- Molina Healthcare (FL)
- …investigations. + Conducts low to medium, and extensive investigations, including reviews of medical records and data analysis, and makes determinations as to ... waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding... medical review audits that may also include coding and billing reviews. The SIU Investigator is responsible… more
- AdventHealth (Orlando, FL)
- …you'll bring to the team:** + Clinical Documentation Improvement: Analyze patient medical records to identify areas where documentation needs improvement, ... the clinical leader and liaison between the CDI department, physicians, and coding /billing teams. This role is responsible for ensuring that clinical documentation… more
- Fresenius Medical Center (St. Petersburg, FL)
- …Manager to oversee the facility's Home Therapies Program. + Maintains integrity of medical and operations records and complies with all data collections and ... **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations.… more
- Molina Healthcare (FL)
- …and other business requirements critical to claim accuracy. Maintain audit records , and provide counsel regarding coverage amount and benefit interpretation within ... modules within the core processing system (QNXT). * Conducts focal healthcare Medical claim audits on samples of processed transactions impacted by these… more
- MyFlorida (Monticello, FL)
- …+ Record Keeping and Documentation : proficiency in maintaining accurate, organized medical records and adhering to privacy regulations. + Time Management ... care plans; and assessment and screening for student health risks and medical conditions. Ensures the safety of individuals attending school clinics. Identifies… more
- Community Health Systems (Naples, FL)
- …and standards. **Qualifications** + 0-2 years of experience in health information management, medical records , or a related healthcare role required + Experience ... (HIM) Specialist is responsible for managing and maintaining patient health records in accordance with healthcare regulations and organizational policies. This role… more
- Centene Corporation (Fort Myers, FL)
- …HEDIS measures and risk adjustment. Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding . Assists in resolving ... for the health plan peers on HEDIS measures, appropriate medical record documentation and appropriate coding . Supports...by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA… more
- Datavant (Tallahassee, FL)
- …you will play a pivotal role in elevating the impact of our medical record documentation. You will conduct daily evaluations and engage in direct communication ... with providers to enhance documentation clarity, completeness, and overall medical record quality. By ensuring accurate and comprehensive physician documentation,… more
- Elevance Health (Tampa, FL)
- …and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately ... related questions as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations. +… more
- 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 ... - 5:00pm Central time Remote position **Essential Job Duties** * Performs clinical/ medical reviews of previously denied cases in which a formal appeals request… more
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