- CHS (Clearwater, FL)
- **Overview** ** ** **Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance ... claims and customer service calls to ensure validity, accuracy, and compliance with appropriate policies, procedures, and regulations + **Health, Dental, Vision, and… more
- Elevance Health (Tampa, FL)
- **Clinical Provider Auditor II** **Hybrid 1:** This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and connectivity, while ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II i** s responsible for identifying issues and/or entities that… more
- Humana (Miramar, FL)
- …1 consults and collaborates with clinicians to ensure high accountability of compliance and quality. The Quality Assurance, Clinical Professional 1 work assignments ... accuracy, and Medicare Conditions of Participation demand meticulous documentation. A QA Auditor will help ensure all records meet federal, state, and payer-specific… more
- Elevance Health (Miami, 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
- AdventHealth (Tampa, FL)
- …in assigned area for Cardiac Cath Lab. Researches and analyzes charges, CPT coding , and national coverage decisions in conjunction with medical charts to ensure ... compliance with Medicare, Medicaid and other third party payers...in a reasonable amount of time . The Clinical Auditor is responsible for assigned operational areas. **The value… more
- HCA Healthcare (Orange Park, FL)
- …of our team. **Job Summary and Qualifications** As a work from home Inpatient Coding Auditor , you will be responsible for performing internal quality assessment ... on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company… more
- HCA Healthcare (Tampa, FL)
- …work from home position.** **This position has a specialization in Inpatient Coding .** **Benefits** Parallon offers a total rewards package that supports the health, ... **Job Summary and Qualifications** As a Vendor Resource Management Coding Lead, you will be responsible for performing concurrent...weekly/monthly quality data to identify trends by vendor and coder/ auditor that need to be addressed + Prepares and… more
- CVS Health (FL)
- …regarding ICD coding and documentation requirements. + Comprehensive knowledge of coding guidelines and regulations to meet compliance requirements, such as ... Federal regulations and internal policies and procedures. Contributes to compliance reporting and documentation, highlighting findings, recommendations, and areas of… more
- MUFG (Tampa, FL)
- …between enterprise and application teams. + Integrate regulatory and compliance requirements into control specifications. + Perform risk assessments on ... reports + Participate in security governance of SDLC, design reviews and secure coding standards (OWASP) + Utilize the MITRE ATT&CK framework to identify and… more
- AdventHealth (Altamonte Springs, FL)
- …with physicians, nursing and HIM coders. The CDI Quality & Compliance Team Leader strategically facilitates and obtains appropriate and quality physician ... practitioners, nursing, care management and quality abstracters. The Quality Auditor Manager adheres to strict departmental and organizational goals, objectives,… more