- Datavant (Tallahassee, FL)
- …for healthcare. **What We're Looking For:** As an HCC (Hierarchical Condition Category) Auditor you will review medical records that have been coded in a ... You Will Do:** + Audit coded charts assigned by quality supervisor per the client guidelines + Ability to...a diagnosis level + Answer rebuttals entered on the auditor by coders and or auditors + Participate in… more
- AdventHealth (Tampa, FL)
- …heart failure, cancer and other diseases. **The role you'll contribute:** The Coding Quality Auditor , under the general supervision of the Outpatient Coding ... is responsible for the internal coding audit and clinical quality reviews. The Coding Quality Auditor...+ Must have one of the following certifications: + Certified Pension Consultant (CPC) + Certified Coding… more
- AdventHealth (Tampa, FL)
- …Primary Stroke Center. **The ro** **le you'll contribute:** The Inpatient Coding Quality Auditor , under general supervision of the Inpatient Operations Manager, ... for the daily auditing of records. The Inpatient Coding Quality Auditor works in collaboration with the...required + 1-2 years of auditing experience preferred + Certified Coding Specialist (CCS) required. Will accept RHIA or… more
- Highmark Health (Tallahassee, FL)
- … Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or ... and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs,… more
- CVS Health (Tallahassee, FL)
- …each and every day. Aetna's Revenue Integrity team is hiring Senior Coding Data Quality Auditors to support our growing risk adjustment efforts. This role plays a ... a passion for continuous improvement. This position will sit within our Coding Quality Operations team and offers the flexibility of working from home. **Position… more
- Datavant (Tallahassee, FL)
- …educational and life experiences to realize our bold vision for healthcare. As an Auditor , HCC Risk Adjustment Coder, you will review medical records to identify and ... of HCC Auditing experience + High school diploma or GED equivalent + AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials (CPC, CPC-H,… more
- AdventHealth (Orlando, FL)
- …development, ongoing audits for the system level and campus level, and quality improvement efforts. Works under general supervision and utilizes critical thinking ... and accuracy for severity of illness (SOI), risk of mortality (ROM), and quality . + Completes accurate and timely record review to ensure the integrity of… more
- AdventHealth (Maitland, FL)
- …year **The role you'll contribute:** Under the general supervision of the Coding Quality Manager, the Data Quality Reviewer is responsible for validating the ... respectful to all. **The value you'll bring to the team:** + Performs quality reviews on coded records to validate ICD-10, ICD-10-PCS, MS-DRG, APR-DRGs, and overall… more
- Humana (Tallahassee, FL)
- …compliance, mainly primary care and risk adjustment, pharmacy knowledge a plus + Certified Coder (CPC, CRC, and/or CMC) + Experience with metrics and reporting ... need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel,… more
- Molina Healthcare (Miami, FL)
- …Quality program leadership and direction **Preferred License, Certification, Association** + Certified Professional in Health Quality (CPHQ) + Nursing License ... **JOB DESCRIPTION** **Job Summary** Molina's Quality Improvement function oversees, plans, and implements new...(RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all… more