- Elevance Health (Tampa, FL)
- …be considered._ The **DRG CODING AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of ... its clients. Also responsible for performing clinical reviews of medical records and other documentation to evaluate issues of...Certified Coding Specialist and/or CIC as a Certified Inpatient Coder . + Requires 5 years of experience working with… more
- CenterWell (Apopka, FL)
- …doctors, advanced practice professionals, pharm D, care coach nurses, medical assistants, behavioral health, specialists, quality-based coders, referral coordinators ... accordance with standards of care. . Follows level of medical care and quality for patients and monitors care...in a timely manner working with a quality- based coder to optimize coding specificity. . Follows policy and… more
- Trinity Health (Fort Lauderdale, FL)
- …**Shift:** **Description:** **Remote Position** **POSITION PURPOSE** **Performs annual and targeted medical record audits including, but not limited to analysis of ... medical record documentation; validation of primary and secondary diagnoses...improve HCC, high risk scoring, along with provider and coder education. Responsible for practitioner education in areas related… more
- CenterWell (Palm Beach Gardens, FL)
- …treats center patients in accordance with standards of care. + Follows level of medical care and quality for patients and monitors care using available data and ... limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care. + Acts as...in a timely manner working with a quality- based coder to optimize coding specificity. + Follows policy and… more
- Elevance Health (Miami, FL)
- …considered._ The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) ... of business, and its clients. Specializes in review of DRG coding via medical record and attending physician's statement provided by acute care hospitals on paid… more
- Molina Healthcare (Orlando, FL)
- …for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position uses information from a tip, member benefits, and ... medical records to document relevant findings of a post...registered nurse (RN), Licensed practical nurse (LPN) and/or Certified Coder (CPC, CCS, and/or CPMA) **Preferred Education** Bachelor's degree… more
- Elevance Health (Tampa, FL)
- …Related Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs ... you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of … more
- Community Health Systems (Naples, FL)
- …with providers through education and the physician query process, ensuring medical records accurately reflect patient severity of illness and support continuity ... and acuity. + Adheres to corporate recommended CDI workflows and uses CDI and medical records software, such as 3M 360 Encompass and Iodine Interact, to support… more
- Datavant (Tallahassee, FL)
- …access, developing training plans, and creating support structures for successful coder engagement and outcomes. + Supervise quality assurance and performance ... exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its...vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion. This job is not eligible… more
- Elevance Health (Tampa, FL)
- …abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. + Researches new healthcare related questions as ... an Associate Degree in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA) and minimum of 4 years related experience, including… more