- Molina Healthcare (FL)
- …performing accurate and reliable medical review audits that may also include coding and billing reviews. The SIU Investigator is responsible for reviewing and ... SIU Investigator is also responsible for recognizing and adhering to national and local coding and billing guidelines in order to maintain coding accuracy and… more
- Northwest Florida Community Hospital (Chipley, FL)
- …medical procedures. + Review and analyze medical records to ensure appropriate coding of diagnoses and procedures. + Resolve billing issues with insurance companies ... + Work closely with other departments, such as medical coding and billing, to ensure accurate and timely billing...abreast of changes in medical billing regulations and ensure compliance with these changes. Education: + High school diploma… more
- Highmark Health (Tallahassee, FL)
- …a big impact for those we serve. This job performs highly complex benefit coding , new client and group installation, as well as set-up of network structures (eg ... processes and business rules. **ESSENTIAL RESPONSIBILITIES** + Perform highly complex benefit coding , new client and group installation, as well as set-up of network… more
- AdventHealth (Maitland, FL)
- …the consolidated PHSO entity. o Responsible for leading government/regulatory relationships and compliance , including all regulatory and rate filings. o Serve as the ... executive liaison to our legal and compliance team within AH. o Maintaining matrix reporting relationship...and Exchange populations. o Driving engagement of providers with coding tools and documentation actions. o Driving productivity and… more
- Community Health Systems (Naples, FL)
- …and other payers, researching and resolving claim issues while maintaining compliance with billing regulations and organizational policies. The Billing Specialist I ... works closely with internal teams, including clinic staff and coding professionals, to optimize billing operations and support revenue cycle efficiency. **Essential… more
- CVS Health (Tallahassee, FL)
- …follow through on escalations and urgent requests. They must possess an analytical system coding ability to translate plan benefits into system data coding . The ... partners. + Ability to utilize Meritain's proprietary system for analytical coding of detailed customized plans rather than standard offerings. + Participate… more
- Bristol Myers Squibb (Miami, FL)
- …The individual is required to achieve all assigned goals while maintaining compliance with all BMS standards. The Southeast geography/territory will cover: Florida, ... Government payer policy, local payer dynamics and coverage policy, complex reimbursement, coding & billing dynamics, and all components of the Cell Therapy ordering… more
- Insight Global (Fort Lauderdale, FL)
- …necessary and investigates variances as requested. Produces monthly investment compliance analyses and credit card reconciliations, researches and resolves ... related schedules, and notes. Maintains, updates, and prepares bond financing, compliance analyses, and reports that support preand post-issuance of tax-exempt debt.… more
- HCA Healthcare (Ocala, FL)
- …**In this role you will:** + Conduct reviews of charging, coding , and clinical documentation, collaborating with Corporate Revenue Integrity Leadership during ... directors, to enhance documentation accuracy, charging workflows, and overall compliance . + Collaborates with Facility Department Directors in developing… more
- AdventHealth (Altamonte Springs, FL)
- …policies and procedures, continually ensuring quality documentation and regulatory compliance . Actively participates in outstanding customer service and accepts ... resources entrusted to them. . Reviews concurrent medical record for documentation compliance including completeness and accuracy for severity of illness (SOI), risk… more