant industry/program experience

SmartExplore AI is experimental.

New, Posted 22 hours ago

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