Job Closed
This listing is no longer active.
As a Florida Blue employee, you will thrive in our Be Well, Work Well, GuideWell culture where being well as an individual, and working well as a team, are both important in serving our members and communities. We are an Equal Employment Opportunity employer committed to cultivating a work experience where everyone feels like they belong and can perform at their best in pursuit of our mission. All qualified applicants will receive consideration for employment.
Medicare Sr. Coding & Quality Educator, CPMA, CPC-I
Location
United States
Posted
52 days ago
Salary
$77.6K - $126K / year
Seniority
Senior
No structured requirement data.
Job Description
Medicare Sr. Coding & Quality Educator, CPMA, CPC-I
Florida Blue
Job Summary The work of a Sr. Coding & Coding Quality Educator relates to practices and principles associated with medical record auditing and utilizes various techniques in examining, evaluating and providing feedback and training to various stakeholders (certified coders, physician's practices, etc.) Key responsibilities include setting up a standard medical record auditing process and assisting in all matters relating to implementation of coding quality and coding training programs for Coders and Physicians, creating an integrated Program plan to carry out goals and managing/monitoring progress of the program execution. Essential Functions - The essential functions listed represent the major duties of this role, additional duties may be assigned. - Work closely with and coach certified coders and assist in assessing the strengths and weaknesses, ensuring that quality issues translate into timely training and ongoing coding reinforcement to the coders. - Verify, document and communicate quality audit results, develop audit reports and evaluate the effectiveness of corrective action plans and follow up. - Identify coding opportunities and make recommendations to improve internal controls and operational effectiveness and efficiency. - Assist in preparation & development of provider training tools and lead and conduct educational and training programs for physician training on various aspects of documentation and ICD-10-CM coding. - Perform review of specific provider/provider group medical records, develop audit reports and communicate audit results to external physician groups and physician group administration. - Coordinate quality audit program reporting and provider coding training with appropriate areas within Medicare Advantage Risk Adjustment and promote teamwork. - Responsible for the development and ongoing, end-to-end management of the quality audit program ensuring that QA activities and measurements are objective. - Responsible for quality audit program performance and adherence to established ICD-10-CM and CMS-HCC coding guidelines, ensuring compliance with all regulations. - Develop and maintain appropriate reporting, identifying metrics that will reflect true audit program performance. - Gain management concurrence and support for recommended control improvements. - Test and improve training program based upon experience and feedback. - Gather information, constantly update knowledge on various changes that are happening in the field of quality audit and modify coding guidelines to incorporate new knowledge. Share changes with coders as well as physician practices partners. - Manage multiple complex issues and projects simultaneously. - Work collaboratively with other areas of Revenue Program Management to identify, implement and monitor continuous improvement opportunities. - May require travel 0-25% of the time to Florida Blue office locations and provider engagements. Required Experience: 5+ years related work experience. Experience Details: Professional coding including proficiency in ICD-10-CM coding guidelines and risk adjustment HCC coding Related Bachelor’s degree or additional related equivalent work experience AAPC Certified Professional Medical Auditor (CPMA) certification AAPC Certified Professional Coding Instructor (CPC-I) certification 1 Year Knowledge of CMS-HCC risk adjustment data validation process. Organization and time management skills Demonstrate written and verbal communication skills. Preferred Qualifications: Knowledge of government regulations, requirements, and standards related to the management of health information. Knowledge of Scope and Statistical Sampling Methodologies Detail-oriented, commitment to accuracy, ability to problem solve. Working knowledge of MS Office (Excel, Word, PowerPoint) General Physical Demands: Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally. Physical/Environmental Activities Must be able to travel to multiple locations for work (i.e. travel to attend meetings, events, conferences). Occasionally What We Offer: As a Florida Blue employee, you will thrive in our Be Well, Work Well, GuideWell culture where being well as an individual, and working well as a team, are both important in serving our members and communities. To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to: - Medical, dental, vision, life and global travel health insurance; - Income protection benefits: life insurance, short- and long-term disability programs; - Leave programs to support personal circumstances; - Retirement Savings Plan including employer match; - Paid time off, volunteer time off, 10 holidays and 2 well-being days; - Additional voluntary benefits available; and - A comprehensive wellness program Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for intern, part-time and seasonal employees may differ. To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases. Annualized Salary Range: $77,600 - $126,100 Typical Annualized Hiring Range: $77,600 - $97,000 Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring. We are an Equal Employment Opportunity employer committed to cultivating a work experience where everyone feels like they belong and can perform at their best in pursuit of our mission. All qualified applicants will receive consideration for employment.
