• Claims and Call Auditor (Call Center QC)

    CHS (Clearwater, FL)
    **Overview** ** ** **Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance ... + Reviews Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) to determine proper category for benefit code determination.… more
    CHS (06/14/25)
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  • HCC Risk Adjustment Auditor - Full Time…

    Datavant (Tallahassee, FL)
    …for healthcare. **What We're Looking For:** As an HCC (Hierarchical Condition Category) Auditor you will review medical records that have been coded in a ... You Will Do:** + Audit coded charts assigned by quality supervisor per the client guidelines + Ability to...a diagnosis level + Answer rebuttals entered on the auditor by coders and or auditors + Participate in… more
    Datavant (08/01/25)
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  • Coding Quality Audit Reviewer

    HCA Healthcare (Jacksonville, FL)
    …**Introduction** Do you want to join an organization that invests in you as a Coding Quality Audit Reviewer? At Parallon, you come first. HCA Healthcare has ... make a difference. We are looking for a dedicated Coding Quality Audit Reviewer like you to...Summary and Qualifications** As a work from home Inpatient Coding Auditor , you will be responsible for… more
    HCA Healthcare (06/21/25)
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  • Quality Senior Analyst

    CVS Health (Tallahassee, FL)
    …highlighting findings, recommendations, and areas of concern to be delivered to coding resources. + Adhere to stringent timelines consistent with project deadlines ... and directives. + Demonstrates a strong commitment to enhancing and promoting quality ; consistently delivers accurate and thorough work, and supports others in… more
    CVS Health (08/08/25)
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  • System CDI Quality Team Leader Educator

    AdventHealth (Altamonte Springs, FL)
    …including attending physicians, allied health practitioners, nursing, care management and quality abstracters. The Quality Auditor Manager adheres ... collaboration with physicians, nursing and HIM coders. The CDI Quality & Compliance Team Leader strategically facilitates and obtains...them to resolves discrepancies with DRG assignments and other coding issues. + Leads out on CDI projects as… more
    AdventHealth (08/07/25)
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  • Practice Transformation Associate

    CVS Health (Tallahassee, FL)
    …achieves this goal through analyzing and sharing provider performance metrics related to quality , clinical outcomes, coding , and utilization used to support ABH ... in managed care with a focus on HEDIS and Quality with experience facilitating and leading meetings with provider...Knowledge of HEDIS and Pay for Performance metrics, ICD-10 coding , Medicaid risk adjustment methodology, and common billing and… more
    CVS Health (07/12/25)
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