- CDM Smith (Orlando, FL)
- …**Business Unit:** FSU **Job Description:** CDM Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical ... in evaluating and analyzing financial data related to disaster-related claims , including property damage, business interruption, and other loss categories. The … more
- MyFlorida (Fort Pierce, FL)
- CONSTRUCTION MANAGER - 55012386 Date: Sep 3, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 859988 Agency: Department of Transportation Working Title: CONSTRUCTION MANAGER - 55012386 Pay Plan: SES Position Number: 55012386 Salary: $97,495.12… more
- Elevance Health (Tampa, FL)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all...Health Information Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder. +… more
- Molina Healthcare (Tampa, FL)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... SAI targets are met. + Leads efforts to improve claim payment accuracy and financial performance without needing extensive...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more
- Molina Healthcare (Tampa, FL)
- …+ Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management ... of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of… more
- Highmark Health (Tallahassee, FL)
- …and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting ... and research related to special projects and providing coverage for coding manager (s). (10%) + Depending on location provides or arranges for education/training of… more
- University of Miami (Medley, FL)
- …work in Miami, FL. Under the general direction of the Outpatient Coding Manager , the Outpatient Coder 3 reviews documentation in the electronic medical record (EMR) ... query response, ADT correction. + Daily review of OP Claim edit. + Able to code Ambulatory Surgery, Infusion,...that have been assigned by the coding supervisor or manager . + Check email often for any correspondence coming… more
- Elevance Health (FL)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- University of Miami (Hialeah, FL)
- …misplaced documentation; promptly reports findings to the Professional Coding Manager . + Assesses documentation and/or queries physician for additional information ... + Identify compliance or coding issues to management + Process Charge Review and Claim Edits + Adhere to departmental coding goals established by site + Complete… more
- University of Miami (Medley, FL)
- …III to work remotely. Under the general direction of the Inpatient Coding Manager , the Inpatient Coder III reviews documentation in the electronic medical record ... that have been assigned by the coding supervisor or manager . + Check IP Uncoded Cardiovascular Special Procedures work...highest dollar utilizing the get next feature. + Work claim edits and review accounts from hospital billing. +… more