Related Guides
Related Categories
Related Job Pages
More Auditor Jobs
Environmental Market Leader
Apex CompaniesApex Companies is a nationally recognized environmental consulting and engineering firm committed to creating a safe, sustainable, and equitable future. Since its founding in 1988,
Are you highly motivated, hard-working, and seeking to join a growth-focused consulting & engineering firm? Are you looking for a company that will invest in your development and grow your professional skills? If so, consider a career with Apex! Powered by record sales, extraordinary client retention, strategic acquisitions, and an entrepreneurial spirit, Apex Companies is one of the fastest growing engineering and environmental consulting firms in the US. We were recently recognized by the Zweig Group as one of the fastest growing firms in the AEC industry. We take pride in providing our clients with exceptional service and have earned numerous awards for project excellence. We continue to grow, and we want you to grow with us. Environmental Market Leader – South Atlantic Division Locations: North Carolina, South Carolina, Georgia, Florida Work Model: Remote Position Overview The Environmental Market Leader – South Atlantic Division is a high‑impact, growth‑oriented leadership role responsible for expanding Apex’s environmental consulting business across our South Atlantic Division (Carolinas, Georgia, and Florida). This position is ideal for a senior seller‑doer who thrives in externally facing roles, enjoys building trusted client relationships, and wants to directly influence the growth and direction of a business. This role offers the opportunity to help shape Apex’s environmental strategy in the South Atlantic by driving organic growth, deepening key client relationships, and leveraging Apex’s national technical capabilities. The Practice Leader will collaborate closely with Division leadership, National Account Managers, and technical teams while maintaining a strong personal presence in the market. The Opportunity With the chance to engage with clients on an ongoing basis and help shape Apex’s environmental footprint in the region, this is a high‑visibility role offering significant growth potential and long‑term career advancement. The successful candidate will operate entrepreneurially while being supported by Apex’s established platform, leadership team, and national resources. Your Responsibilities as a Environmental Market Leader: - Drive growth of Apex’s environmental consulting services across the South Atlantic, with accountability for pipeline development, opportunity creation, and revenue generation; looking for a focus on site characterization, investigation, and remediation for industrial/commercial and municipal clients. - Serve as a client-facing leader and trusted advisor, maintaining active engagement with key industrial, commercial, and municipal clients to both long-term partners and new business opportunities. - Identify, shape, and pursue new opportunities by leveraging your professional network and collaborating with Apex’s National Account Managers, Regional Commercial Leaders, Service Line Leaders, and local technical teams. - Lead and influence pursuit strategy, go/no‑go decisions, proposal development, and contract negotiations for strategic opportunities. - Provide technical and strategic leadership on select environmental engagements, ensuring quality execution while maintaining a primary focus on client satisfaction and repeat business. - Work closely with National Account Managers and Commercial Line Leaders to build and execute on account plans and develop opportunities across the Division. - Direct high-visibility projects, ensuring technical excellence, regulatory compliance, and successful environmental outcomes. - Collaborate and communicate effectively on key technical concepts to regulators, stakeholders, and teaming partners. - Manage program and project performance with a focus on quality, innovation, and client satisfaction. - Travel to client locations as needed for meetings and business development. What we're looking for: Industry Experience - 12+ years of experience in environmental consulting or industry with progressive responsibility in client-facing, seller-doer roles. - Professional registration as a PE or PG in North Carolina, South Carolina, Georgia or Florida - Proven success in client engagement, building opportunities through existing relationships, and managing complex environmental programs. - Deep technical expertise with site characterization, investigation, remediation, and regulatory strategy. - Strong communication skills — both technical and strategic — with a proven ability to gain credibility with regulators, stakeholders, and clients. - A passion for mentoring, leadership, and advancing a culture of excellence and safety. - Established professional network within the South Atlantic market. Sales and Growth Experience - Demonstrated success growing client accounts and developing new business in a consulting environment. - Track record of identifying opportunities, shaping pursuits, and converting relationships into revenue. - Strong commercial acumen with the ability to align technical solutions to client business needs. - Commitment to a growth mindset and long‑term client relationship development Leadership Attributes - Confident, collaborative leader with strong communication and presentation skills. - Ability to operate independently while thriving in a team-based, cross-functional environment. - Passion for mentoring and developing high performing technical and seller-doer teams. - Comfortable operating in a fast paced, PE backed environment focused on performance and growth. Why you'll love working for us: - Company-subsidized medical and dental. - Company-paid life, short, and long-term disability. - 401k match, tuition assistance, and more. - Cross-training and the ability to work on a variety of projects. - Performance-based bonuses or other incentives. - Working with the best and brightest in the industry. - 2,000+ employee national firm with 70+ locations across the US. Apex Job Title: Principal Req ID: 11427 #LI-TB1 We believe in equality for all and celebrate the diversity and differences of our employees, customers, and communities. We do not discriminate based on gender, race or color, ethnicity or national origin, age, disability, religion, sexual orientation, gender identity or expression, veteran status, or any other applicable characteristics protected by law. Apex aims to make apexcos.com accessible to all users. If you have a disability or special need that requires accommodation to navigate our website or complete the application process, please contact Talent@apexcos.com or (301) 417-0200. Likewise, feel free to reach out to us if you would like to view or discuss Apex policy related to equal employment opportunity or have any related concerns. EO/AA/VEV/Disabled Employer TO ALL RECRUITMENT AGENCIES: Apex Companies does not accept unsolicited agency resumes. Please do not forward resumes for any of our job postings to our career’s sites, or to any employees of Apex Companies or affiliates. Apex Companies is not responsible for any fees related to unsolicited resumes.
