• Diagnosis Related Group Clinical Validation…

    Elevance Health (FL)
    …Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential ... recognizing aberrant coding and documentation patterns such as inappropriate billing for readmissions, inpatient admission status, and Hospital-Acquired Conditions… more
    Elevance Health (12/09/25)
    - Related Jobs
  • DRG Coding Auditor (ICD-9/10cm, MS-DRG, AP-DRG,…

    Elevance Health (Tampa, FL)
    …Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder . + Requires 5 years of experience working with ICD-9/10CM, ... quality assurance environment preferred. + Broad knowledge of medical claims billing /payment systems provider billing guidelines, payer reimbursement policies, … more
    Elevance Health (12/09/25)
    - Related Jobs
  • Compliance Analyst

    HCA Healthcare (Orange Park, FL)
    …related experience required + Registered Health Information Technician (RHIT) or Certified Professional Coder (CPC) preferred **Parallon** provides full-service ... Healthcare. Our services include scheduling, registration, insurance verification, hospital billing , revenue integrity, collections, payment compliance, credentialing, health information… more
    HCA Healthcare (12/18/25)
    - Related Jobs
  • Clinical Fraud Investigator II - Registered Nurse…

    Elevance Health (FL)
    …Requirements:** + Requires an Associate Degree in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA) and minimum of 4 years ... identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to identify opportunities for fraud and abuse… more
    Elevance Health (12/18/25)
    - Related Jobs
  • Payment Integrity Clinician

    Highmark Health (Tallahassee, FL)
    …Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** + Demonstrated ability ... member satisfaction. Will be expected to identify potential discrepancies in provider billing practices and intervene for resolution and education or if necessary… more
    Highmark Health (11/14/25)
    - Related Jobs