- Centene Corporation (Tallahassee, FL)
- …requires an RN or LPN license in the candidate's state. **Position Purpose:** Perform clinical/ coding medical claim review to ensure compliance with ... coding practices through a comprehensive review and analysis of medical claims, ...directives, precedent, AMA and CMS code edit criterion + Review medical records to ensure billing is… more
- HCA Healthcare (Jacksonville, FL)
- …coding guidelines and policy + Demonstrates and applies expert level knowledge of medical coding practices and concepts + Participates on special reviews or ... join an organization that invests in you as a Coding Quality Audit Reviewer ? At Parallon, you...Company policy + Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/ medical… more
- Cognizant (Tallahassee, FL)
- …coding , billing, and compliance best practices. - **Support Quality Assurance and Peer Review ** . Perform peer reviews of coding staff to maintain high ... **Experience:** Minimum 5 years of related experience (facility-based auditing and coding experience). **Travel:** None required **About the role:** As an ICD-10… more
- Banner Health (FL)
- …you. **Requirements:** + **5 years recent experience in acute-care Inpatient facility-based medical coding (clearly reflected in your attached resume);** + **DRG ... coding based on documentation for positive outcomes. 5. Performs ongoing audits/ review of inpatient and/or outpatient medical records to assure the use… more
- HCA Healthcare (Miami, FL)
- …coding guidelines and policy + Demonstrates and applies expert level knowledge of medical coding practices and concepts + Participates on special reviews or ... Company policy + Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/ medical...compelling, we encourage you to apply for our Inpatient Coding Auditor opening. We promptly review all… more
- AdventHealth (Orlando, FL)
- …succeed:** **EDUCATION AND EXPERIENCE REQUIRED:** . High school diploma and two years of coding education ( medical coding certificate program or 2-year HIM ... responsible for reviewing, analyzing, and interpreting clinical documentation in the medical record, applying appropriate ICD-10-CM/PCS coding conventions and… more
- Datavant (Tallahassee, FL)
- …role is an opportunity to make a significant impact in the field of medical coding . You will provide essential consulting services and educational support, ... guiding healthcare professionals on improved coding practices. Collaborating closely with key stakeholders such as...strongly encouraged to apply **What You Will Do:** + Review medical records and assign precise codes… more
- Molina Healthcare (FL)
- …build tools, workflow process, training, audits, and production management. * Integrates medical chart coding principles, clinical guidelines, and objectivity in ... performance of medical audit activities. Draws on advanced ICD-10 ...and generate audit letters, train team members. * Manage medical claim review team nurses, ensure operational… more
- Elevance Health (Tampa, FL)
- …documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending physician's ... position will work virtually._ _Alternate locations may be considered._ The **DRG CODING AUDITOR** is responsible for auditing inpatient medical records and… more
- Elevance Health (Miami, FL)
- …benefit of the Company, for all lines of business, and its clients. Specializes in review of DRG coding via medical record and attending physician's ... Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation...Analyzes and audits claims by integrating advanced or convoluted medical chart coding principles (found in the… more
- Insight Global (Miami, FL)
- …Information Management team. The ideal candidate will be responsible for accurately coding inpatient medical records using ICD-10-CM/PCS codes and ensuring ... Global is looking to hire 2 remote Inpatient DRG Coding Specialists for a healthcare provider in the South...reimbursement and supporting quality patient care. Responsibilities include: * Review and analyze inpatient medical records to… more
- Veterans Affairs, Veterans Health Administration (West Palm Beach, FL)
- …experience that indicates knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding , and the structure and format of a health ... review of the patient health record to abstract medical , surgical, ancillary, demographic, social, and administrative data to...courses in medical terminology, anatomy and physiology, medical coding , and introduction to health records);… more
- The Hartford (Lake Mary, FL)
- …regulations including: + Analyzing of bill for proper assignment of detailed medical coding information + Interpreting workers compensation rules for repricing ... Examiner role. Successful candidates will be responsible for performing Medical Bill review and investigation of ... documentation to support billing + Ability to discuss coding to medical providers Qualifications: + Certified… more
- Humana (Tallahassee, FL)
- …In** The Coding Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for ... healthcare? Do you have a solid background in medical auditing, coding ** **,** **and medical record review ?** **If** **you answered** YES **to one or… more
- University of Florida (Gainesville, FL)
- …High school diploma or equivalent and five years of experience in professional medical coding , with experience in two or three clinical specialties. Appropriate ... will have a thorough knowledge of anatomy, surgical and medical terminology coding , a working knowledge of...Surgery including those performed in Gainesville and Halifax Regional Medical Center. Requires review of operative reports… more
- CVS Health (Tallahassee, FL)
- …Coder (CPC) will perform medical claim reviews to ensure compliance with coding practices through a comprehensive record review for medical , behavioral, ... correct coding and appropriate documentation during the review of medical records. The CPC must...Professional Coder (CPC) - 3+ years of experience in medical coding or documentation auditing. - Strong… more
- Elevance Health (Miami, FL)
- …and experience, which would provide an equivalent background. RN, LPN or medical coding certification strongly preferred. **Preferred Skills, Capabilities, and ... system and writes report of the findings of the review and requests payments for any overpayments. + Identifies...Experiences:** + Medical coding certification is highly preferred. +… more
- St. George Tanaq Corporation (Tallahassee, FL)
- …Experience and Skills** + One (1) year of Medicare appeals, medical review , clinical, healthcare regulatory interpretation/application, healthcare compliance or ... Dispute Resolution Reviewer I Fully Remote*GA Job Type Full-time Description...healthcare or related discipline Additional experience in Medicare appeals, medical review , clinical, or other related experience… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …claim disputes including clinical records, itemized bills, prior authorizations, concurrent review , coding guidelines and provider compensation to determine ... Position Purpose: The Clinical Reviewer serves as a subject matter expert in...serves as a subject matter expert in the clinical review of claims, claim disputes, appeals and FWA special… more
- AdventHealth (Altamonte Springs, FL)
- …collaboration with physicians, nursing and HIM coders, the Second Level Reviewer I strategically facilitates and obtains appropriate and quality physician ... complexity of care of the patient. The Second Level Reviewer I educates members of the patient care team...you will bring to the team:** . Reviews concurrent medical record for documentation compliance including completeness and accuracy… more