• Diagnosis Related Group Clinical Validation…

    Elevance Health (Tampa, FL)
    **Diagnosis Related Group Clinical Validation Auditor-RN** **Virtual:** This role enables associates to work virtually full-time, with the exception of required ... face-to-face onboarding and skill development. The **Diagnosis Related Group Clinical Validation Auditor** is responsible for auditing inpatient medical records… more
    Elevance Health (06/10/25)
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  • Clinical Coding and OASIS Review Manager

    BAYADA Home Health Care (Orlando, FL)
    …will be considered for this role (Please note, while this is a clinical opening, BAYADA does have non- clinical openings available). BAYADA believes that ... direct deposit, and employee assistance program **Responsibilities:** + Review clinical information for appropriateness, congruency, and accuracy as it relates… more
    BAYADA Home Health Care (05/17/25)
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  • IPA Coding Associate Director

    CenterWell (Tallahassee, FL)
    …The IPA Coding Leader manages a diverse team responsible for ensuring clinical documentation supports accurate coding and is reflective of the disease prevalence ... IPA strategic partners to develop market-specific strategies to promote accurate clinical documentation, ensures all state, federal and internal policies and… more
    CenterWell (04/24/25)
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  • Clinical Fraud Investigator II

    Elevance Health (Tampa, FL)
    ** Clinical Fraud Investigator II** **Location** : _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and ... dynamic and adaptable workplace. Alternate locations may be considered. The ** Clinical Fraud Investigator II** is responsible for identifying issues and/or entities… more
    Elevance Health (06/24/25)
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  • Non- Clinical Coding and OASIS Review…

    BAYADA Home Health Care (Orlando, FL)
    …in addressing and meeting business and development goals. This is a **non- clinical ** role (Note: Clinical opportunities are also available). **BAYADA Perks:** ... BAYADA Benefits, click here (https://www.bayada.com/benefits/) . **Responsibilities:** + Review clinical information for appropriateness, congruency, and accuracy as it… more
    BAYADA Home Health Care (05/17/25)
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  • Facility Coding Inpatient DRG Quality

    Banner Health (FL)
    …care. POSITION SUMMARY This position is responsible for the interpretation of clinical documentation completed by the health care team for the health record(s) ... and for quality assurance in the alignment of clinical documentation and billing codes. Works with clinical...required. Requires Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) or Certified Professional Coder (CPC)… more
    Banner Health (06/15/25)
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  • Remote Senior Inpatient Coding Specialist

    AdventHealth (Orlando, FL)
    Coder is responsible for reviewing, analyzing, and interpreting clinical documentation in the medical record, applying appropriate ICD-10-CM/PCS coding ... for maintaining relationships that are equally respectful to all. The Senior Coder demonstrates experience and expertise, so coding quality review is not required… more
    AdventHealth (06/03/25)
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  • Coding Auditor Educator

    Highmark Health (Tallahassee, FL)
    …and disease processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and assistance from management, ... designs and implements coder education program, continuing education programs and Medical Staff...Coding Specialist (CCS) + AAPC Credentials (Outpatient): Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified… more
    Highmark Health (05/09/25)
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  • Coding Quality Auditor

    Houston Methodist (FL)
    …good feedback during coding section meetings, coding education in-services, and coder /CDMP meetings. Takes initiative to assist others and shares knowledge with ... utilizing the established physician query process. Provides assistance to Clinical Documentation Management Program (CDMP) with appropriate MS-DRG and APR-DRG… more
    Houston Methodist (04/12/25)
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  • Manager, DRG Coding & Validation (RN) Remote

    Molina Healthcare (FL)
    **Job Description** **Job Summary** The Manager, Clinical DRG Coding & Validation must have an extensive background in either facility-based nursing and/or inpatient ... high quality claims payment to ensure payment integrity. Responsible for performing clinical reviews of medical records and other documentation to evaluate issues of… more
    Molina Healthcare (06/14/25)
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