• Manager, DRG Coding & Validation (RN) Remote

    Molina Healthcare (FL)
    …unrestricted Registered Nurse (RN) license and Certified Coding Specialist (CCS), (CIC), Certified Professional Coder (CPC) License in good standing and ... 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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  • 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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  • 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 ... as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to identify opportunities for...our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors… more
    Elevance Health (06/24/25)
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