• Risk Adjustment Audit Operations Analyst…

    Molina Healthcare (St. Petersburg, FL)
    …Assist with the identification and validation of data sources needed to support RADV audit cycles. + Support the generation of chart retrieval chase lists based ... team, assisting in the execution of CMS and internal audit activities. This position contributes to the development of... activities. This position contributes to the development of chart retrieval chase lists by helping identify and validate… more
    Molina Healthcare (08/08/25)
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  • Compliance Audit Manager

    Cardinal Health (Tallahassee, FL)
    medical terminology; E/M rules, teaching physician guidelines, and/or medical necessity defense reviews; healthcare compliance audit methodology, principles ... and apply documentation and coding rules, laws and regulations and to interpret medical record progress notes, handwritten and electronic chart entries, provider… more
    Cardinal Health (08/27/25)
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  • Director, Clinical Data Acquisition (HEDIS / Risk…

    Molina Healthcare (St. Petersburg, FL)
    …Operations experience. + Risk Adjustment and Data Validation experience. + Chart Collection audit experience. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... is responsible for the implementation, monitoring, and oversight of all chart collection for HEDIS, or HEDIS-like projects, Risk Adjustment, Risk Adjustment… more
    Molina Healthcare (08/21/25)
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  • Site Medical Director

    YesCare Corp (Tallahassee, FL)
    …at the Leon County in Tallahassee, FL** **Administrative** + Serve as Chairman of the Medical Audit Committee. + Consult with medical providers in the ... **Experience & Requirements** + Graduate of an accredited medical school. + Fully licensed to practice medicine...action on patient complaints, infection control, peer review and chart audits. + Manage referrals to outside healthcare facilities… more
    YesCare Corp (08/22/25)
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  • DRG Coding Auditor

    Elevance Health (Tampa, FL)
    …you will make 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, clinical guidelines, and industry knowledge to substantiate conclusions. + Utilizes … more
    Elevance Health (08/13/25)
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  • Auditor, Risk Adjustment (Remote)

    Molina Healthcare (Miami, FL)
    …**Required Education** Associates degree. **Required Experience** 3 Years in coding and medical record chart review and experience with risk adjustment data ... validation related activities, including, but not limited to: progress tracking, chart retrieval, file transmissions, and adherence to applicable timelines * Support… more
    Molina Healthcare (07/25/25)
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  • Senior Overreader, HEDIS/Quality Improvement…

    Molina Healthcare (Orlando, FL)
    …notes or feedback from the HEDIS audit . Makes recommendations based off of the audit and chart review. + Assists with ad hoc projects. + Participates in ... conducts oversight and audits of the data collected and abstracted from medical records for HEDIS projects, HEDIS like projects and supplemental data collection.… more
    Molina Healthcare (08/21/25)
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  • Inpatient Medical Coder - FT - Up to $5,000…

    Datavant (Tallahassee, FL)
    …for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to ... ICD-10-CM, and ICD-10-PCS codes + Accurately sequence and abstract medical codes from patient records, ensuring precision and adherence...ensuring precision and adherence to documentation + Oversee and audit the work of Level 1 & 2 Coders,… more
    Datavant (06/25/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (FL)
    …you will make 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 to substantiate conclusions. +… more
    Elevance Health (08/23/25)
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  • Consultative Coding Professional

    CenterWell (Tallahassee, FL)
    …and approaches to assignments. **Consultative Coder** The Consultative Coder provides medical coding expertise to support clinical staff (Physicians and Advanced ... Practice Providers) to ensure the documentation within medical records supports diagnostic and procedural coding. **Relationship/Concierge Services:** + Cultivate… more
    CenterWell (08/23/25)
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