• Medical Claim Review Nurse (RN)

    Molina Healthcare (Tampa, FL)
    …for a RN with experience with appeals, claims review, and medical coding . **Job Summary** Utilizing clinical knowledge and experience, responsible for review of ... appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and… more
    Molina Healthcare (09/06/25)
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  • Medicare Risk Adjustment

    TEKsystems (Sunrise, FL)
    …provider information in support of member outreach and claims reimbursement. Education /Experience: High school diploma or equivalent. 0-2 years of customer service ... Experience with preserved medical record retrieval systems preferred. Billing or coding experience preferred. Excel skills. Responsibilities: - Retrieves charts from… more
    TEKsystems (09/23/25)
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  • Apps Dev Tech Lead Analyst - C13

    Citigroup (Tampa, FL)
    …with application development methodologies and standards for program analysis, design, coding , testing, debugging and implementation. + Subject Matter Expert (SME) ... Consistently demonstrates clear and concise written and verbal communication. ** Education and Experience:** + Bachelor's degree/University degree or equivalent… more
    Citigroup (08/13/25)
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  • Quality Practice Advisor

    Centene Corporation (Fort Myers, FL)
    …for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures, appropriate medical record documentation and appropriate ... coding . Assists in resolving deficiencies impacting plan compliance to...as assigned. + Complies with all policies and standards. ** Education /Experience:** + Bachelor's Degree or equivalent required + 3+… more
    Centene Corporation (09/24/25)
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  • Business Systems Analyst 3 - Revenue Integrity

    University of Miami (Miami, FL)
    …of Revenue Integrity Systems, the analyst collaborates with clinical departments, coding teams, IT, and compliance to monitor revenue cycle performance, resolve ... + Support implementation of automation tools and reporting dashboards. + Provide education and feedback to clinical and operational teams on charge capture best… more
    University of Miami (08/22/25)
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  • Assistant Project Manager - Traffic

    System One (Tallahassee, FL)
    …productivity in a fast-paced environment. Ad trafficking involves coordinating, substantiating, coding , reviewing and optimizing campaign tactics so they're ready to ... details are entered into the trafficking systems, trafficking instructions (matrices/ coding /tagging) are created, reviewed and executed accordingly, risk is… more
    System One (09/30/25)
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  • Clinical Documentation Specialist RN

    Houston Methodist (FL)
    …with physicians, nursing staff, other patient care givers, and medical records coding staff to ensure that appropriate reimbursement is received for the level ... + Educates all internal customers on clinical documentation opportunities, coding , and reimbursement issues, as well as performance improvement methodologies… more
    Houston Methodist (08/13/25)
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  • Physician Advisor

    AdventHealth (Orlando, FL)
    …+ Mental Health Resources and Support + Pet Insurance* + Debt-free Education * (Certifications and Degrees without out-of-pocket tuition expense) **Our promise to ... Provides clinical support/validation for Care Management, CDI and Quality teams. Provides education and serves as a resource to Medical Staff colleagues regarding… more
    AdventHealth (09/04/25)
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  • Clinical Provider Auditor II

    Elevance Health (Miami, FL)
    …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 ... Requires a AA/AS and minimum of 4 years medical coding /auditing experience, including minimum of 1 year in fraud,...in fraud, waste abuse experience; or any combination of education and experience, which would provide an equivalent background.… more
    Elevance Health (09/06/25)
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  • FDC-Field Office Manager - SES - - Columbia…

    MyFlorida (Lake City, FL)
    …processes and activities while ensuring budget compliance and providing accurate budgetary coding and projections. The FOM is oversees human resources operations for ... ensuring real-time expenditure tracking, responsible for accurate projections, budgetary coding , and compliance with financial regulations. Advises executive leadership… more
    MyFlorida (10/01/25)
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