- Datavant (Tallahassee, FL)
- …regulations and accreditation guidelines. + Coders must meet and maintain a 95% coding accuracy rate. + Any other task requested by leadership. **What you will ... certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials ( CPC , CPC -H, COC, CIC, or CRC). +...or CRC). + A minimum of 2 years HCC coding experience, while certified. + Full understanding and knowledge… more
- Molina Healthcare (Miami, FL)
- …validation Required Li **Required License, Certification, Association** Active and unrestricted Coding Certification, Active CCS, CCS-P, or CPC credential ... payment in all markets * Performs monthly audit on internal Molina Coding Specialists * Audits external Molina Vendors. **Job Qualifications** **Required Education**… more
- CVS Health (Tallahassee, FL)
- …analyzing and sharing provider performance metrics related to quality, clinical outcomes, coding , and utilization used to support ABH programs. They will be a ... Knowledge of HEDIS and Pay for Performance metrics, ICD-10 coding , Medicaid risk adjustment methodology, and common billing and...the organization **Preferred Qualifications** + RHI, RHIT, CRC, or CPC certified Coder or auditor (CMAS) or + RN… more
- Humana (Tallahassee, FL)
- …experience conducting comprehensive health care fraud investigations (Medical Coding or Healthcare (Medical Chart Review/Insurance Billing) or Internal/External ... areas * Graduate degree and/or certifications (MBA, JD, MSN, Clinical Certifications, CPC , CCS, CFE, AHFI). * Understanding of healthcare industry, claims processing… more
- USAA (Tampa, FL)
- …industry, Medicare or Medicare Supplement preferred. + Proficient knowledge of medical claims coding ICD-10, CPT, HCPC, EDI 837, etc. + CFE, CHC, AHFI, or Certified ... Professional Coder ( CPC ) certifications. + 2 or more years of experience in negotiating or settling health insurance claims. + Proficient knowledge of state and… more