- Conduent (Orlando, FL)
- …be part of a culture where individuality is noticed and valued every day. **Pharmacy Claims Auditor CPhT** **Do you have a CPhT certification?** **Would you like ... behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a...claim data. This is to ensure billed pharmacy claims are being accurately submitted. You will also be… more
- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... to bending, reaching, kneeling, stooping and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** PA123… more
- Elevance Health (Tampa, FL)
- …** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company , for all lines of ... **DRG CODING AUDITOR ** **Location** : _This position will work virtually._...and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside… more
- Elevance Health (Tampa, FL)
- **Performance Quality Auditor II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... and ensures essential face-to-face onboarding and skill development. The **PERFORMANCE QUALITY AUDITOR II** is responsible for evaluating the quality of services and… more
- Sedgwick (Jacksonville, FL)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor As an Attorney Auditor at Sedgwick, you'll have the opportunity ... Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. +...professional needs. **PRIMARY PURPOSE OF THE ROLE** The Attorney Auditor reviews legal and non-legal invoices on behalf of… more
- Humana (Tallahassee, FL)
- …Coding Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper ... this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization, including offshore and vendor partners, with a focus… more
- Elevance Health (Tampa, FL)
- **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role enables associates to work virtually full-time, with the exception of required ... onboarding and skill development. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure… more
- Elevance Health (Tampa, FL)
- **Clinical Provider Auditor II** **Hybrid 1:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while ... eliminate and prevent unnecessary medical-expense spending. The **CLINICAL PROVIDER AUDITOR II** is responsible for identifying issues and/or entities that may… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
- Hiring Company : Delicatessen Services Co., LLC Overview:Supervise and support with the development and rollout of Tracegains and other QMSs. Responsible for ... COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety &...SQF or any other GFSI Scheme certification desired. + Auditor Certification preferred (ie American Society for Quality -… more
- Highmark Health (Tallahassee, FL)
- ** Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding ... and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting… more