• DRG Coding Auditor

    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 (06/24/25)
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  • Manager, DRG Coding & Validation (RN) Remote

    Molina Healthcare (FL)
    …Registered Nurse (RN) license and Certified Coding Specialist (CCS), (CIC), Certified Professional Coder (CPC) License in good standing and certification ... MS-DRG, AP-DRG and APR-DRG with a broad knowledge of medical claims billing /payment systems provider billing guidelines, payer reimbursement policies, medical… 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 ... service. + Provide customer service/education and act as a resource to Medicare Certified Offices with regards to CMS guidelines, Home Care Coding, PDGM guidelines… more
    BAYADA Home Health Care (05/17/25)
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  • Clinical Coding and OASIS Review Manager

    BAYADA Home Health Care (Orlando, FL)
    …OASIS Review, Utilization Review, Quality Assurance, Remote, Home Health Coding, Coder , Medicare **As an accredited, regulated, certified , and licensed ... and ICD 10 coding while using the Medicare PDGM billing model and CMS guidelines. + Review and communicate...customer service/education and act as a resource to Medicare Certified Offices with regards to CMS guidelines, Home Care… more
    BAYADA Home Health Care (05/17/25)
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  • Revenue Integrity Analyst II

    Intermountain Health (Tallahassee, FL)
    **Job Description:** This position is responsible for billing , follow-up, and resolving issues that delay or prevent payment of the patient's account within ... years of prior experience leading others or leading project or programs. Certified Revenue Cycle Representative (CRCR) Certification completed within 3 months of… more
    Intermountain Health (06/27/25)
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  • Clinical Fraud Investigator II

    Elevance Health (Tampa, 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 (06/24/25)
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