- LogixHealth (Dania, FL)
- …contribute to our fast-paced, collaborative environment and bring your expertise to review reimbursements and issues in Carrier Payment Audits. The ideal candidate ... skills, excellent interpersonal communication, and analytical skills. Key Responsibilities: + Review all insurance company reimbursements in all practices for all… more
- LogixHealth (Dania, FL)
- …contribute to our fast-paced, collaborative environment and will bring your expertise to review and carry out processes on all out of network claims. The ideal ... communication, and a well-rounded knowledge of insurance payers. Key Responsibilities: + Review , organize, and file IDR emails and complete responses + Monitor and… more
- Elevance Health (FL)
- …letters. + Maintains accuracy and quality standards as established by audit management. + Identifies potential documentation and coding errors by recognizing ... the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How...clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding… more
- Centene Corporation (Tallahassee, FL)
- …and respond to inquiries from state and federal regulatory agencies timely. + Quality Review all external audit deliverables for completeness and ... + Serves as a subject matter expert on external audit processes, policies, and quality improvement initiatives....Intake. + Supports the Corrective Action Plan development and review prior to submission to the external auditors. +… more
- Centene Corporation (Tallahassee, FL)
- …and responds to inquiries from state and federal regulatory agencies timely. + Quality Review all external audit deliverables for completeness and ... resource and liaison on external audit policies, communications, external audit workflow, and quality improvements initiatives. + Socializes identified risks… more
- AdventHealth (Altamonte Springs, FL)
- …and in collaboration with physicians, nursing and HIM coders. The CDI Quality & Compliance Team Leader strategically facilitates and obtains appropriate and ... quality physician documentation for any clinical conditions or procedures...Stewardship, and Teamwork + Completes accurate and timely record review to ensure the integrity of clarification compliance for… more
- CHS (Clearwater, FL)
- …Manager of Quality to implement appropriate standards for accuracy and audit procedures intended to validate those standards are met. This includes setting ... random audit percentages for Examiners reflecting experience and historical quality results. It will also include development of coaching and training programs… more
- Datavant (Tallahassee, FL)
- …KPIs such as suspecting accuracy, chart throughput, RAF impact, data latency, coding quality metrics, and client engagement. **Cross-Functional Collaboration** + ... the development of robust, scalable, and actionable analytics that improve coding outcomes, measure product impact, and support value-based client delivery across… more
- Sumitomo Pharma (Tallahassee, FL)
- …Characteristics (SmPC), and Canadian Product Monograph (PM) + Ensures timely and quality review and assessment of ICSRs, including seriousness, expectedness, ... safety narratives, adverse event coding , concomitant medication coding , and causality statements....study team meetings and governance committees. + Performs aggregate review of post-marketing safety data in support of safety… more
- AdventHealth (Altamonte Springs, FL)
- …provider communication, provider and clinical documentation specialist education, oversight of the Quality and Safety Review Process and guidance for recommended ... guide and monitor system and market performance of the Quality and Safety Review (QSR) Process. Collaborate...efforts. Ensure that there is an internal and external audit process for CDI and QSR activities Review… more