- Conviva (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Director, Medical Coding extracts clinical information from a variety of medical records ... codes (eg, ICD-10-CM, CPT) to patient records. The Director, Medical Coding requires an in-depth understanding of... coding team and leaders to address post-visit review coding KPIs (quality, Turn-Around-TAT, appropriate clinician… more
- Centene Corporation (Tallahassee, FL)
- …coding certification and past medical claims experience. **Position Purpose:** Perform clinical/ coding medical claim review to ensure compliance with ... coding practices through a comprehensive review and analysis of medical claims, ...directives, precedent, AMA and CMS code edit criterion + Review medical records to ensure billing is… more
- Conviva (Tallahassee, FL)
- …experience in medical coding collaboration with healthcare providers + Medical record review knowledge + Medicare Risk Adjustment knowledge + Extensive ... embedded within the clinical education team and will work also closely with Coding operations team and Clinical Excellence team under the CenterWell Primary Care… more
- Highmark Health (Tallahassee, FL)
- …using skills including but not limited to Hierarchical Condition Category (HCC) Coding , medical coding , clinical terminology and anatomy/physiology, Centers ... ESRD, and ACA HCC Models; works independently in various coding applications and electronic medical record systems...requirements. + Assists with Regulatory Audits by performing first coding review and ranking of charts. Build… more
- Sutherland Global Services (Tallahassee, FL)
- Have you kept up with the changes in medical coding , physician practices, and the healthcare industry in general? Are you proficient with ICD-10, CPT and HCPCS ... and a background coding for multi-specialty practices + Thorough knowledge of medical terminology and medical abbreviations and the ability to read text for… more
- Prime Therapeutics (Tallahassee, FL)
- … (ICR) **Job Description Summary** Facilitates efforts in the development of medical pharmacy solutions programs. Supports drug utilization review (DUR) efforts ... practices, working closely with internal staff in the refinement of the medical pharmacy management solutions programs, providing consultation on pharmacy issues to… more
- HCA Healthcare (Tallahassee, FL)
- …and/or charge entry experience in the healthcare field is required . Knowledge of medical terminology and coding is highly preferred . Familiarity with third ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...do in this role:** . You will receive and review charge documents for accuracy and coordinates with front… more
- Cardinal Health (Tallahassee, FL)
- …+ Clear knowledge of Medicare (A, B, C, D) + 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience is preferred + 1-2 years of ... limited to Word, Outlook, and preferred Excel capabilities + Previous medical experience is preferred **_Responsibilities_** + Deliver virtual or telephonic… more
- Cardinal Health (Tallahassee, FL)
- …and pharmacy insurance benefit practices, preferred * 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience * 1-2 years experience ... to Word, Outlook and preferred Excel capabilities * Previous medical experience is preferred * Adaptable and Flexible, preferred...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Cardinal Health (Tallahassee, FL)
- …and pharmacy insurance benefit practices, preferred + 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience + 1-2 years' experience ... to Word, Outlook and preferred Excel capabilities + Previous medical experience is preferred + Adaptable and Flexible, preferred...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- CVS Health (Tallahassee, FL)
- …Adjustment Revenue Integrity initiatives. + Responsible for leading the reconciliation of data ( coding review results and medical record images) from ... as the support of auditing activities related to vendor reconciliation of coding results and medical record images as well as other technical projects. + Drive… more
- Highmark Health (Tallahassee, FL)
- …Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This job performs thorough medical record review to abstract medical and demographic ... **QUALIFICATIONS:** Minimum + High School/GED + Successful completion of coding courses in anatomy, physiology and medical ...of coding courses in anatomy, physiology and medical terminology + 1 year of Hospital and/or Physician… more
- Intermountain Health (Tallahassee, FL)
- …record data using International Classification of Diseases Clinical Modification and Procedure Coding System (ICD-10-CM and PCS) at an advanced level of complexity. ... expertise to work alongside and collaborate with Clinical Documentation Integrity to review complex inpatient facility encounters and assign ICD-10 CM and PCS codes… more
- MyFlorida (Tallahassee, FL)
- …and maintains the electronic record management activities involved with the Case Coding , Consultative Examination (CE), and/or Medical Evidence of Record (MER) ... OPS MEDICAL CASE RECORD SPECIALIST - 64801339 Date: Sep...that are initialized through the automated claims process, initial review , pre-development, and assignment of disability claims. This requires… more
- Humana (Tallahassee, FL)
- …will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to ... clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed… more
- Baylor Scott & White Health (Tallahassee, FL)
- …of disease, and medical terminology + Critical thinking skills for chart review and abstraction + Efficient Time Management skills + Proficiency in use of ... identifies trends and deficiencies for follow-up + Researches complex coding HCC issues and keeps abreast of coding... coding HCC issues and keeps abreast of coding and compliance changes as communicated by CMS, HHS,… more
- CVS Health (Tallahassee, FL)
- …in North Carolina and have a NC License without encumbrances.** In the Medical Director role you will provide oversight for medical policy implementation. ... You'll participate in the development, implementation, and evaluation of clinical/ medical programs and expand Aetna's medical management programs to address… more
- HCA Healthcare (Tallahassee, FL)
- …provides satisfaction and personal growth, we encourage you to apply for our Medical Business Office Specialist opening. We promptly review all applications. ... We care like family! Jump-start your career as a Medical Business Office Specialist today with Tallahassee Outpatient Surgery...for your patients prior to surgery You will identify coding or billing problems from EOBs and works to… more
- CVS Health (Tallahassee, FL)
- …**Position Summary** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Cardiology) that can be remote based, work from home. This role ... can be remote based anywhere in the US. The Medical Director (Cardiology) will be a Subject Matter Expert...and providers. You will lead all aspects of utilization review /quality assurance, directing case management. In this role you… more
- CVS Health (Tallahassee, FL)
- …**This is a remote based (work at home) based anywhere in the US.** The Medical Director (Ortho/Total Joint) will be a Subject Matter Expert (SME) with a background ... post-graduate direct patient care experience specifically. This role expands Aetna's medical management programs to address member needs across the continuum of… more