• Medical Review Nurse (RN)

    Molina Healthcare (FL)
    …and applicable software program(s) proficiency. **PREFERRED QUALIFICATIONS:** + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), ... has been made, or is likely to be made, to ensure medical necessity and appropriate/accurate billing and claims processing. + Reevaluates medical claims and… more
    Molina Healthcare (09/06/25)
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  • DRG Coding Auditor

    Elevance Health (Tampa, FL)
    …certification as a Registered Health Information Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder . + Requires 5 ... or hospital coding or quality assurance environment preferred. + Broad knowledge of medical claims billing /payment systems provider billing guidelines, payer… more
    Elevance Health (10/25/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (FL)
    …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... Related Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs… more
    Elevance Health (11/12/25)
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