Environmental Market Leader
Apex CompaniesApex Companies is a nationally recognized environmental consulting and engineering firm committed to creating a safe, sustainable, and equitable future. Since its founding in 1988,
Are you highly motivated, hard-working, and seeking to join a growth-focused consulting & engineering firm? Are you looking for a company that will invest in your development and grow your professional skills? If so, consider a career with Apex! Powered by record sales, extraordinary client retention, strategic acquisitions, and an entrepreneurial spirit, Apex Companies is one of the fastest growing engineering and environmental consulting firms in the US. We were recently recognized by the Zweig Group as one of the fastest growing firms in the AEC industry. We take pride in providing our clients with exceptional service and have earned numerous awards for project excellence. We continue to grow, and we want you to grow with us. Environmental Market Leader – South Atlantic Division Locations: North Carolina, South Carolina, Georgia, Florida Work Model: Remote Position Overview The Environmental Market Leader – South Atlantic Division is a high‑impact, growth‑oriented leadership role responsible for expanding Apex’s environmental consulting business across our South Atlantic Division (Carolinas, Georgia, Florida). This position is ideal for a senior seller‑doer who thrives in externally facing roles, enjoys building trusted client relationships, and wants to directly influence the growth and direction of a business. This role offers the opportunity to help shape Apex’s environmental strategy in the South Atlantic by driving organic growth, deepening key client relationships, and leveraging Apex’s national technical capabilities. The Practice Leader will collaborate closely with Division leadership, National Account Managers, and technical teams while maintaining a strong personal presence in the market. The Opportunity With the chance to engage with clients on an ongoing basis and help shape Apex’s environmental footprint in the region, this is a high‑visibility role offering significant growth potential and long‑term career advancement. The successful candidate will operate entrepreneurially while being supported by Apex’s established platform, leadership team, and national resources. Your Responsibilities as a Environmental Market Leader: - Drive growth of Apex’s environmental consulting services across the South Atlantic, with accountability for pipeline development, opportunity creation, and revenue generation; looking for a focus on site characterization, investigation, and remediation for industrial/commercial and municipal clients. - Serve as a client-facing leader and trusted advisor, maintaining active engagement with key industrial, commercial, and municipal clients to both long-term partners and new business opportunities. - Identify, shape, and pursue new opportunities by leveraging your professional network and collaborating with Apex’s National Account Managers, Regional Commercial Leaders, Service Line Leaders, and local technical teams. - Lead and influence pursuit strategy, go/no‑go decisions, proposal development, and contract negotiations for strategic opportunities. - Provide technical and strategic leadership on select environmental engagements, ensuring quality execution while maintaining a primary focus on client satisfaction and repeat business. - Work closely with National Account Managers and Commercial Line Leaders to build and execute on account plans and develop opportunities across the Division. - Direct high-visibility projects, ensuring technical excellence, regulatory compliance, and successful environmental outcomes. - Collaborate and communicate effectively on key technical concepts to regulators, stakeholders, and teaming partners. - Manage program and project performance with a focus on quality, innovation, and client satisfaction. - Travel to client locations as needed for meetings and business development. What we're looking for: Industry Experience - 12+ years of experience in environmental consulting or industry with progressive responsibility in client-facing, seller-doer roles. - Professional registration as a PE or PG in North Carolina, South Carolina, Georgia or Florida - Proven success in client engagement, building opportunities through existing relationships, and managing complex environmental programs. - Deep technical expertise with site characterization, investigation, remediation, and regulatory strategy. - Strong communication skills — both technical and strategic — with a proven ability to gain credibility with regulators, stakeholders, and clients. - A passion for mentoring, leadership, and advancing a culture of excellence and safety. - Established professional network within the South Atlantic market. Sales and Growth Experience - Demonstrated success growing client accounts and developing new business in a consulting environment. - Track record of identifying opportunities, shaping pursuits, and converting relationships into revenue. - Strong commercial acumen with the ability to align technical solutions to client business needs. - Commitment to a growth mindset and long‑term client relationship development Leadership Attributes - Confident, collaborative leader with strong communication and presentation skills. - Ability to operate independently while thriving in a team-based, cross-functional environment. - Passion for mentoring and developing high performing technical and seller-doer teams. - Comfortable operating in a fast paced, PE backed environment