• Senior Coding Data Quality Auditor, Coding Quality…

    CVS Health (Tallahassee, FL)
    …auditing. + CPC ( Certified Professional Coder) or CCS-P ( Certified Coding Specialist -Physician) required. + Experience with International Classification ... ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of...process and Hierarchical Condition Categories (HCC) required. + CRC ( Certified Risk Adjustment Coder) required within the first six… more
    CVS Health (08/24/25)
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  • Health Plan Operations, Payment Integrity Program…

    Molina Healthcare (FL)
    …of business. + PMP, Certified Business Analysis Professional (CBAP), or Certified Coding Specialist (CCS) certification. + Project Management Experience. + ... At least 3 years of Experience with Medicaid and/or Medicare . + Proven experience owning operational projects from concept...**PREFERRED QUALIFICATIONS:** + Experience with Medicare , Medicaid, and Marketplace lines… more
    Molina Healthcare (08/14/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Tampa, FL)
    …or more of the following: + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified ... MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the… more
    Molina Healthcare (08/15/25)
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  • Coding Auditor Educator

    Highmark Health (Tallahassee, FL)
    …AHIMA Credentials (Inpatient or Outpatient): Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) + AAPC Credentials (Outpatient): ... in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine...Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical… more
    Highmark Health (08/08/25)
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  • System CDI Quality Team Leader Educator

    AdventHealth (Altamonte Springs, FL)
    …for ECFMG Certification and examination at the time of graduation. . CCDS ( Certified Clinical Documentation Specialist ) certification . CDIP ( Certified ... nursing, and care management. This includes quarterly compliance updates from Medicare . + Effectively and appropriately communicates with physicians and other… more
    AdventHealth (08/07/25)
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  • Home Health Speech Therapy Care Manager

    AdventHealth (Orange City, FL)
    …current car insurance **Preferred qualifications:** + Recent, relevant experience in a Medicare - certified home health agency as a case-manager + Certified ... + 1 year relevant clinical Speech therapy experience + Speech Therapist - Certified + Active American Heart Association BLSValid in state Driver's License with… more
    AdventHealth (08/07/25)
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  • Facility Coding Inpatient Complex Coder

    Banner Health (FL)
    …diagnoses and operations, or an Associate's degree in a health care field. Requires Certified Coding Specialist (CCS) or Certified Outpatient Coder (COC) or ... and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health… more
    Banner Health (07/10/25)
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  • Occupational Therapist OT Home Health

    AdventHealth (Palm Coast, FL)
    …current car insurance **Preferred qualifications:** . Recent, relevant experience in a Medicare - certified home health agency as a case-manager . Certified ... Case Manager . Certificate for OASIS Specialist - Clinical This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay… more
    AdventHealth (09/02/25)
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  • ASC Surgical Coder

    TEKsystems (Tampa, FL)
    …* High school diploma or equivalent. * Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent coding credential. * Minimum 2 ... surgery. * Strong understanding of CPT guidelines for outpatient surgery and Medicare 's ASC payment system. Skills Surgical Coder, Surgical Coding, ASC, Ambulatory… more
    TEKsystems (08/27/25)
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  • Outpatient Coding Auditor Virtual

    AdventHealth (Tampa, FL)
    …one of the following certifications: + Certified Pension Consultant (CPC) + Certified Coding Specialist (CCS) This facility is an equal opportunity employer ... rules applicable to AdventHealth West Florida Division and requirements of Medicare and payor specifications. Assist with timely interaction between departments to… more
    AdventHealth (08/25/25)
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