- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... claims and calls and provides feedback to their Manager . + Maintains up-to-date working knowledge on regulatory requirements...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… 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
- Elevance Health (Miami, FL)
- …using medical charts, medical notes, and provider contracts. + Verifies dollar amount on claim is correct in claims system and writes report of the findings ... **Provider Auditor ** _This position will work a hybrid model...itemized bills and providers contracts to ensure that a claim is paid in accordance with the contract, provider… 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
- 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 ... granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor -RN** is responsible for auditing inpatient medical records to ensure clinical… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
- …Boars Head Brand. Complete special projects as assigned by the Sr. QA Manager . Job Description: Essential Duties and Responsibilities + Provide advanced super user ... COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety &...able to attend a training course. + Serve Safe Manager Certification or be able to attend a training… more
- Elevance Health (Miami, FL)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Virtual:** This role enables associates to work virtually full-time, with the ... 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 (Tampa, FL)
- **Clinical Provider Auditor II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required inperson training sessions, ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II i** s responsible for identifying issues and/or entities that… more
- Highmark Health (Tallahassee, FL)
- …and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting ... and research related to special projects and providing coverage for coding manager (s). (10%) + Depending on location provides or arranges for education/training of… more
- Siemens Energy (Orlando, FL)
- **A Snapshot of Your Day** Siemens Energy is seeking an experienced Quality Manager in Projects to join our team in Orlando, FL. Ensuring that quality standards are ... and activities, compile/review final Quality Documentation packages for customer, warranty claim support. **What You Bring** + Bachelor's degree in engineering,… more
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