- Molina Healthcare (Miami, FL)
- …long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and ... readmissions. + Validates member medical records and claims submitted/correct coding , to ensure appropriate reimbursement to providers. + Resolves escalated… more
- Elevance Health (Miami, FL)
- …Requirements:** Requires a AA/AS and minimum of 1 year related medical coding /auditing experience; or any combination of education and experience, which ... as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations. + Collaborates with the… more
- Veterans Affairs, Veterans Health Administration (Bay Pines, FL)
- …the VAMC. Selects and assigns codes from the current version of several coding systems to include current versions of the International Classification of Diseases ... (ICD), Current Procedural Terminology (CPT), and/or Healthcare Common Procedure Coding System (HCPCS). Adheres to accepted coding practices, guidelines and… more
- MyFlorida (Naples, FL)
- …performed into the Health Management System per Department of Health policies and EH coding pamphlet. Provides training and education in assigned EH programs to ... Florida laws and regulations. This includes appropriate interaction, consultations, and education with customers. Assist with plan review and issuance of permits… more
- Deloitte (Tampa, FL)
- …you will have the opportunity to work on multiple projects leveraging your education and prior work experience to help our clients more confidently make decisions ... medical records for inpatient and outpatient service areas for accuracy of coding and documentation to ensure regulatory compliance + Apply knowledge of medical… 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...for inquiries and research requests. + Create and present education to Expert Claim Review Teams and other departments… more
- Cardinal Health (Tallahassee, FL)
- …department audits to determine accuracy and adequacy of documentation and coding related to physician or hospital (inpatient and outpatient) billing and/or ... define audit priorities based on previous audit findings, management priorities, coding utilization patterns, national normative data, CMS and CCI initiatives, OIG… more
- HCA Healthcare (Ocala, FL)
- …rollover assistance services and preferred banking partnerships + Education assistance (tuition, student loan, certification support, dependent scholarships) ... team. **Job Summary and Qualifications** As a work from home Inpatient Coding Specialist, you will review and evaluate hospital inpatient medical record… more
- Zelis (FL)
- …post pay comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines and rules, evidence based clinical criteria plan, and policy ... on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. Conduct… more
- Datavant (Tallahassee, FL)
- …and reporting requirements. + Communicate documentation improvement opportunities and coding issues to appropriate personnel for follow up and resolution. ... + Maintain a 95% coding accuracy rate and a 95% accuracy rate for...site-designated productivity standards. + Be responsible for tracking continuing education credits to maintain professional credentials. + Attend Datavant… more