• Facility Coding Inpatient DRG Quality

    Banner Health (FL)
    …coding expertise to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials utilizing ... of clinical documentation and correctness of billing codes prior to claim submission; to identify possible opportunities for improvement of clinical documentation… more
    Banner Health (09/06/25)
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  • Eligibility Analyst

    Prime Therapeutics (Tallahassee, FL)
    …This role is responsible for mentoring and training the Eligibility Specialist . **Responsibilities** + Serves as subject matter expert representing eligibility on ... execution + May manage Medicaid subrogation activities including monitoring batch claim files, outgoing eligibility files, verification of letters of authority and… more
    Prime Therapeutics (09/05/25)
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  • Employee Relations Consultant-SES

    MyFlorida (Tallahassee, FL)
    …Office of Workforce Management Employee Relations Consultant (Human Resource Specialist /LR - SES) Tallahassee This position was previously advertised. Applicants ... and job aids. + Investigates and responds to reemployment assistance (RA) claim notices, information requests, and wage audits; participates in RA appeal hearings… more
    MyFlorida (09/03/25)
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  • Medical Billing /Payroll _ Home Care

    BrightStar Care (Naples, FL)
    …into a database using this set medical protocol to produce a statement or claim . * Investigate rejected claims , verify this information with the health provider, ... We are looking for the an experienced medical Billing and Payroll Specialist . Responsibilities include weekly processing of billing and payroll.. Managing… more
    BrightStar Care (08/28/25)
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  • Prior Authorization Technician - Remote

    Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
    …FL Position Type Full Time Job Category Pharmaceutical Description PRIOR AUTHORIZATION SPECIALIST (REMOTE) WHO WE ARE Polaris Pharmacy Services is an industry leader ... Authorization Technicians to join the Polaris team. OVERVIEW The Prior Authorization Specialist is responsible for managing and identifying a portfolio of rejected… more
    Polaris Pharmacy Services, LLC (09/04/25)
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  • Coding Auditor Educator

    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 ... or Outpatient): Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) + AAPC Credentials (Outpatient): Certified Professional Coder… more
    Highmark Health (08/08/25)
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  • Senior Workers' Compensation Examiner

    MyFlorida (Tallahassee, FL)
    … specialist with reviewing and evaluating medical-only workers' compensation claims , processing and paying medical and legal bills associated with workers' ... OPPORTUNITY DIVISION: RISK MANAGEMENT BUREAU: STATE EMPLOYEE WORKERS' COMPENSATION CLAIMS CITY: TALLAHASSEE COUNTY: LEON SPECIAL NOTES: High School diploma… more
    MyFlorida (09/05/25)
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  • Clinical Coder III - Department of Neurosurgery

    University of Florida (Gainesville, FL)
    …of the patient is to the subscriber, obtaining insurance policy numbers and claim address and subscriber information such as date of birth, address, etc. Fills ... out claim information record for every charge submitted in Epic,...American Academy of Professional Coders (AAPC) or Certified Coding Specialist (CCS-P) required. Preferred Qualifications: + Knowledge of medical… more
    University of Florida (09/05/25)
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  • Diagnosis Related Group Clinical Validation…

    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
    Elevance Health (08/23/25)
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  • Professional Coder 3

    University of Miami (Hialeah, FL)
    …+ Identify compliance or coding issues to management + Process Charge Review and Claim Edits + Adhere to departmental coding goals established by site + Complete ... Associate (CCA), Certified Professional Coder (CPC; CPC-A), Certified Coding Specialist (CCS), Certified Coding Specialist -Physician Office (CCS-P), and/or… more
    University of Miami (09/03/25)
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