Top 79 Clinical reviewer Jobs in Florida

Second Level Reviewer I PRN Remote
AdventHealth Corporate —Altamonte Springs, FL
- $31.82 - $59.17 an hour
- PRN
- Remote
- Background check
- Nursing
- RN License
- Paid parental leave
- Disability insurance
Utilization Review Specialist (Remote)
The Florida House —Deerfield Beach, FL
- Per diem
- Remote
- Nursing
- Addiction Medicine
- Mid-level
- Continuing education credits
- Disability insurance
Quick Apply
8d
Utilization Review Specialist
We Level Up —Pompano Beach, FL
- $50,000 - $90,000 a year
- Full-time
- Remote
- 18 years or older
- CPR Certification
- HIPAA
Quick Apply
DRG Nurse Reviewer Appeals and Hearings- Remote
Gainwell Technologies —Florida
- $95,000 - $110,000 a year
- Full-time
- Remote
- RN License
- Presentation skills
- Travel
- Health insurance
- Tuition reimbursement
Second Level Reviewer I
AdventHealth Corporate —Altamonte Springs, FL
- $66,170.74 - $123,073.07 a year
- Full-time
- Background check
- Nursing
- RN License
- Paid parental leave
- Disability insurance
Insurance Reviewer Clinical
Florida Cancer Affiliates —Ocala, FL
- HIPAA
- Research
- Mid-level
- Wellness program
- Disability insurance
2d
Physician Reviewer - Internal Medicine
Dane Street, LLC —West Palm Beach, FL
- Contract
- Remote
- Medicine
- Internal Medicine
- Mid-level
Quick Apply
Utilization Reviewer 2
Enlyte —Tampa, FL
- $59,500 - $76,000 a year
- Full-time
- RN License
- Mid-level
- Office
- Health savings account
- AD&D insurance
CLINICAL REVIEWER - MA - FULL TIME
WATSON CLINIC LLP —Lakeland, FL
- Full-time
- Clinic experience
- High school diploma or GED
- Communication skills
Quick Apply
9d
Clinical Documentation Integrity - Second Level Reviewer
University of Miami —Hialeah, FL
- Full-time
- Remote
- Nursing
- Medicine
- Microsoft Excel
- Health insurance
- Dental insurance
Medical Reviewer
Medical Consultants Management LLC —Deerfield Beach, FL
- Bilingual
- Writing skills
- Clinic experience
- Paid holidays
- Health insurance
Quick Apply
OASIS Reviewer
Revival Home Health Care a Centers Company —Margate, FL
- Full-time
- Nursing
- RN License
- Mid-level
Quick Apply
Utilization Management Rep I (contract)
Elevance Health —Tampa, FL
- Call employer
- Hybrid work
- High school diploma or GED
- US work authorization
- Data entry
- Health savings account
- Disability insurance
RN Professional Practice Quality Reviewer (Full Time, Days)
Nicklaus Children's Hospital —Miami, FL
- Full-time
- Nursing
- Microsoft Excel
- Microsoft Access
5d
UTILIZATION REVIEWER
Larkin Community Hospital —South Miami, FL
- Full-time
- Spanish
- RN License
- English
13d
Utilization Management Reviewer
Mental Health Resource Center —Jacksonville, FL
- Full-time
- Background check
- Nursing
- Psychiatry
- Paid holidays
- Disability insurance
Quick Apply
Hospice Physician Audit Reviewer (Remote)
VITAS Healthcare —Miramar, FL
- Full-time
- Remote
- Senior level
- Hospice & Palliative Medicine
Quick Apply
12h
Clinical Nurse Reviewer
Zelis —Saint Petersburg, FL
- $59,000 - $75,050 a year
- Full-time
- Nursing
- RN License
- Inventory management
- Paid holidays
- Disability insurance
Intake RN
Centers Plan for Healthy Living —Margate, FL
- Full-time
- RN License
- HIPAA
- Mid-level
Quick Apply
Senior Clinical Reviewer
Christian Care Ministry —Orlando, FL
- $31.97 - $43.51 an hour
- Full-time
- 18 years or older
- Anatomy knowledge
- Microsoft Excel
- Paid parental leave
- Health savings account
2d

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clinical reviewer jobs near florida

Second Level Reviewer I PRN Remote

AdventHealth Corporate -
Altamonte Springs, FL

Apply Now

Job Details

PRN
$31.82 - $59.17 an hour

Benefits

Paid parental leave
Disability insurance
Health insurance
Dental insurance
Paid time off
Parental leave
Vision insurance
403(b)
Benefits from day one
Life insurance

Qualifications

Triage
Acute care facility experience
Typing

Full Job Description

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
Paid Time Off from Day One
403-B Retirement Plan
4 Weeks 100% Paid Parental Leave
Career Development
Whole Person Well-being Resources
Mental Health Resources and Support
Pet Benefits

