Jobs in Lakeland, Florida | December 2024 Opportunities

A career at Auto-Owners is challenging and rewarding. Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs.We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team.Auto-Owners Insurance, a top-rated insurance carrier, is seeking an experienced and motivated Claims Investigator professional to join our Special Investigation unit. The position requires the following, but is not limited to:Become familiar with the specialized investigation of claimsMeet with people involved with claims. This may be outside our office environment.Increased role as a trainer/resource for branch associates in the Claims Department.Develop and present educational materials to claim associates that focus on fraud awareness/investigation.Desired Skills & ExperienceBachelor’s degree or equivalent experienceAbility to handle conflict comfortableField Claim Rep with Auto and Field experience preferredAbility to read, interpret and react to documents such as insurance policies, procedures manuals, and legal documents.Able to assemble information, develop opinions and clearly express decisions using sound reasoning and judgment.Ability to write reports and compose correspondence.Ability to communicate, both verbally and in writing, and possess good problem resolution skills and good interpersonal skills.Able to accurately deal with mathematics and financial areas and develop an understanding of personal and business finance documents.Can tactfully and effectively deal with all types of people.Able to drive an automobile, possess a valid driver license, and maintain a driving record consistent with the Company’s underwriting guidelines for coverage.Ability to organize assigned work.Ability to maintain a professional image.BenefitsAuto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you!Equal Employment OpportunityAuto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law.*Please note that the ability to work in the U.S. without current or future sponsorship is a requirement.

Position DetailsLakeland 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 OffWork Hours per Biweekly Pay Period: 80.00Shift: Flexible Hours and/or Flexible ScheduleLocation: 210 South Florida Avenue Lakeland, FL Pay Rate: Min $24.73 Mid $30.92Position SummaryUnder the direction of the Coding and Clinical Documentation Improvement Manger , 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 ResponsibilitiesPeople At The Heart Of All That We DoFosters 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 ImprovementBehaves 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.StewardshipDemonstrates responsible use of LRH's resources including people, finances, equipment and facilities.Knows and adheres to organizational and department policies and procedures.People At The Heart Of All We DoFosters 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 ImprovementBehaves 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.Standard Work Duties Determines whether the coding assigned was properly assigned based upon clinical indicators and review of the medical documentation and application of coding guidelines.Develop and apply appeal arguments to defend the coding and clinical decisions while being able to address and refute the coding determination made by the carrier/payer.Drafts appeal letters, including the coding argument with clinical and coding references, to support the coding decision. This may include providing additional medical record documentation.Identifies areas for education to improve complete and accurate coding and billing and provide feedback to management regarding trends or patterns noticed in the coding for discussion.Continued follow-up on denials as payers may continue to deny. Collaboration with Physician Advisor as required to continue appeal process.Continuously reviews changes in coding rules and regulations including in Coding Clinic, CMS, and other payer guidelines.Complete denials/appeals reports for leadership.Documents all findings in the denials management application and routes to the appropriate person in the workflow for follow-up.Assigns and sequence documents all findings in the denials management application and routes to the appropriate person in the workflow for follow-up.s diagnostic and procedural codes using appropriate classification systems utilizing official coding guidelines.Performs special projects and/or other duties as assigned.Competencies & SkillsNonessential: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 supervisionMS-DRG and APR-DRG methodology expertise required. Strong knowledge of ICD-10-CM, ICD-10-PCS, POAs, HACs, PSIs, SOIs, ROMs and mortality rates as well as physician queries.Qualifications & ExperienceNonessential:Associate DegreeEssential:High School diploma with Associate Degree from accredited HIM program or certificate in coding from an accredited college.Other information:Certifications Essential: CCSCertifications Preferred: Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).Experience:Essential: 2-5 years acute care hospital inpatient coding experience within the past five years.