- NCH (Naples, FL)
- …or clinically validate a diagnosis. * Acts as a liaison between the Coding Department and the Clinical Documentation Integrity Specialist to reconcile ... issues, documentation opportunities, coding guidelines and changes to include Coding Clinic, and clinical documentation requirements. * Excellent verbal and… more
- Molina Healthcare (FL)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... records to document relevant findings of a post pay clinical review. This position manages documents and prioritizes case...GED (or higher) **Required Experience** + 3+ years CPT coding experience (surgical, hospital, clinic settings) or 5+ years… more
- Elevance Health (Miami, FL)
- …of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria.** PRIMARY ... policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support… more
- AdventHealth (Orlando, FL)
- …ongoing feedback to physicians, administration, Physician Advisor, CDI Director, and VP of Clinical Services. + Works in conjunction with Coding Liaison, CDI ... and 125,000 outpatients each year **The role you'll contribute:** The Clinical Documentation Integrity Physician Liaison is a Registered Nurse, Advanced Practice… more
- Ascension Health (Jacksonville, FL)
- …appropriate utilization of alternate levels of care, community resources, clinical documentation improvement, coding , quality and/or compliance processes. ... + Develop strategy and processes to reduce denials and audits. + Assist with appeals and length of stay market initiatives. + Utilize hospital data sources to identify & analyze patterns of over or under-utilization of services, quality metrics and collaborate… more
- Humana (Tallahassee, FL)
- …May apply intermediate mathematical skills. **Where you Come In** The Medical Coding Coordinator extracts clinical information from a variety of medical ... a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that… more
- Zelis (FL)
- …and post pay comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines and rules, evidence based clinical criteria plan, and ... to determine accuracy of the DRG billed, based on industry standard coding guidelines and the clinical evidence supplied by the provider in the form of medical… more
- Insight Global (Maitland, FL)
- …Health. This role focuses on enhancing the quality and completeness of clinical documentation to ensure accurate coding , patient safety, measurable outcomes, ... Job Description The Manager of Clinical Documentation Improvement (CDI) leads the strategic planning,...exam at 70% Plusses: Experience with Vizient Epic Iodine Coding background Must-Haves: Active RN license (FL or pen… more
- Humana (Tallahassee, FL)
- …these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and ... and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal… more
- CenterWell (Tallahassee, FL)
- …conflict resolution skills. An aspect of the role includes an overview of coding practices and clinical documentation, grievance and appeals processes, and ... and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal… more