- Datavant (Tallahassee, FL)
- …patient's stay. + Follow AHA guidelines and coding clinics for accurate coding and required documentation to ensure compliance . + Query physicians regarding ... case mix index, secondary diagnoses, and procedure impact on DRG. + Improve coding specificity by educating physicians and caregivers on the importance of clear… more
- St. George Tanaq Corporation (Tallahassee, FL)
- …AI/ML systems. + Expertise in encryption, authentication, access control, and secure coding . + Knowledge of federal frameworks and compliance requirements ... Officer (HUD OCIO). The Senior Security Engineer will embed cybersecurity and compliance into HUD's DevOps and AI/ML modernization initiatives. This role ensures… more
- Cardinal Health (Tallahassee, FL)
- …the At-Home Solutions business + 7+ years of related work experience supporting compliance programs in DMEPOS suppliers, coding and medical necessity expertise, ... What the Ethics and Compliance Department contributes to Cardinal Health Ethics &...orthotics, and supplies("DMEPOS"), including detection and correction of documentation, coding , identifying potential errors and/or medical necessity of items… more
- Zelis (St. Petersburg, FL)
- …outpatient claims for Health Plans and TPA's to ensure adherence to proper coding and billing, analyzing inpatient DRG claims based on industry standard inpatient ... coding guidelines, and supporting the Office of the Chief...regulatory research from multiple sources to keep abreast of compliance enhancements and additional bill review opportunities. + Support… more
- HCA Healthcare (Ocala, FL)
- …team. **Job Summary and Qualifications** As a work from home Inpatient Coding Specialist, you will review and evaluate hospital inpatient medical record ... and/or validate the appropriate ICD-10-CM and ICD-10- PCS codes. You will perform coding and/or code/DRG validation across multiple entities. **What you will do in… more
- Highmark Health (Tallahassee, FL)
- …data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days. **ESSENTIAL ... and cash flow as it pertains to the unbilled coding report. (10%) + Keeps informed of the changes/updates...in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources and implementing these updates… more
- Highmark Health (Tallahassee, FL)
- …clinical outcomes, cost, and member experience. + **Operational Integration & Coding :** Engage non-clinical teams to ensure operational guidelines are aligned with ... intent. Develop and maintain a thorough understanding of medical coding (ICD-10, CPT, HCPCS) and ensure accurate coding... coding (ICD-10, CPT, HCPCS) and ensure accurate coding principles are incorporated into policy criteria. + **Policy… more
- J&J Family of Companies (Pompano Beach, FL)
- …authorizations and appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations (local payers, government payers, ... of national, regional, local, and account market dynamics including coverage and coding requirements. + Grow the knowledge of hub and specialty distribution channels… more
- Intermountain Health (Tallahassee, FL)
- …and stays current on CMS, federal and state regulations, payor guidelines, ensuring compliance and alignment with charge, coding and charge edits. + Audits ... maintenance of consistent charge capture or charge edits to ensure regulatory compliance and revenue optimization for assigned service line(s). This position will… more
- MetLife (Tampa, FL)
- …with the DevSecOps and, along with a strong understanding of secure coding practices, application security scanning, and compliance frameworks. DevSecOps tools, ... practices meet the needs of a highly regulated financial services environment ( compliance , audit, risk management). * Toolchain & Technology Oversight: Own and… more