• Medical Necessity Coding

    HCA Healthcare (Ocala, FL)
    …general/focus education for facility leaders on (but not limited to) compliance , medical necessity , charge practices, coding requirement etc. + Tracks ... join an organization that invests in you as a Medical Necessity Compliance Coordinator? At...substitute education requirements. + Minimum 3 years of hospital coding experience preferred + Minimum 5 years healthcare experience… more
    HCA Healthcare (04/13/25)
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  • Consultant, Ethics & Compliance (Audit)

    Cardinal Health (Tallahassee, FL)
    …detection and correction of documentation, coding , and billing errors and/or medical necessity of services billed. Particular areas of focus include: ... assigned. **_Qualifications_** + 4-8 years experience in physician and/or hospital technical coding /auditing, medical necessity reviews, or related work.… more
    Cardinal Health (04/25/25)
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  • Director of Audit and Education

    AdventHealth (Maitland, FL)
    …training. **KNOWLEDGE AND SKILLS PREFERRED:** + Current knowledge of coding compliance and medical necessity audit correction process. + Demonstrates ... + Computer knowledge of Microsoft software, Power Point, Visio, electronic medical record applications, coding software. **LICENSURE, CERTIFICATION OR… more
    AdventHealth (05/07/25)
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  • Investigator, SIU RN-Remote

    Molina Healthcare (FL)
    medical determinations as necessary, and applies clinical knowledge to assess the medical necessity , level of services, and/or appropriateness of care in ... to health care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews.… more
    Molina Healthcare (04/12/25)
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  • Authorization Specialist

    Option Care Health (Tallahassee, FL)
    …involves setting up patient accounts, obtaining necessary clinical documentation, and verifying medical necessity . The specialist must have a solid understanding ... of basic medical coding , diagnosis codes, and ...system + Obtain and review clinical documentation to verify medical necessity + Communicate with healthcare providers… more
    Option Care Health (05/07/25)
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  • Associate Care Management Coordinator

    Highmark Health (Tallahassee, FL)
    …and in writing when the information provided is not adequate to make a medical necessity determination + Maintain or exceed department call center standards + ... based on the benefits for the line of business, and in compliance with the organization's policies, procedures and regulatory requirements. Document, process and… more
    Highmark Health (05/02/25)
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  • Clinical Pharmacist

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    …Determinations and monitoring of optimal cost effective drug management + Perform medical necessity reviews for formulary exceptions and prior authorizations ... and management of the Health Plan's Medicare Prescription Drug Program, including compliance and oversight of Medicare Part D laws, regulations and reporting… more
    DOCTORS HEALTHCARE PLANS, INC. (05/02/25)
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  • Engineer I: Facility Control Systems Engineer…

    RTX Corporation (West Palm Beach, FL)
    …and Allen Bradley PLC hardware. + Experience with Labview or similar graphical coding environments. + PID tuning experience. + HMI design experience. + Experience ... may be eligible for benefits, including but not limited to, medical , dental, vision, life insurance, short-term disability, long-term disability, 401(k) match,… more
    RTX Corporation (05/07/25)
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  • Facility Control Systems Engineer (Onsite)

    RTX Corporation (West Palm Beach, FL)
    …and ladder logic programming. + Experience with Labview or similar graphical coding environments. + Experience with PID tuning skills. + HMI design experience. ... may be eligible for benefits, including but not limited to, medical , dental, vision, life insurance, short-term disability, long-term disability, 401(k) match,… more
    RTX Corporation (04/29/25)
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