- Sedgwick (Tampa, FL)
- …provided to insurance carriers, corporate legal departments and government entities. The auditor will apply client specified billing guidelines and/or Generally ... Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor ** **This is a fully remote position, and candidates residing in any… more
- CHS (Clearwater, FL)
- **Overview** ** ** **Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance ... + Maintains up-to-date working knowledge on regulatory requirements associated with billing and claims processing, as well as HIPAA guidelines/established Encryption… more
- Elevance Health (Tampa, FL)
- **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ _This role enables associates to work virtually full-time, with the exception of required in-person training ... recover, eliminate and prevent unnecessary medical-expense spending. The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records and generating… more
- Elevance Health (FL)
- **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role enables associates to work virtually full-time, with the exception of required ... Friday 8AM -5PM (local time) The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
- Elevance Health (Tampa, FL)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Hybrid 1:** This role requires associates to be in-office **1-2** days per ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
- Nuvance Health (Pembroke Pines, FL)
- …PA, SC, TN, TX, and VA. *Job Title: Senior Professional Facility Auditor * *Company: Nuvance Health* *Department: Facility Charging and Coding* *Location: Remote* ... Role* Nuvance Health is seeking a detail-oriented and experienced *Senior Professional Facility Auditor * to join our Facility Charging and Coding team. In this role,… more
- Highmark Health (Tallahassee, FL)
- …activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code ... which supports compliant coding. Interacts with external consultants regarding billing , coding and/or documentation and evaluates their recommendations and/or… more
- Molina Healthcare (FL)
- …conducting various audits including, but not limited to; vendor, focal, audit the auditor . Confirm that documentation is clear and concise to ensure accuracy in ... in order to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims....& ABILIITIES:** + Minimum 2 years as an operational auditor for at least one core operations function +… more
- CVS Health (Tallahassee, FL)
- …for Performance metrics, ICD-10 coding, Medicaid risk adjustment methodology, and common billing and common billing practices + Demonstrated understanding of ... across the organization **Preferred Qualifications** + RHI, RHIT, CRC, or CPC certified Coder or auditor (CMAS) or + RN or LPN or LISW or + Three years' experience… more
- HCA Healthcare (Jacksonville, FL)
- …team. **Job Summary and Qualifications** As a work from home Inpatient Coding Auditor , you will be responsible for performing internal quality assessment reviews on ... Healthcare. Our services include scheduling, registration, insurance verification, hospital billing , revenue integrity, collections, payment compliance, credentialing, health information… more
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