• Diagnosis Related Group Clinical Validation…

    Elevance Health (Tampa, FL)
    …an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of medical audit ... activities. + Draws on advanced ICD-10 coding expertise, mastery of clinical guidelines, and industry knowledge...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (06/10/25)
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  • Medical Records Coder III Outpatient

    BayCare Health System (Tampa, FL)
    …encounters to accurately assign diagnosis and procedural codes-using ICD-10-CM and CPT-4 coding systems. + Works in conjunction with various departments for missing ... hold reports. + Strong utilization of medical terminology and anatomy. + Assists Manager /Director with mentoring/training of Coder I and Coder II team members and… more
    BayCare Health System (05/29/25)
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  • System Implementation Specialist - Public Sector

    Public Consulting Group (Tallahassee, FL)
    …will be performed using the SaaS platform tools, Java, JavaScript, and other coding languages. + Produce clean, efficient code based on defined functional and ... Agile approaches. + Proficient in Java, JavaScript, or other relevant coding languages for system configuration, development, and troubleshooting. + Participation in… more
    Public Consulting Group (06/10/25)
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  • Clinical Provider Auditor II

    Elevance Health (Tampa, 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 3 years medical coding /auditing experience, including minimum of 1 year in fraud,...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (06/18/25)
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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,...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (06/18/25)
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  • Medical Records Coder II

    BayCare Health System (Tampa, FL)
    …Coder II assigns diagnosis and procedural codes using ICD-10-CM, ICD-10-PCS, and CPT-4 coding systems and monitors bill hold reports. + Assists Manager /Director ... and a great place to work! **Certifications and Licensures** + Preferred CCS ( Coding ) + Preferred RHIT (Health Information) **Education** + Required High School or… more
    BayCare Health System (05/29/25)
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  • Healthcare Analytics Business Consultant (SQL…

    CVS Health (Tallahassee, FL)
    …is a full time role and is ideal for a data professional with strong coding skills in SQL and Python who can transform complex healthcare data into actionable ... for diverse audiences + Collaborate with SIU investigators, Program Integrity Manager , and Compliance to understand business processes and translate them into… more
    CVS Health (05/16/25)
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  • Client Policy Specialist

    Zelis (FL)
    …of Zelis editing products with an ability to clearly articulate correct coding and claim adjudication guidelines, interpretation of client policies and present Zelis ... edits/editing suites to assigned clients. + Primary contact for Client Manager to support the retention and expansion of Zelis Editing Products for assigned clients.… more
    Zelis (04/28/25)
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  • Claims and Call Auditor (Call Center QC)

    CHS (Clearwater, FL)
    …appropriate leadership, with accuracy, and work with the MPS Call Center Manager /Supervisor/Team Lead and analyze the data for training purposes. + Identifies ... variances related to claims and calls and provides feedback to their Manager . + Maintains up-to-date working knowledge on regulatory requirements associated with… more
    CHS (06/14/25)
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  • Business Analyst II

    Elevance Health (Tampa, FL)
    …+ Experience with overpayment recoveries/government business. + Datamining using CPT/HCPCS coding . + Internal/external policies. + Claims system research. + Root ... processing. + Provider billing. + FWA investigations. + Cost containment CPT/HCPCS coding . Please be advised that Elevance Health only accepts resumes for… more
    Elevance Health (06/26/25)
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