- Elevance Health (Miami, FL)
- …or insurance sector), including a minimum of 1 year related experience in a quality audit capacity; or any combination of education and experience, which would ... **Performance Quality Analyst II** **Location:** This role requires associates...implementation audits of providers, claims processing and payment, benefit coding , member and provider inquiries, enrollment & billing transactions… more
- Datavant (Tallahassee, FL)
- …preferably within an academic medical facility. + Experience with significant level of coding quality review feedback + Experience in computerized encoding ... codes from patient records, ensuring precision and adherence to documentation + Oversee and audit the work of Level 1 & 2 Coders, where applicable + Champion… more
- AdventHealth (Orlando, FL)
- …downgrade denials management, and clinical validation processes. + Compliance and Quality Alignment: Ensure clinical documentation aligns with coding guidelines, ... regulations, and hospital policies. Support hospital initiatives related to compliance, audit readiness, and quality reporting metrics. Participate in… 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
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... for improvement, and cost and savings involved. + Participates in continuing quality improvement activities. + Adheres to University and unit-level policies and… more
- Ascension Health (Panama City, FL)
- …inpatient trauma cases. + Apprise program coordinator of all relevant trauma audit filter inconsistencies via periodic quality assurance reports. Produce various ... Preferences** Key Attributes: 2+ years of experience in trauma registry abstraction, coding , clinical documentation review , or trauma program data management.… more
- Molina Healthcare (Orlando, FL)
- …Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ) or other health care coding or management ... of care provided to members. Contributes to overarching strategy to provide quality and cost-effective member care. Candidates with UM and Appeals experience are… more
- MUFG (Tampa, FL)
- …years' experience in a combination of risk management, Cloud information security, secure coding , application security, and IT roles. Audit and Cyber Risk ... across development and production environments, including code reviews + Review third-party application architectures and identify risk + Collaborate with… more
- Northwest Florida Community Hospital (Chipley, FL)
- …payment methodologies from Medicare and Medicaid is critical. + Promptly audit remittance advices to ensure timely and optimal payment. Communicate deficiencies ... efficiency throughout the revenue cycle process. + Oversees physician coding function and trains staff to ensure that physician...them to the proper services required. + Coordinates CDM review and change process; reviews appropriateness of CPT and… more
- PwC IT Services Co. (Tampa, FL)
- …C#.NET, C++ Programming Language, Client Management, Coaching and Feedback, Code Review , Coding Standards, Communication, Computer Engineering, Computer Science, ... style, you motivate, develop and inspire others to deliver quality . You are responsible for coaching, leveraging team members...the same. + Effectively mentor others. + Use the review of work as an opportunity to deepen the… more