- Oracle (Tallahassee, FL)
- …agents for clinical and operational workflows (summarization, prior auth, patient messaging, coding ). 2. Select and version foundation models and prompts to meet ... privacy, cost, latency, and safety targets. 3. Add guardrails, uncertainty handling, human-in-the-loop, and evidence-grounded citations. 4. Adapt LLMs with healthcare data via prompt engineering, instruction tuning, and preference optimization. 5. Evaluate… more
- Molina Healthcare (Jacksonville, FL)
- …the financial impact to effectively negotiate new or amended contracts (eg coding and chargemaster impact analysis) * Strong written and verbal communication skills ... required to present analytical results and findings to healthplans' senior management team and key stakeholder meetings (PowerPoint) * Coordinates and provides peer review of our quarterly national contract performance analysis by team members to ensure timely… more
- Molina Healthcare (Tampa, FL)
- …standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding /billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts ... and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms. * Understanding of… more
- The Hartford (Hollywood, FL)
- …solutions. + Conduct code reviews and ensure adherence to best practices and coding standards. + Troubleshoot and resolve technical issues related to AWS services. + ... Implement security best practices to protect sensitive data. + Stay updated with the latest AWS technologies and industry trends. Qualifications: + Bachelor's degree in Computer Science, Information Technology, or a related field. + 8+ years of experience in… more
- Molina Healthcare (Tampa, FL)
- …the financial impact to effectively negotiate new or amended contracts (eg coding and chargemaster impact analysis) + Strong written and verbal communication skills ... required to present analytical results and findings to health plans' senior management team and key stakeholder meetings (PowerPoint) + Coordinates and provides peer review of our quarterly national contract performance analysis by team members to ensure… more
- Datavant (Tallahassee, FL)
- …will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, ... presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help...profee auditor proficient in multi-specialty including procedure and E/M coding in multiple settings **What You Will Do:** +… more
- Datavant (Tallahassee, FL)
- …will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, ... presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help...HCC is a plus. **You Will:** + Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and… more
- Datavant (Tallahassee, FL)
- …will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, ... presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help...must have a CCS and 5 years of experience coding and/or auditing and strong spinal fusion experience as… more
- Zelis (St. Petersburg, FL)
- …outpatient claims for Health Plans and TPA's to ensure adherence to proper coding and billing, analyzing inpatient DRG claims based on industry standard inpatient ... coding guidelines, and supporting the Office of the Chief...FL, and Hyderabad, India. We foster a hybrid and remote friendly culture, and all our employee's work locations… more
- BayCare Health System (Tampa, FL)
- …AM to 3:30 PM + **Days:** Monday through Friday The **Advanced Inpatient Coding Specialist** is a full-time remote position. **_Sign on bonuses available!_** ... the Tampa Bay area. **Position Details:** + **Location:** Fully Remote (must reside in the state of Florida, Georgia,...This position requires 3 years' Inpatient Coding experience and a Certified Coding Specialist… more