- Molina Healthcare (Orlando, FL)
- …to reduce the likelihood of a formal appeal being submitted. * Reevaluates medical claims and associated records independently by applying advanced clinical ... in the specific programs supported by the plan such as utilization review, medical claims review, long-term services and supports (LTSS), or other specific… more
- Molina Healthcare (FL)
- …different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding /billing (UB04/1500 form). * Advanced understanding of key managed ... executive level strategy and leadership for team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data… more
- CVS Health (Tallahassee, FL)
- …Experience in healthcare fraud, waste and abuse + Knowledge of Medicaid healthcare claims adjudication (QNXT) & regulatory reporting + Experience with data ... and is ideal for a data professional with strong coding skills in SQL and Python who can transform...skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud, waste,… more
- HCA Healthcare (Jacksonville, FL)
- **Description** **Introduction** Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...+ Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family… more
- AdventHealth (Maitland, FL)
- …it relates to reimbursement methodologies Applies detailed understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10 ... relates to reimbursement methodologies + Applies detailed understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10… more
- HCA Healthcare (Miramar, FL)
- **Description** **Introduction** Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...+ Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family… more
- HCA Healthcare (Sarasota, FL)
- …remote position Introduction Are you passionate about the patient experience? At HCA Healthcare , we are committed to caring for patients with purpose and integrity. ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...+ Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family… more
- Molina Healthcare (Miami, FL)
- …better health, more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data ( medical , pharmacy and ancillary) to ... Education** Master's Degree **Preferred Experience** * Preferred experience in healthcare medical economics and/or strong financial analytics background… more
- Molina Healthcare (Tampa, FL)
- …better health, more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data ( medical , pharmacy and ancillary) to ... Education** Master's Degree **Preferred Experience** + Preferred experience in healthcare medical economics and/or strong financial analytics background… more
- Zelis (FL)
- …policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and ... working knowledge of Health Insurance, Medicare guidelines and various healthcare programs + Understanding of hospital coding ...and billing rules + Clinical skills to evaluate appropriate Medical Record Coding + Experience conducting root… more
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