• Medical Claims Specialist - Remote

    Rising Medical Solutions (Tampa, FL)
    …Associate's or Bachelor's degree preferred + CPC (Certified Professional Coder ), CCS (Certified Coding Specialist) or equivalent medical coding certification ... insurance or healthcare experience, preferably in claims or medical billing -related position(s) Skills/Competencies + Knowledge of Group Health Insurance, Workers'… more
    Rising Medical Solutions (09/27/25)
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  • Claim Field Analyst (Tampa/Orlando, Florida)

    CVS Health (Tallahassee, FL)
    …and claim trainings to improve provider claims issues. as well as billing practices, while collaborating with internal and/or external departments to identify claim ... educations, review claim trends, and ensure understanding of Aetna Medicaid claim and billing policies and procedures. This person is expected to spend 70% of their… more
    CVS Health (09/24/25)
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  • Sr. Patient Accounts Representative (H)

    University of Miami (Miami, FL)
    …appropriately. The Senior Patient Accounts Representative uses advanced knowledge of billing procedures and coding expertise to assist management in the training ... any errors, and researches coverage policies. + Assists patients with insurance and billing questions. + Sets up budget plans on outstanding accounts, mails copies… more
    University of Miami (09/13/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Tampa, FL)
    …necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical ... an appeal has been submitted, to ensure medical necessity and appropriate/accurate billing and claims processing. + Identifies and reports quality of care issues.… more
    Molina Healthcare (09/06/25)
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  • Inpatient Audit Specialist

    Datavant (Tallahassee, FL)
    …for reviewing records via client's auditing tool, updating coding and submitting for billing . Evaluator experience a plus. **What You Will Do:** + Performs Inpatient ... to ensure optimal workflow and turnaround time + Provides coder education via the auditing process + Function in...via client's auditing tool, updating coding and submitting for billing . Evaluator experience a plus. + 5+ years of… more
    Datavant (10/04/25)
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  • Coding Quality Education Manager

    AdventHealth (Altamonte Springs, FL)
    …This position is responsible for the Retrospect Review program, quality audits, coder education and operates in accordance with the requirements of the ICD-10-CM ... processes. + Supports organizational efforts in coding, documentation improvement and billing accuracy. + Validates and ensures departmental metrics and productivity… more
    AdventHealth (09/13/25)
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  • Supervisor, Coding

    Baylor Scott & White Health (Tallahassee, FL)
    …to meet daily un-coded accounts receivable. + Is a resource for resolving billing edits using the National Correct Coding Initiative and Local and National Coverage ... Determinations. Facilitates billing issues with Physician Fee Schedules (PFS) and informs...Certified Coding Specialist-Physician Based (CCS-P), or + Certified Professional Coder (CPC), or + Reg Health Info Administrator (RHIA),… more
    Baylor Scott & White Health (09/10/25)
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  • Clinical Fraud Investigator II - Registered Nurse…

    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 (10/03/25)
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  • APC Coordinator Virtual

    AdventHealth (Maitland, FL)
    …resolution of accounts discharged but not final billed and ensure we are billing clean claims. The APC Coordinator will assist in overseeing the outpatient coding ... + Registered Health Information Technician (RHIT) - Cert Required + Certified Professional Coder (CPC) + Certified Coding Specialist (CCS) This facility is an equal… more
    AdventHealth (10/02/25)
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  • Senior Analyst, Encounters

    Molina Healthcare (St. Petersburg, FL)
    …GED **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : + 5-7 years of experience in billing , claims, encounters, and data analysis + 5 years or more of managed ... multiple organizations **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION** : + Certified Professional Coder (CPC) To all current Molina employees: If you are… more
    Molina Healthcare (09/24/25)
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