• SIU Specialist - Pharmacy Tech - Remote…

    Prime Therapeutics (Tallahassee, FL)
    …our passion and drives every decision we make. **Job Posting Title** SIU Specialist - Pharmacy Tech - Remote in the California market **Job Description** Responsible ... in accordance with procedures or to present to management to recommend for audit or investigation. Serves as a corporate resource on fraud, waste and abuse… more
    Prime Therapeutics (09/23/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (FL)
    …coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise, mastery ... findings letters. + Maintains accuracy and quality standards as established by audit management. + Identifies potential documentation and coding errors by… more
    Elevance Health (09/30/25)
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  • System CDI Quality Team Leader Educator

    AdventHealth (Altamonte Springs, FL)
    …compliance for all CDSs throughout all facilities on a quarterly basis through audit process + Completes accurate and concise input of audits to provide feedback ... + Understands and supports documentation strategies (upon completion of training ) and continues to educate self and team members...them to resolves discrepancies with DRG assignments and other coding issues. + Leads out on CDI projects as… more
    AdventHealth (08/07/25)
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  • RN Clinical Appeals Nurse

    Molina Healthcare (Orlando, FL)
    …following: + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare ... Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. + Provides training , leadership and mentoring for less experienced appeal LVN, RN… more
    Molina Healthcare (09/26/25)
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