• Compliance Audit Manager

    Cardinal Health (Tallahassee, FL)
    …well as the development and completion of the annual enterprise risk assessment and audit and monitoring plan. The Manager has supervisory responsibility for all ... E/M rules, teaching physician guidelines, and/or medical necessity defense reviews; healthcare compliance audit methodology, principles and techniques; CMS… more
    Cardinal Health (08/27/25)
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  • Audit Business Manager , Meritain…

    CVS Health (Plantation, FL)
    …Position may sit in any US location.** **Minimum Requirements** + Minimum 4 years audit experience or in related field + Healthcare or TPA industry experience ... all appropriate parties and **implements best practices and writes Audit Policies & Procedures.** + Acts as a liaison...financial reporting. + Designs and oversees the execution of audit procedures, including sampling and testing, to maintain and… more
    CVS Health (08/21/25)
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  • QA Audit Manager - Operations

    Healthfirst (FL)
    …problem-solving approaches in producing analyzing and interpreting reports on trending audit finding results and summarizing details to Operations leadership to ... address identified areas for improvement. + Serve as point of escalation for audit disputes. + Conduct comprehensive needs analysis to ensure that audit programs… more
    Healthfirst (08/16/25)
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  • Healthcare Reimbursement Analyst,…

    LogixHealth (Dania, FL)
    …issues and appeal if necessary, using software or other resource tools + Prepare audit results and keep department manager current of all findings and audits ... provide cutting edge solutions that will directly improve the healthcare industry. You'll contribute to our fast-paced, collaborative environment...we have had a clear vision of a better healthcare system and have continually evolved to get there.… more
    LogixHealth (07/24/25)
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  • Audit & Reimbursement Senior

    Elevance Health (Tampa, FL)
    ** Audit & Reimbursement Senior** **_Virtual:_** _This role enables associates to work virtually full-time, with the exception of required in-person training ... Medicare and Medicaid Services to transform federal health programs. The ** Audit and Reimbursement Senior** will support our Medicare Administrative Contract (MAC)… more
    Elevance Health (08/26/25)
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  • Audit & Reimbursement II (US)

    Elevance Health (Tampa, FL)
    ** Audit & Reimbursement II** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... for Medicare and Medicaid Services to transform federal health programs. The ** Audit and Reimbursement II** will support our Medicare Administrative Contract (MAC)… more
    Elevance Health (09/06/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Tampa, FL)
    …Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified Professional in ... decision making pertinent to clinical experience + Documents clinical review summaries, bill audit findings and audit details in the database + Provides… more
    Molina Healthcare (09/06/25)
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  • Inpatient Audit Specialist

    Datavant (Tallahassee, FL)
    …company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right ... team. Together, we're rising to the challenge of tackling some of healthcare 's most complex problems with technology-forward solutions. Datavanters bring a diversity… more
    Datavant (08/13/25)
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  • Inpatient Audit Specialist

    Datavant (Tallahassee, FL)
    …company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right ... team. Together, we're rising to the challenge of tackling some of healthcare 's most complex problems with technology-forward solutions. Datavanters bring a diversity… more
    Datavant (07/29/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Tampa, FL)
    …Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified Professional in ... Healthcare Quality + other healthcare certification To all current Molina employees: If you...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
    Molina Healthcare (08/15/25)
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