• Inpatient DRG Reviewer

    Zelis (FL)
    …gained, and the personal interests that shape who you are. Position Overview The Inpatient DRG Reviewer will be primarily responsible for conducting ... post-service, pre-payment and post pay comprehensive inpatient DRG reviews based on...Clinic and client specific coverage policies. Conduct prompt claim review to support internal inventory management to achieve greatest… more
    Zelis (09/27/25)
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  • Inpatient Medical DRG Coder…

    Cognizant (Tallahassee, FL)
    **Job Title: Inpatient Medical DRG Coder - Hospital (Remote)** **Location:** [Remote] **Employment Type:** [Full-time] M-F flexible hours A ** DRG coder** is ... a medical coding professional who specializes in assigning **Diagnosis-Related Group ( DRG )** codes for inpatient hospital stays. DRG (Diagnosis-Related… more
    Cognizant (10/04/25)
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  • Inpatient Coding Quality Auditor

    HCA Healthcare (Orange Park, FL)
    …**This is a fully work from home position.** **This position requires Inpatient Coding and DRG Validation Experience.** **Schedule: Monday-Friday Day Shift** ... If you find this opportunity compelling, we encourage you to apply for our Inpatient Coding Quality Auditor opening. We promptly review all applications. Highly… more
    HCA Healthcare (09/27/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Tampa, FL)
    …Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP- DRG and APR- DRG )** is responsible for auditing inpatient medical records to ensure clinical ... documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group ( DRG ) paid claims. **How you will make an… more
    Elevance Health (09/23/25)
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  • Coding Quality Audit Reviewer

    HCA Healthcare (Orange Park, FL)
    …fully remote/work from home!** **Schedule: Monday-Friday Day Shift** **Must have DRG Validation experience and Inpatient Coding experience** **Benefits** ... that invests in you as a Coding Quality Audit Reviewer ? At Parallon, you come first. HCA Healthcare has...**Job Summary and Qualifications** As a work from home Inpatient Coding Auditor, you will be responsible for performing… more
    HCA Healthcare (09/27/25)
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  • Medical Records Tech (Clinical Documentation…

    Veterans Affairs, Veterans Health Administration (Tampa, FL)
    …diagnoses and significant procedures to accurately reflect the patient's hospital course and DRG assignment in the inpatient setting and to accurately reflect ... setting. Responsible for reviewing the overall quality and completeness of clinical documentation. Inpatient CDI focuses on the concurrent review of inpatient more
    Veterans Affairs, Veterans Health Administration (10/10/25)
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  • Medical Records Technician (Coder - Outpatient…

    Veterans Affairs, Veterans Health Administration (Tampa, FL)
    …complication or comorbidity (CC/MCC) and POA indicators to obtain correct MS- DRG . Medical Records Technician (Coder-Outpatient and Inpatient ), GS-7 Experience. ... ICD-10-CM, ICD-10-PCS, CPT, and HCPCS classification systems to both inpatient and outpatient records. Inpatient duties consist... duties consist of the performance of a comprehensive review of documentation within the health record to assign… more
    Veterans Affairs, Veterans Health Administration (10/08/25)
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  • Inpatient Medical Coding Auditor

    Humana (Tallahassee, FL)
    …you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in ... a part of our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records… more
    Humana (09/24/25)
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  • Facility Inpatient Coding Specialist

    HCA Healthcare (Ocala, FL)
    …organizations. Apply Today! **Job Summary and Qualifications** As a work from home Inpatient Coding Specialist, you will review and evaluate hospital ... and ICD-10- PCS codes. You will perform coding and/or code/ DRG validation across multiple entities. **What you will do...personal growth, we encourage you to apply for our Inpatient Coding Specialist opening. We promptly review more
    HCA Healthcare (09/27/25)
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  • Coding Auditor Inpatient

    AdventHealth (Orlando, FL)
    …Under the general supervision of the Coding Quality Manager, the Data Quality Reviewer is responsible for validating the coding performed by inpatient or ... + Performs quality reviews on coded records to validate ICD-10, ICD-10-PCS, MS- DRG , APR-DRGs, and overall coding accuracy retrospectively and concurrently. + May… more
    AdventHealth (09/11/25)
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  • Inpatient Audit Specialist

