• Auditor-Coding

    Ascension Health (Jacksonville, FL)
    …and ongoing audits of claims to ensure accuracy of coding and billing , and sufficiency of supporting documentation. **Responsibilities:** + Audit specified number of ... records per coder as defined in the system coding audit plan....Develop corrective action plans to address opportunities for coding, billing and documentation improvement. + Identify trends and educational… more
    Ascension Health (03/31/25)
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  • Manager, DRG Coding & Validation (RN) Remote

    Molina Healthcare (FL)
    …MS-DRG, AP-DRG and APR-DRG with a broad knowledge of medical claims billing /payment systems provider billing guidelines, payer reimbursement policies, medical ... (RN) license and Certified Coding Specialist (CCS), (CIC), Certified Professional Coder (CPC) License in good standing and certification current. Registered Health… more
    Molina Healthcare (06/14/25)
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  • Non-Clinical Coding and OASIS Review Manager

    BAYADA Home Health Care (Orlando, FL)
    …it relates to the OASIS and ICD 10 coding while using the Medicare PDGM billing model and CMS guidelines. + Review and communicate OASIS edit recommendations to each ... with regards to CMS guidelines, Home Care Coding, PDGM guidelines and billing related issues. + Provide ongoing communication with service offices via e-mail,… more
    BAYADA Home Health Care (05/17/25)
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  • Clinical Coding and OASIS Review Manager

    BAYADA Home Health Care (Orlando, FL)
    …it relates to the OASIS and ICD 10 coding while using the Medicare PDGM billing model and CMS guidelines. + Review and communicate OASIS edit recommendations to each ... with regards to CMS guidelines, Home Care Coding, PDGM guidelines and billing related issues. + Provide ongoing communication with service offices via e-mail,… more
    BAYADA Home Health Care (05/17/25)
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  • Clinical Fraud Investigator II

    Elevance Health (Tampa, FL)
    …identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to identify opportunities for fraud and abuse ... an Associate Degree in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA) and minimum of 4 years related experience, including… more
    Elevance Health (06/24/25)
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