- Humana (Tallahassee, FL)
- …Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider ... community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from...one of these qualifications for 4 years) * MS-DRG coding /auditing experience * Experience reading and interpreting claims… more
- Rising Medical Solutions (Tampa, FL)
- …+ 2-4 years of insurance or healthcare experience, preferably in claims or medical billing-related position(s) Skills/Competencies + Knowledge of Group ... knowledge of medical terminology, CPT and ICD coding , and healthcare billing practices + Well-developed...offices, providers, and case managers nationwide, RISING provides comprehensive medical claims solutions to our valued clients:… more
- 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
- Highmark Health (Tallahassee, FL)
- …for education/training of facility healthcare professionals in use of coding guidelines and practices, proper documentation techniques, medical terminology ... **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data… more
- Cognizant (Tallahassee, FL)
- …High School Diploma or equivalent is required + A minimum of 1 years of medical claims processing is required + Facets experience is highly preferred + Knowledge ... Claims Processors to join our growing team. The ** Medical ** ** Claims Processor** is responsible for the...of physician practice and hospital coding , billing, and medical terminology, CPT, HCPCS,… more
- 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
- CHS (Clearwater, FL)
- …experience is preferred + Knowledge of medical terminology + Knowledge of medical coding systems + Knowledge of Medicaid/Medicare Guidelines + Knowledge of ... Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ...and procedures. + Reviews Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) to… more
- LogixHealth (Dania, FL)
- …Excel, and Outlook Preferred: + One to two years related experience + Healthcare industry knowledge + Medical billing experience Benefits at LogixHealth: We ... revenue cycle management services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting… more
- Molina Healthcare (FL)
- …or equivalent combination of education and experience **PREFERRED EXPERIENCE:** 3+ years healthcare Medical claims auditing **PHYSICAL DEMANDS:** Working ... to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of...within the core processing system (QNXT). * Conducts focal healthcare Medical claim audits on samples of… more
- Molina Healthcare (Tampa, FL)
- …will work on set schedule) Looking for a RN with experience with appeals, claims review, and medical coding . **Job Summary** Utilizing clinical knowledge ... refers members with special needs to the appropriate Molina Healthcare program per policy/protocol. **JOB QUALIFICATIONS** Graduate from an...two years of experience in Claims Auditing, Medical Necessity Review and Coding experience +… more