• Senior Health Economics Analyst

    ChenMed (Miami, FL)
    …data such as hospital/physician /ASC claims, utilization data, and healthcare industry coding systems ICD-10, CPT /HCPCS, Revenue Codes, MS/APR-DRGs and APCs + ... Excellent communication skills across verbal, written, and presentation applications (Microsoft Word, PowerPoint, Excel, etc) + Experience with PowerBI, Qlikview & SQL preferred + Spoken and written fluency in English + This job requires use and exercise of… more
    ChenMed (07/15/25)
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  • Clinical Program Manager- Payment Integrity…

    Molina Healthcare (Miami, FL)
    …payment integrity. + Strong working knowledge of managed care claims coding (Current Procedural Terminology ( CPT ), International Classification of Diseases ... All reviews must be conducted in accordance with accepted coding criteria, established guidelines, and relevant payment and medical...(ICD), Healthcare Common Procedure Coding System (HCPCS), Revenue Codes), and federal/state Medicaid payment… more
    Molina Healthcare (08/14/25)
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  • Lead Analyst, Payment Integrity

    Molina Healthcare (Tampa, FL)
    …payment integrity. + Strong working knowledge of managed care claims coding (Current Procedural Terminology ( CPT ), International Classification of Diseases ... (ICD), Healthcare Common Procedure Coding System (HCPCS), Revenue Codes), and federal/state Medicaid payment rules. + Skilled in Excel and SQL, with the ability to… more
    Molina Healthcare (08/14/25)
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  • Payment Integrity Program Manager - Health Plan

    Molina Healthcare (St. Petersburg, FL)
    …payment integrity. + Strong working knowledge of managed care claims coding (Current Procedural Terminology ( CPT ), International Classification of Diseases ... (ICD), Healthcare Common Procedure Coding System (HCPCS), Revenue Codes), and federal/state Medicaid payment rules. + Skilled in Excel and SQL, with the ability to… more
    Molina Healthcare (08/14/25)
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  • Health Plan Operations, Payment Integrity Program…

    Molina Healthcare (FL)
    …payment integrity. + Strong working knowledge of managed care claims coding (Current Procedural Terminology ( CPT ), International Classification of Diseases ... (ICD), Healthcare Common Procedure Coding System (HCPCS), Revenue Codes), and federal/state Medicaid payment rules. + Skilled in Excel and SQL, with the ability to… more
    Molina Healthcare (08/14/25)
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  • Remote HCC Coder

    Insight Global (Tampa, FL)
    …backlog for inpatient and outpatient Medicare advantage projects . Must obtain an active Coding certification (CPC) through AAPC or AHIMA, or a CCS. Will be ... coding more risk adjustment vs profee. Most of the...experience there. Will also be responsible to validate the CPT codes and non-HCC codes. These markets are still… more
    Insight Global (08/14/25)
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  • Claims Adjudication Specialist - Remote

    Cognizant (Tallahassee, FL)
    …years claim processing is required. * Knowledge of physician practice and hospital coding , and medical terminology, CPT , HCPCS, ICD-10 * Experience making ... payments with UB/institutional (CMS-1450) and/or professional (CMS 1500) claims * Knowledge of Medicare/ Medicaid payment and coverage guidelines and regulations. * 1 year of Facets experience. * Experience in the analysis and processing of claims for… more
    Cognizant (08/15/25)
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  • Medical Claims Adjudication - remote

    Cognizant (Tallahassee, FL)
    …claims processing experience is required. + Knowledge of physician practice and hospital coding , and medical terminology, CPT , HCPCA, ICD-10 + Experience making ... payments with UB/institutional (CMS-1450) and/or professional (CMS 1500) claims. + Knowledge of Medicare/Medicaid payment and coverage guidelines and regulations. + Must be able to work with minimal supervision. + 1 year of Facets experience. + Experience in… more
    Cognizant (08/01/25)
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  • Clinical Coder III - Department of Neurosurgery

    University of Florida (Gainesville, FL)
    …anexperienced surgical coderto perform highly specialized diagnosis and procedural coding for all operative procedures and inpatient consulting services performed ... a thorough knowledge of anatomy, surgical and medical terminology coding , a working knowledge of the billing requirements of...either verify or to apply the appropriate ICD-10 and CPT codes. Confirms physician attestation statements are in place,… more
    University of Florida (08/16/25)
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  • Senior Outpatient Coder

    Houston Methodist (FL)
    …to encounters of high complexity. + Maintains and achieves departmental standards of coding quality by assigning accurate ICD-10-CM/ICD-10-PCS and CPT codes and ... ESSENTIAL FUNCTIONS** + Interacts and communicates effectively with members of the coding team and the appropriate stakeholders. + Participates and provides good… more
    Houston Methodist (07/31/25)
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