• Coding Specialist Rapid

    AdventHealth (Altamonte Springs, FL)
    …Administrator (RHIA) + Registered Health Information Technician (RHIT) - Cert Required + Certified Billing and Coding Specialist (CBCS) + Certified Pension ... of the Outpatient Coding Operations manager, the Rapid In & Out Coder is responsible for reviewing, analyzing, and interpreting clinical documentation contained in… more
    AdventHealth (10/03/25)
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  • 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 (11/12/25)
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  • Medical Review Nurse (RN)

    Molina Healthcare (FL)
    …Office suite and applicable software program(s) proficiency. **PREFERRED QUALIFICATIONS:** + Certified Clinical Coder (CCC), Certified Medical Audit ... or is likely to be made, to ensure medical necessity and appropriate/accurate billing and claims processing. + Reevaluates medical claims and associated records by… more
    Molina Healthcare (09/06/25)
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  • 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 (10/25/25)
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  • Claim Field Analyst (Tampa, Florida)

    CVS Health (Tallahassee, FL)
    …skills. + Regular and reliable attendance. + Associate's or Bachelor's degree. + Certified Professional Coder ( _CPC_ ) certification. **Education** + High ... and claim trainings to improve provider claims issues. as well as billing practices, while collaborating with internal and/or external departments to identify claim… more
    CVS Health (11/05/25)
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  • Director, Clinical Data Acquisition

    Molina Healthcare (Jacksonville, FL)
    …Health Quality (CPHQ) * Nursing License (RN may be preferred for specific roles) * Certified Risk Adjustment Coder (CRC) To all current Molina employees: If you ... projects, and other state specific audit projects and deliverables related to accurate billing and coding. This role also works with the Health Plan Risk/Quality… more
    Molina Healthcare (10/22/25)
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  • Ambulatory Payment Classification Coordinator

    AdventHealth (Maitland, FL)
    …Administrator (RHIA) + Registered Health Information Technician (RHIT) - Cert Required + Certified Professional Coder (CPC) + Certified Coding Specialist ... 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… more
    AdventHealth (10/02/25)
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  • 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)
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  • Clinical Fraud Investigator II - Registered Nurse…

    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 (11/04/25)
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  • Supervisor Medical Coding

    CenterWell (Tallahassee, FL)
    billing and coding experience in a health care organization + CPC ( Certified Professional Coder ) Certification required through AAPC or CSS Certification ... through AHIMA **Preferred Qualifications** + Prior Supervisor experience + Passionate about contributing to an organization focused on continuously improving customer experience **Additional Information** + Position is remote but travel will be required; <25%… more
    CenterWell (10/31/25)
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