- HCA Healthcare (Miami, FL)
- …you to apply! **Job Summary and Qualifications** As a work from home Inpatient Coding Auditor , you will be responsible for performing internal quality assessment ... of each individual is recognized. Submit your application for the opportunity below: Inpatient Coding Quality Auditor Parallon. **This is a fully work from home… 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 ... to recover, eliminate and prevent unnecessary medical-expense spending. The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records… more
- Elevance Health (FL)
- …Identifies potential documentation and coding errors by recognizing aberrant coding and documentation patterns such as inappropriate billing for ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This...medical claims billing and payment systems, provider billing guidelines, payer reimbursement policies, and coding … more
- Humana (Tallahassee, FL)
- …of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation ... and billing for services rendered is complete, compliant and accurate...compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied and frequently require… more
- Elevance Health (Tampa, FL)
- …as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations. + Collaborates ... **Clinical Provider Auditor II** **Supports the Payment Integrity line of...an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities for fraud… more
- Humana (Miramar, FL)
- …accuracy, and Medicare Conditions of Participation demand meticulous documentation. A QA Auditor will help ensure all records meet federal, state, and payer-specific ... standards, reducing audit risk and financial exposure. The QA Auditor will review Start of Care (SOC), Recertification, and Discharge documentation for completeness… more
- Molina Healthcare (FL)
- …and state specific policies and regulations in order to identify incorrect coding , abuse and fraudulent billing practices, waste, overpayments, and processing ... including, but not limited to; vendor, focal, audit the auditor . Confirm that documentation is clear and concise to...& ABILIITIES:** + Minimum 2 years as an operational auditor for at least one core operations function +… more
- MyFlorida (Tallahassee, FL)
- …of daily food costs to the Special Purpose Investment Account (SPIA); receipt, coding , and vouchering of vendor invoices; collection and recording of data for ... identification and notification of cash needs to support program expenditures; billing , receipt, and recording of infant formula rebates; identification, tracking,… more
- MyFlorida (Tallahassee, FL)
- …Insurance, Program Integrity Unit as an Audit Manager and will serve as an auditor and contract manager for the state group insurance program's post payment claims ... Microsoft Office Suite and Power BI * Knowledgeable of heath care coding conventions, fraud schemes, general areas of vulnerability, reimbursement methodologies and… more