• Analyst , Coding Data Quality…

    CVS Health (FL)
    …+ CPMA (Certified Professional Medical Auditor), CDEO (Certified Documentation Expert Outpatient ) or CPC-I (Certified Professional Coding Instructor) preferred. ... proficiency in the following: + Proven ability to support coding judgment and decisions using industry standard evidence and...Leads dispute resolution. + Acts as mentor to provide education to internal staff based on audit findings; provides… more
    CVS Health (10/02/25)
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  • Quality Senior Analyst

    CVS Health (FL)
    …in medical documentation, fraud, abuse and penalties for documentation and coding violations based on governmental guidelines. ** Education ** + Bachelor's ... highlighting findings, recommendations, and areas of concern to be delivered to coding resources. + Adhere to stringent timelines consistent with project deadlines… more
    CVS Health (09/30/25)
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  • Analyst , Configuration Oversight (Claims…

    Molina Healthcare (Orlando, FL)
    …and services billed under Institutional and non-institutional claims. * Validates coding , updating and maintaining benefit plans, provider contracts, fee schedules ... principles and state specific policies and regulations to identify incorrect coding , abuse and fraudulent billing practices, waste, overpayments, and processing… more
    Molina Healthcare (09/17/25)
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