- CHS (Clearwater, FL)
- **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... equivalent is required + Experience in medical customer service, quality assurance, or insurance training is preferred. **Certificates, Licenses,...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
- Humana (Tallahassee, FL)
- …looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement, handle provider ... community and help us put health first** In this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization,… 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 ... integration, and ensures essential face-to-face onboarding and skill development. The **PERFORMANCE QUALITY AUDITOR II** is responsible for evaluating the … more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
- … Certification preferred (ie American Society for Quality - Certified HACCP Auditor , Certified Quality Auditor , Certified Supplier Quality ... BH Audit Team with performing Food Safety & Product Quality audits at different venues to include but not...COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety &… more
- Elevance Health (Tampa, FL)
- … AUDITOR ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines ... **DRG CODING AUDITOR ** **Location** : _This position will work virtually._...AA/AS or minimum of 5 years of experience in claims auditing, quality assurance, or recovery auditing.… more
- Elevance Health (Tampa, FL)
- …applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum ... **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role enables associates to work...Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes… more
- Highmark Health (Tallahassee, FL)
- …and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, ... processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and assistance from management, designs and… more
- Elevance Health (Tampa, FL)
- …**External Audit Facilitator** is responsible for managing the process for claims and customer service audits/ quality control reviews, including implementation ... + Reviews, negotiates, and approves scope presented by external auditor . + For implementation audits, ensures the claims... auditor . + For implementation audits, ensures the claims system is coded accurately by independently developing and… more
- Wolters Kluwer (Tampa, FL)
- …of Excellence ("LBACOE"), which consists of Legal Invoice Analysts, Quality Assurance Analysts, Operations Support Specialists, Managers, Associate Directors, and ... as needed. Further your responsibility is for the creation and implementation of quality assurance methodologies, subject to approval by management, as well as the… more