Schedule:

PRN

Shift:

Day (United States of America)

Address:

900 HOPE WAY

City:

ALTAMONTE SPRINGS

State:

Florida

Postal Code:

32714

Job Description:

Reviews concurrent medical records for documentation compliance, including completeness and accuracy for severity of illness (SOI), risk of mortality (ROM), and quality. Completes accurate and timely record reviews to ensure the integrity of documentation compliance. Inputs data into CDI Software accurately and concisely, resulting in precise metrics obtained through the reconciliation process. Recognizes opportunities for documentation improvement using strong critical-thinking skills and sound judgment. Initiates and formulates CDI severity worksheets and clinically credible clarifications for inpatients, presenting opportunities for improved documentation compliance to physicians, nurse practitioners, and other clinical team members. Transcribes documentation clarifications as appropriate for SOI, ROM, PSI, HCCs, and HACs to ensure documentation compliance. Educates members of the patient-care team regarding documentation regulations and guidelines, including physicians, allied health practitioners, and nursing, with quarterly and annual compliance updates from Medicare. Communicates effectively and appropriately with physicians and other healthcare providers to ensure accurate and complete clinical documentation. Collaborates with HIM staff to resolve discrepancies with DRG assignments and other coding issues. Completes well-timed follow-up case reviews on all cases, prioritizing resolution of those with clinical documentation clarifications. Participates in department meetings, providing feedback on outstanding issues, presentations for educational opportunities, and addressing needs identified by CDI leaders. Assumes personal responsibility for professional growth, development, and continuing education to maintain a high level of proficiency. Performs other duties as assigned.

Knowledge, Skills, and Abilities:

Excellent interpersonal skills including excellent verbal and written communication skills; proficient in and demonstrates excellent physician relations. [Required]
Able to organize and present information clearly and concisely; excellent computer and keyboarding skills; ability to use multiple software programs simultaneously; high degree of prioritization skills. [Required]
Ability to learn/develop and fine-tune the skills necessary to perform optimally as a Clinical Documentation Specialist. [Required]
Dependable, self-motivated and pleasant. [Required]
Utilize and demonstrate excellent critical-thinking, problem-solving and deductive-reasoning skills. [Required]
Knowledge of pathophysiology, disease processes and treatments. [Required]
Strong ability to organize/triage work and manage multiple priorities at once. [Required]
Knowledge of clinical documentation requirements that identify clinical conditions or procedures. [Preferred]
Coding background. [Preferred]
Knowledge of quality guidelines. [Preferred]

Education:

Bachelor's of Nursing [Required]
Master's [Preferred]

Field of Study:

in healthcare related field

Work Experience:

5+ years acute care nursing experience with specific medical/surgical, Intensive Care, post-acute care unit, or Emergency Department experience. [Required]
3+ years of Clinical Documentation Specialist experience [Required]

Additional Information:

An equivalent combination of education and relevant work experience may be considered in lieu of the stated degree requirement:- BSN and 3+ years of Clinical Documentation Specialist experience OR - 4+ years of Clinical Documentation Specialist experience OR - Less than 2 years of Clinical Documentation Integrity experience and 10 years of acute care nursing experience.

Licenses and Certifications:

Registered Nurse (RN) [Required] OR
Physician Assistant (PA) [Required] OR
Advanced Practice Registered Nurse (APRN) [Required] OR
Certified Clinical Documentation Specialist (CCDS) [Required]
Certified Billing and Coding Specialist (CBCS) [Preferred]
Certified Cardiac Device Specialist (CCDS) [Required]

Physical Requirements: (Please click the link below to view work requirements)

Physical Requirements -https://tinyurl.com/23km2677

Pay Range:

$31.82 - $59.17

Background Screening Requirement (Florida Law)

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse:
https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Apply Now

Refine Your Search

clinical reviewer jobs in florida

Second Level Reviewer I PRN Remote

Utilization Review Specialist (Remote)

Utilization Review Specialist

DRG Nurse Reviewer Appeals and Hearings- Remote

Second Level Reviewer I

Insurance Reviewer Clinical

Physician Reviewer - Internal Medicine

Utilization Reviewer 2

CLINICAL REVIEWER - MA - FULL TIME

Clinical Documentation Integrity - Second Level Reviewer

Medical Reviewer

OASIS Reviewer

Utilization Management Rep I (contract)

RN Professional Practice Quality Reviewer (Full Time, Days)

UTILIZATION REVIEWER

Utilization Management Reviewer

Hospice Physician Audit Reviewer (Remote)

Clinical Nurse Reviewer

Intake RN

Senior Clinical Reviewer

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