    Datavant (Tallahassee, FL)
    …on medical records, utilizing ICD-10-CM, CPT, and appropriate coding references for accurate DRG and APC assignment. + Review non-CC/MCC records to assess proper ... to realize our bold vision for healthcare. As an ** Inpatient Auditing Specialist** you will be instrumental in addressing... by the facility or CCS HIM director. + Review disagreements on APC/ DRG changes with the… more
    Datavant (10/09/25)
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  • Remote Senior Inpatient Coding Specialist

    AdventHealth (Orlando, FL)
    …and 125,000 outpatients each year **The role you'll contribute:** The Inpatient Coder is responsible for reviewing, analyzing, and interpreting clinical ... the medical record, applying appropriate ICD-10-CM/PCS coding conventions and MS- DRG Medicare Prospective Payment System requirements. Actively participates in… more
    AdventHealth (09/06/25)
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  • Inpatient Medical Coder - FT - Up to $5,000…

    Datavant (Tallahassee, FL)
    …for healthcare. **What We're Looking For** We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal ... coding accuracy rate and a 95% accuracy rate for MS- DRG assignments + Maintain site-specific productivity benchmarks + Foster...to Succeed:** + A minimum of 3 years of inpatient coding facility experience + CCS, RHIT, or RHIA… more
    Datavant (09/24/25)
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  • Senior Inpatient Coding Specialist

    AdventHealth (Orlando, FL)
    …and 125,000 outpatients each year **The role you'll contribute:** The Inpatient Coder is responsible for reviewing, analyzing, and interpreting clinical ... the medical record, applying appropriate ICD-10-CM/PCS coding conventions and MS- DRG Medicare Prospective Payment System requirements. Actively participates in… more
    AdventHealth (08/07/25)
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  • Inpatient Medical Coding Auditor

    Cognizant (Tallahassee, FL)
    …and work collaboratively with stakeholders and teams. **In this role, you will:** + Review ICD-10 inpatient patient records for accuracy and compliance + ... **About the role** As an Inpatient Medical Coding Auditor, you will make an...+ CCS, RHIT or RHIA (AHIMA) certification + APR DRG experience + Minimum of five years of facility-based… more
    Cognizant (09/23/25)
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  • Facility Outpatient Coder Team Lead

    HCA Healthcare (Fort Pierce, FL)
    …incentive plan driven, customer needs, identified trends, RAC, payer, etc.) for inpatient and/or outpatient coding (eg, DRG /code validation, query validation) + ... feedback and education as it relates to coding opportunities found during the review of accounts + Ensures rebill requests are entered timely through the… more
    HCA Healthcare (09/27/25)
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  • Coding Quality Auditor

    Houston Methodist (FL)
    …accuracy in code assignment of diagnosis and procedure to outpatient and/or inpatient encounters based upon documentation within the electronic medical record while ... rules and regulatory body guidelines. This position performs data quality review to ensure data integrity, coding accuracy, and revenue preservation. Additional… more
    Houston Methodist (10/10/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Tampa, FL)
    …Complex Claim review including DRG Validation, Itemized Bill Review , Appropriate Level of Care, Inpatient Readmission, and any opportunity identified ... set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience,… more
    Molina Healthcare (09/06/25)
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  • Physician Advisor

    AdventHealth (Orlando, FL)
    …health professionals. Maintains a positive and supportive relationship between the inpatient facilities, payors and physicians (hospitalist groups and primary care ... clinical language, coding guidelines, severity of illness, risk of mortality and DRG assignment. Explain importance of correct disease reporting and ICD code capture… more
    AdventHealth (09/04/25)
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  • Physician Advisor

    AdventHealth (Orlando, FL)
    …managed care payers. The PA role is responsible for providing physician review of utilization, claims management, and quality assurance related to inpatient ... to the team:** + SCOPE OF RESPONSIBILITY: Responsible for reviewing and authorizing inpatient days and the evaluation of inpatient utilization patterns within… more
    AdventHealth (09/24/25)
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