• Clinical Denial Coding Review Specialist

    HCA Healthcare (Ocala, FL)
    **Description** **Introduction** Do you have the career opportunities as a Clinical Denial Coding Review Specialist you want with your current employer? We have an ... which is part of the nation's leading provider of healthcare services, HCA Healthcare . **Benefits** Parallon offers...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
    HCA Healthcare (11/26/25)
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  • Investigator, Coding Special Investigative…

    Molina Healthcare (FL)
    … Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position uses ... to law enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of … more
    Molina Healthcare (11/20/25)
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  • DRG Coding Auditor

    Elevance Health (Tampa, FL)
    …spending. The **DRG CODING AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit ... you will make an impact:** + Analyzes and audits claims by integrating medical chart coding...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
    Elevance Health (10/25/25)
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  • Medical Coding Appeals Analyst

    Elevance Health (Miami, FL)
    …not eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical ... issues and to audit claims adjudication for accuracy. + Perform pre-adjudication claims reviews to ensure proper coding was used. + Prepares correspondence… more
    Elevance Health (09/12/25)
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  • Hospital Concurrent Coding Analyst

    Intermountain Health (Tallahassee, FL)
    …Classification of Diseases ICD-10 and Diagnosis Related Groups (DRG) codes for claims concurrently while a patient is in a hospital. It ensures accurate ... codes in support of the provision of value-based care by Intermountain Healthcare to appropriate populations. It ensures compliance and accurate submission of… more
    Intermountain Health (11/26/25)
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  • Medical Biller/ Claims Processing…

    IQVIA (Miami, FL)
    **Patient Support Medical Claims Processing ​Representative** _Contract Remote Role - Location (Open to Remote US)_ As the only global provider of commercial ... a 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative** to join our...or equivalent + Experience in claim processing required + Medical Billing Certification required + Coding Certification… more
    IQVIA (11/20/25)
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  • Coding and Reimbursement Specialist

    Elevance Health (Miami, FL)
    …Coding and Reimbursement Specialist** is responsible for reviewing, auditing, and coding medical records for the purpose of reimbursement, training, education ... as required by law. **How you will make an impact:** + Audits and reviews medical documentation for appropriate ICD-9 and CPT coding and documentation. + Queries… more
    Elevance Health (11/19/25)
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  • Medical Director - OP Claims Mgmt

    Humana (Tallahassee, FL)
    …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare, Medicaid, and Medicare Advantage requirements… more
    Humana (11/24/25)
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  • STD Claims Support Specialist

    MetLife (Tampa, FL)
    …made by team member(s) within authority limit including Financial accuracy of coding Claims System including accurate claim Benefit Amount/Salary and ... Preferred: . Associate Degree . 2 plus years of claims management experience preferably in Healthcare field...Skills, Preferred: * Prior STD, state leave and/or Family Medical Leave Act claims knowledge preferred. *… more
    MetLife (11/16/25)
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  • Manager, Medical Economics (New York Health…

    Molina Healthcare (Tampa, FL)
    …different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding /billing (UB04/1500 form) + Demonstrated understanding of key managed ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical… more
    Molina Healthcare (11/21/25)
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