• Attorney Auditor

    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
    Sedgwick (07/09/25)
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  • Claims and Call Auditor (Call Center QC)

    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
    CHS (06/14/25)
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  • DRG Coding Auditor

    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 (07/22/25)
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  • Diagnosis Related Group Clinical Validation…

    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 (07/17/25)
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  • Clinical Provider Auditor II

    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
    Elevance Health (07/22/25)
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  • Sr Professional Facility Auditor

    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
    Nuvance Health (07/18/25)
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  • Coding Auditor Educator

    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
    Highmark Health (05/09/25)
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  • Specialist, Configuration Oversight

    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
    Molina Healthcare (07/18/25)
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  • Practice Transformation Associate

    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
    CVS Health (07/12/25)
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  • Coding Quality Audit Reviewer

    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
    HCA Healthcare (06/21/25)
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