focused on performance and growth. Why you'll love working for us: - Company-subsidized medical and dental. - Company-paid life, short, and long-term disability. - 401k match, tuition assistance, and more. - Cross-training and the ability to work on a variety of projects. - Performance-based bonuses or other incentives. - Working with the best and brightest in the industry. - 2,000+ employee national firm with 70+ locations across the US. Apex Job Title: Principal Req ID: 11427 #LI-TB1 We believe in equality for all and celebrate the diversity and differences of our employees, customers, and communities. We do not discriminate based on gender, race or color, ethnicity or national origin, age, disability, religion, sexual orientation, gender identity or expression, veteran status, or any other applicable characteristics protected by law. Apex aims to make apexcos.com accessible to all users. If you have a disability or special need that requires accommodation to navigate our website or complete the application process, please contact Talent@apexcos.com or (301) 417-0200. Likewise, feel free to reach out to us if you would like to view or discuss Apex policy related to equal employment opportunity or have any related concerns. EO/AA/VEV/Disabled Employer TO ALL RECRUITMENT AGENCIES: Apex Companies does not accept unsolicited agency resumes. Please do not forward resumes for any of our job postings to our career’s sites, or to any employees of Apex Companies or affiliates. Apex Companies is not responsible for any fees related to unsolicited resumes.
CCC Intelligent Solutions Inc. (CCC) is a leading cloud platform for the multi-trillion-dollar insurance economy, creating intelligent experiences for insurers, repairers, automakers, part suppliers, and more. At CCC, we’re making life just work by empowering more than 35,000 businesses with industry-leading technology to get drivers back on the road and to health quickly and seamlessly. We’re pushing boundaries with innovative AI solutions that simplify and enhance the claims and repair journey. Through purposeful innovation and the strength of its connections, CCC technologies empower the people and industry relied upon to keep lives moving forward when it matters most. Learn more about CCC at www.cccis.com. The Role CCC is now hiring in Flint, MI for a Vehicle Inventory Rep with target compensation of $250 per month with the potential to earn more plus mileage and new hire incentives. Vehicle Inventory Reps travel to specific automobile dealerships to inventory their used vehicle fleet, by logging information about each vehicle, including the VIN, equipment configuration, price, and mileage. Additionally, this role completes audits of body shops within their specific area. This position is ideal for those seeking reliable supplemental income. Key Responsibilities: - Visit assigned dealerships once per month to document vehicle details (VIN, price, mileage, equipment, etc.) - Follow manufacturer guidelines to complete audits with high quality and efficiency - Conduct visual inspections of used vehicles - Ensure accurate data entry to support CCC’s automotive market valuations - Meet monthly deadlines and work independently What We Offer: - Flexible hours – Set your own schedule - Paid training – No automotive experience required - Mileage reimbursement - All necessary supplies provided - Work outdoors in a casual environment - Paid sick time - New Hire Incentives Requirements: - Ability to work outside in various weather conditions - Ability to bend, stoop, and stand for extended periods - High school diploma or equivalent - Internet access for submitting data - Reliable transportation + valid driver’s license & auto insurance - Self-motivated with strong time management skills About CCC's Commitment to Employees: Here, you belong. You are seen, valued, and respected. We celebrate you for who you are and all you bring. Every voice is heard and is important to our success. You can hear what employees have to say about our culture here If you require reasonable accommodation to complete a job application, please contact (800) 621-8070.
Registered Nurse Coding Auditor
NorthwellThe salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).
Preferred Skills: 3-5 years of Inpatient Coding experience Inpatient Coding certificate required CCS, CIC Job Description Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record. Job Responsibility 1.Leverages clinical expertise to identify and validate DRG code assignment. 2.Full review of CDI suggested code changes 3.Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. 4.Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. 5.Applies coding rules and regulations to the validation review process. 6.Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. 7.Communicates DRG changes and rationale to the coding and CDI staff. 8.Identifies appropriate coding changes necessary to provide the most valid documentation in compliance with Federal and State regulations. 9.Operates under general guidance and work assignments are varied and require interpretation and independent decisions on course of action. 10.Reviews potential reassignments; demonstrates accurate and timely review of all reassignments. 11.Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions. Job Qualification 1.Graduate from an accredited School of Nursing. Bachelor’s Degree in Nursing, required, or equivalent combination of education and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed. *Additional Salary Detail The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).
