• Claims Auditor I

    Elevance Health (Miami, FL)
    ** Claims Auditor I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... an accommodation is granted as required by law._ The ** Claims Auditor ** **I** is responsible for pre... payment accuracy by verifying various aspects of the claim including eligibility, system coding and pricing,… more
    Elevance Health (08/30/25)
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  • Claims and Call Auditor (Call Center…

    CHS (Clearwater, FL)
    **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) to determine proper category for benefit code...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
    CHS (06/14/25)
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  • Inpatient Coding Auditor

    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...related activities and services provided by the BayCare Health System HIM Coding Department. + Interacts directly with coders,… more
    BayCare Health System (08/08/25)
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  • DRG Coding Auditor

    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...quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer… more
    Elevance Health (08/13/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (FL)
    …preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems , provider billing guidelines, payer ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This...Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes… more
    Elevance Health (08/23/25)
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  • Coding Auditor Educator

    Highmark Health (Tallahassee, FL)
    …to resolve issues and provide advice on new programs. Provides guidance to system entities in response to external coding audits conducted by the Medicare ... the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems , missed secondary diagnoses and procedures and ensures compliance with DRG/APC structure… more
    Highmark Health (08/08/25)
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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 (08/13/25)
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  • Auditor , Food Safety & Food Quality

    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 ... investigation & resolution. + Enter Local Purveyor Concerns into Tracegains Customer Feedback system and ensure LPs receive follow-up calls as necessary. + Any other… more
    Boar's Head Brand/Frank Brunckhorst Co., LLC (07/01/25)
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  • Specialist, Configuration Oversight (Healthcare…

    Molina Healthcare (Orlando, FL)
    …is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it ... written and verbal + Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using claims processing… more
    Molina Healthcare (08/16/25)
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  • Financial Examiner/Analyst II

    MyFlorida (Tallahassee, FL)
    FINANCIAL EXAMINER/ANALYST II - 42005562 Date: Aug 25, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... years of professional experience as a Financial Examiner/Analyst I or Internal Auditor with the State of Florida. Professional or nonprofessional experience as… more
    MyFlorida (08/26/25)
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