- HCA Healthcare (Tampa, FL)
- …communicate nuances of unique coding requirements for major payers such as Medicare , Medicaid, HMO's, PPO's, IPA's, employers, etc. + Demonstrate and share knowledge ... preferred. + Inpatient/outpatient professional fee coding experience required. + Previous audit experience preferred. + Coding certification through AHIMA or AAPC… more
- Humana (Tallahassee, FL)
- …+ Familiarity with compliance standards, HR data governance, and system audit -readiness. **Preferred Qualifications** + MBA or other Advanced Degree + Demonstrated ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- AdventHealth (Tampa, FL)
- …supervision of the Outpatient Coding Manager, is responsible for the internal coding audit and clinical quality reviews. The Coding Quality Auditor will work in ... rules applicable to AdventHealth West Florida Division and requirements of Medicare and payor specifications. Assist with timely interaction between departments to… more
- Humana (Tallahassee, FL)
- …+ Familiarity with compliance standards, Finance data governance, and system audit -readiness. **Preferred Qualifications** + MBA or other Advanced Degree + ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- AdventHealth (Altamonte Springs, FL)
- …compliance for all CDSs throughout all facilities on a quarterly basis through audit process + Completes accurate and concise input of audits to provide feedback ... nursing, and care management. This includes quarterly compliance updates from Medicare . + Effectively and appropriately communicates with physicians and other… more
- Zelis (St. Petersburg, FL)
- …claims required + Supervisory experience preferred + Solid understanding of audit techniques and identification of revenue opportunities + Experience and working ... knowledge of Health Insurance, Medicare guidelines and various healthcare programs + Strong understanding of hospital coding and billing rules + Clinical and… more
- University of Miami (Medley, FL)
- …Data Set (UHDDS), and other regulatory requirements to assure proper Medicare Severity Diagnostic Related Groups (MS-DRG) assignment. + Review medical record ... response, DRG mismatch, etc. + Mandatory daily review and reconciliation of any pending audit reviews. + Code any high dollar accounts that have been assigned by the… more
- HCA Healthcare (Tallahassee, FL)
- …8. Collaborates with the Behavioral Health Program Director with individual audit functions of staff documentation and competencies 9. Maintains Patient Care ... established by the Hospital, Federal, State, and accrediting agencies (ie, Medicare , Joint Commission, Core Measures, ACHA). 10. Actively participates with the… more
- University of Miami (Miami, FL)
- …the mandates by state and federal programs, inclusive of the Centers for Medicare and Medicaid Services. Maintains fluency of provider workflows across UHealth that ... deadlines, and critical information stays current. + Assists with preparation of audit responses related to governmental program submissions prior to submission to… more
- HCA Healthcare (Gainesville, FL)
- …clinical documentation, making necessary corrections in Patient Accounting. Based on audit findings, present recommendations to Corporate and SSC Revenue Integrity ... calls, ensuring continuous education. + Possess working knowledge of Medicare guidance, inpatient/outpatient status, and observation requirements. + Knowledge of… more