- 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 strongly preferred. **Certificates,...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
- 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...discrepancies. + Provide feedback on processing errors and highlight quality improvement opportunities. + Initiate requests related to large… 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 ** **_Virtual_** **_: _** _ _ __ This...AA/AS or minimum of 5 years of experience in claims auditing, quality assurance, or recovery auditing.… more
- Elevance Health (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 (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
- 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
- Humana (Tallahassee, FL)
- …cycle management (related to billing, coding, collections for Medicare and Medicaid claims ) + Experience with Auditing and monitoring of healthcare records + Must ... need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel,… more
- Sedgwick (Jacksonville, FL)
- …audit project supervisory reviews are completed; a robust and action-oriented quality assessment review program is effective, and enhanced as general accepted ... Major in accounting or technology field strongly preferred. Certified Internal Auditor (CIA), Certified Public Accountant (CPA), Certified Information Systems … more