- HCA Healthcare (Jacksonville, FL)
- **Description** **Introduction** Do you want to join an organization that invests in you as a Coding Quality Audit Reviewer ? At Parallon, you come first. ... make a difference. We are looking for a dedicated Coding Quality Audit Reviewer...result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to… more
- Elevance Health (Miami, FL)
- …based DRG Coding / Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad, deep and niche knowledge of ... all lines of business, and its clients. Specializes in review of DRG coding via medical record...or appeals may only be reviewed by other DRG Coding Audit Principals (or Executives). **How you… more
- Elevance Health (Tampa, FL)
- …based DRG Coding / Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge of medical claims ... medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review...information to make audit determinations and generate audit findings letters. + Maintains accuracy and quality… more
- Intermountain Health (Tallahassee, FL)
- …creates appeals for all payer and regulatory denials and downgrades and provides in-depth coding review , audit findings, and appeal strategies. + Develops ... **Job Description:** The HIM Coding Audit Training Analyst Coordinator provides...coding patterns and trends. + Participates in hospital quality improvement initiatives to assure accurate reimbursement + Participates… more
- Banner Health (FL)
- …teams with different focuses (Facility vs Profee)._ In this **Inpatient Facility-based HIMS Coding Quality Associate** position, you bring your **5 years of ... team that values growth and development! This is a Quality position, not a day-to-day coding production...audit of clinical documentation to ensure that clinical coding is accurate for proper reimbursement and that … more
- AdventHealth (Altamonte Springs, FL)
- …metrics will be tracked and visualized on shared dashboards to track productivity, review quality audit results, and monitor overall program effectiveness ... Cycle compliance and regulations-specific training for all Revenue Integrity employees (eg, coding bulletins regulation training, quality audit industry… more
- Molina Healthcare (FL)
- …coding principles, clinical guidelines, and objectivity in performance of medical audit activities. Draws on advanced ICD-10 coding expertise, clinical ... **Job Description** **Job Summary** The Manager, Clinical DRG Coding & Validation must have an extensive background in either facility-based nursing and/or inpatient… more
- Datavant (Tallahassee, FL)
- …provide superior quality by performing audits pertaining to risk adjustment coding efforts. The individual will be responsible for daily operations pertaining to ... Management to implement benchmarks, establish acceptable thresholds, and effective quality assurance programs. You will: + Maintain a ...assurance program + Play a key role in ensuring coding compliance and accuracy + Monitor the performance of… more
- Datavant (Tallahassee, FL)
- …+ Provide monthly performance data to clients (eg, volume metrics, six-month trends, quality audit scores, and productivity levels). + Include action plans for ... educational and life experiences to realize our bold vision for healthcare. The ** Coding Operations Manager** is essential to the Provider HIM Coding division.… more
- LogixHealth (Dania, FL)
- …contribute to our fast-paced, collaborative environment and bring your expertise to review reimbursements and issues in Carrier Payment Audits. The ideal candidate ... skills, excellent interpersonal communication, and analytical skills. Key Responsibilities: + Review all insurance company reimbursements in all practices for all… more
- LogixHealth (Dania, FL)
- Location: Onsite in Dania, FL This Role: Oversee open and existing contracts. Review payment issues related to payer contracts working directly with VP, RCM and ... provider lists + Research and resolve contracted payment issues as needed + Review and research payment variance reports + Obtain information requested by management… more
- LogixHealth (Dania, FL)
- …contribute to our fast-paced, collaborative environment and will bring your expertise to review and carry out processes on all out of network claims. The ideal ... communication, and a well-rounded knowledge of insurance payers. Key Responsibilities: + Review , organize, and file IDR emails and complete responses + Monitor and… more
- Elevance Health (Tampa, FL)
- …letters. + Maintains accuracy and quality standards as established by audit management. + Identifies potential documentation and coding errors by recognizing ... the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How...clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding… more
- Datavant (Tallahassee, FL)
- …participant materials + Provide support to client relations for trainings needed for client audit findings + Research and analysis of coding error trends What ... Adjustment Trainer to help us uplevel our Risk Adjustment Coding Department through improving overall coding accuracy...learning to the work environment through various methods + Review client level audits and advise training content to… more
- AdventHealth (Altamonte Springs, FL)
- …and in collaboration with physicians, nursing and HIM coders. The CDI Quality & Compliance Team Leader strategically facilitates and obtains appropriate and ... quality physician documentation for any clinical conditions or procedures...Stewardship, and Teamwork + Completes accurate and timely record review to ensure the integrity of clarification compliance for… more
- Intermountain Health (Tallahassee, FL)
- …and payor guidelines, and ensures consistent and compliant application with charge/ coding capture, charge editing, and audit and reimbursement practices. ... Intermountain's policies and procedures. **Essential Functions** 1.Analyze data, develop reports, review trends, and recommend enhancements as defined by the RI… more
- CHS (Clearwater, FL)
- …Manager of Quality to implement appropriate standards for accuracy and audit procedures intended to validate those standards are met. This includes setting ... random audit percentages for Examiners reflecting experience and historical quality results. It will also include development of coaching and training programs… more
- Datavant (Tallahassee, FL)
- …KPIs such as suspecting accuracy, chart throughput, RAF impact, data latency, coding quality metrics, and client engagement. **Cross-Functional Collaboration** + ... the development of robust, scalable, and actionable analytics that improve coding outcomes, measure product impact, and support value-based client delivery across… more
- MyFlorida (Tallahassee, FL)
- …Profile (application) must be complete in its entirety. + Work History (in easy to review chronological order) Consists of: + Any position held by a State of Florida ... your packet may be held up at the final review step. NOTE: Responses to qualifying questions must be...This requires separation of reimbursement requests by division, proper pre- audit of all travel elements, recalculation of amounts to… more
- Sumitomo Pharma (Tallahassee, FL)
- …Characteristics (SmPC), and Canadian Product Monograph (PM) + Ensures timely and quality review and assessment of ICSRs, including seriousness, expectedness, ... safety narratives, adverse event coding , concomitant medication coding , and causality statements....study team meetings and governance committees. + Performs aggregate review of post-marketing safety data in support of safety… more