- Elevance Health (Tampa, FL)
- ** Claims Auditor I, II and Senior**...and post payment and adjudication audits of high dollar claims for limited lines of business, claim ... an accommodation is granted as required by law._ The ** Claims Auditor I** is responsible for pre...an impact :** + Performs audits of high dollar claims . + Ensures claim payment accuracy by… more
- Prime Therapeutics (Tallahassee, FL)
- …career? Come build the future of pharmacy with us. **Job Posting Title** Pharmacy Claims Auditor - Remote **Job Description** The Pharmacy Claims ... analysis of large datasets and audit findings to detect high-risk pharmacy claims , identify billing irregularities, and uncover patters of non-compliance or systemic… more
- Elevance Health (Lake Mary, FL)
- …documentation purposes (eg, letter writing) on lower level auditors. + Identifies new claim types by identifying potential claims outside of the concept where ... **DRG Coding Auditor Principal** **_Virtual: _** _ _ This role...Principal** is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology,… more
- Elevance Health (Tampa, FL)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This...auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all… more
- Sedgwick (Miami, FL)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor ** **This is a fully remote position, and candidates residing in any ... United States are encouraged to apply. As an Attorney Auditor at Sedgwick, you'll have the opportunity to take...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- Elevance Health (FL)
- **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually full-time, ... required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to...Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes… 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 ... is complete, compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied and frequently require interpretation and… more
- BayCare Health System (Tampa, FL)
- …AM to 3:30 PM + **Days:** Monday - Friday The **Inpatient** **Coding Auditor ** is a full-time remote position. _Sign on bonuses available!_ **Responsibilities** + ... The Inpatient Coding Auditor performs inpatient encounter audits and evaluates compliance related...Performs special audits for specific issues within facility Inpatient claims . + Acts as the Liaison for coding issues… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
- …CAPAs, Nutritional Documents, COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety & Product Quality audits at ... training course. + SQF or any other GFSI Scheme certification desired. + Auditor Certification preferred (ie American Society for Quality - Certified HACCP … more
- Molina Healthcare (Miami, FL)
- …7am-3:30pm PST M-F** **Job Summary** Responsible for conducting various healthcare Healthcare claim audits including, but not limited to; vendor, focal, audit the ... auditor . Confirm that documentation is clear and concise to...to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of… more