• Diagnosis Related Group Clinical Validation…

    Elevance Health (FL)
    …an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of medical audit ... activities. + Draws on advanced ICD-10 coding expertise, mastery of clinical guidelines, and industry knowledge...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (12/11/25)
    - Related Jobs

  • Medical Records Coder III Outpatient

    BayCare Health System (Tampa, FL)
    …encounters to accurately assign diagnosis and procedural codes-using ICD-10-CM and CPT-4 coding systems. + Works in conjunction with various departments for missing ... hold reports. + Strong utilization of medical terminology and anatomy. + Assists Manager /Director with mentoring/training of Coder I and Coder II team members and… more
    BayCare Health System (10/10/25)
    - Related Jobs

  • Nurse Auditor 2

    Humana (Tallahassee, FL)
    …audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support ... 2 validates and interprets medical documentation to ensure capture of all relevant coding . Applies clinical and coding experience to conduct a clinical… more
    Humana (12/11/25)
    - Related Jobs

  • RN Medical Review Nurse Remote

    Molina Healthcare (Tampa, FL)
    …readmissions. + Validates member medical records and claims submitted/correct coding , to ensure appropriate reimbursement to providers. + Resolves escalated ... services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. +… more
    Molina Healthcare (12/03/25)
    - Related Jobs

  • Government Operations Consultant II - 1

    MyFlorida (Fort Myers, FL)
    …in operations and clinic productivity. Proposes solutions to documentation, scheduling, and coding issues in clinic. Ensures adequate supply of forms and office ... with the Operations and Management Consultant- II and OMC Manager . Creates Ad-hoc reports from HMS data. Miscellaneous Updates...HMS data. Miscellaneous Updates EAR and HMS Personal Health Coding Pamphlets and shares Medical & Billing coding… more
    MyFlorida (12/10/25)
    - Related Jobs

  • Senior Application Developer - Open Systems

    Highmark Health (Tallahassee, FL)
    …role requires expertise in analyzing customer requirements, designing robust architectures, coding , thorough testing, and deploying solutions that strictly adhere to ... **ESSENTIAL RESPONSIBILITIES** + Takes a lead role for analyzing, designing, coding , testing and implementing more complex application enhancements, as well as… more
    Highmark Health (12/11/25)
    - Related Jobs

  • Clinical Documentation Integrity Coordinator

    BayCare Health System (Clearwater, FL)
    …processes, with a strong understanding of DRG documentation requirements and coding guidelines, and demonstrating effective leadership skills. + Responsible for ... trainings related to clinical documentation, as well as sharing ongoing coding guidelines, rules and regulations updates. + Responsibilities include developing,… more
    BayCare Health System (12/05/25)
    - Related Jobs

  • Contract Support and RCM Analyst - Independent…

    Public Consulting Group (Tallahassee, FL)
    …timely. (20%) **Organizational Relationships** **Reports directly to the ASO Project Manager / Sr. Director of Operations** **Key Qualifications and Education ... Requirements** + Claiming or coding certification desired, preferably with a nationally recognized certify organization, either AAPC (American Academy of… more
    Public Consulting Group (12/02/25)
    - Related Jobs

  • Associate Director, Revenue Cycle Management…

    ChenMed (Miami, FL)
    …claims assembly and submission processes. In close collaboration with Billing, Coding , IT, and Business Intelligence departments, gains insight and understanding of ... target revenue recovery throughout the organization by identifying operational, coding , billing, and reimbursement problems then recommending solutions. + Evaluates… more
    ChenMed (11/06/25)
    - Related Jobs

  • Supervisor Clinical Documentation Integrity

    BayCare Health System (Clearwater, FL)
    …within assigned regional facilities. + Works closely with the CDI System Program Manager to ensure optimization of the CDI Program workflows and its overall success. ... + Proficient in the delivery of Clinical Documentation Integrity process, coding rules and guidelines, as well as in depth analysis of clinical documentation… more
    BayCare Health System (10/31/25)
    - Related Jobs