- Humana (Tallahassee, FL)
- …of our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure ... Follows established guidelines/procedures. **Where you Come In** The Medical Coding Auditor reviews medical claims submitted against medical records provided,… 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
- Humana (Tallahassee, FL)
- …Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider ... caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns… more
- Elevance Health (Lake Mary, FL)
- …at least one of the following: AA/AS or minimum of 15 years of experience in claims auditing, quality assurance, or recovery auditing. + Requires at least one of ... **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)
- … Auditor ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines ... Possibilities. Make an Extraordinary Impact.** **Title** : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) **Virtual: ** _ _...AA/AS or minimum of 5 years of experience in claims auditing, quality assurance, or recovery auditing.… more
- Humana (Tallahassee, FL)
- …of our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure ... correct coding guidelines are met. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the… more
- Elevance Health (Tampa, FL)
- …Nurse license. + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum ... DRG Clinical (RN) Validation Auditor **Virtual** : This role enables associates to...Specializes in review of Diagnosis Related Group (DRG) paid claims . Primary duties may include, but are not limited… more
- Healthfirst (FL)
- **Scope of Responsibilities** **:** + Conduct quality audits of A&G items including grievances, pre-service appeals, and post service appeals utilizing appropriate ... sources of information; including eligibility, claims , authorizations, service forms, faxes, and any additional information required to complete the request. Analyze… more
- Humana (Tallahassee, FL)
- …the areas of Provider Data Validation, Provider Support, Provider Reporting, Quality Audit, and risk adjustment operations related to Provider Reconciliation and ... and external auditors + Evaluate Provider Data Validation, Provider Reporting, Quality Audit, and core risk adjustment operational business areas monthly progress… more