• Coding Auditor Educator

    Highmark Health (Tallahassee, FL)
    …with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts ... and modifier systems, missed secondary diagnoses and procedures and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim… more
    Highmark Health (08/08/25)
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  • Claims and Call Auditor (Call Center QC)

    CHS (Clearwater, FL)
    …claims and customer service calls to ensure validity, accuracy, and compliance with appropriate policies, procedures, and regulations + **Health, Dental, Vision, ... customer service calls within the MPS call center. + Ensures compliance with appropriate company policies, procedures, guidelines, and reporting requirements;… more
    CHS (06/14/25)
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  • Pharmacy Technician Call Center (no evenings…

    AssistRx (Maitland, FL)
    …processing in a licensed pharmacy setting. The Pharmacy Technician operates in compliance with the rules and regulations established by the Florida State Board ... Impactful Work: Join a team that is at the forefront of revolutionizing healthcare by improving patient access to essential medications. + Flexible Culture: Many… more
    AssistRx (08/23/25)
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  • Associate Director Finance Technology Solutions

    Humana (Tallahassee, FL)
    …performance, data integrity, and security through rigorous governance and proactive compliance practices. + Build a best-in-class Finance data and analytics function ... build stakeholder alignment, and drive innovation. + Familiarity with compliance standards, Finance data governance, and system audit-readiness. **Preferred… more
    Humana (08/22/25)
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  • RN Care Manager - Remote, nationwide

    Humana (Tallahassee, FL)
    …time with demonstrated advanced communication and interpersonal skills. This is a very compliance driven and highly visible program at Humana. The nature of the work ... computer applications. Due to the auto dialer process and compliance needs of the business there is limited day...space lacking ongoing interruptions to protect member PHI / HIPAA information **Additional Information - How we Value You**… more
    Humana (08/22/25)
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  • Encounter Data Management Professional

    Humana (Tallahassee, FL)
    …encounter submissions to Medicaid/Medicare. Ensures encounter submissions meet or exceed all compliance standards via analysis of data, and develops tools to enhance ... Medicaid/Medicare + Ensure encounter submissions meet or exceed all compliance standards via analysis of data + Develop tools...space lacking ongoing interruptions to protect member PHI / HIPAA information** **Our Hiring Process** **As part of our… more
    Humana (08/19/25)
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  • Lead Enterprise AI/ML DevOps Engineer

    Humana (Tallahassee, FL)
    …pillars, including continuous integration (CI), continuous delivery (CD), quality, security, compliance , metrics, and reporting. + Ensure compliance with ... space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position,...benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also… more
    Humana (07/29/25)
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  • Deputy General Counsel, Litigation - REMOTE

    Prime Therapeutics (Tallahassee, FL)
    …risk mitigation, and regulatory interpretation + Demonstrated experience in federal healthcare laws and regulations such as HIPAA , Anti-Kickback Statute, ... **Additional Qualifications** + Advanced knowledge of PBM regulatory frameworks and healthcare law, with demonstrated ability to proactively identify and address… more
    Prime Therapeutics (07/19/25)
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  • Telephonic UM Administration Coordinator

    Humana (Tallahassee, FL)
    …1 or more years of Administrative support experience + 1 or more years of Healthcare experience + 1 or more years of telephonic Customer Service experience + Working ... a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Internal- If you have additional questions regarding this role posting,… more
    Humana (08/25/25)
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  • Pre-Service Coordinator

    Humana (Miramar, FL)
    …regulations, laws related to patient confidentiality, release of information, and HIPAA . Always preserve the security and confidentiality of patients' personal ... to make an impact** **Required Qualifications** + 1-3 years Healthcare , DME or medical industry experience + Less than...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    Humana (08/23/25)
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