- 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)
- **Internal Auditor , Senior** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing ... accommodation is granted as required by law. The **Internal Auditor , Senior** is responsible for conducting financial/operationalaudits, internal control… more
- Humana (Tallahassee, FL)
- …a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical information from medical records and assigns ... is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for...**great attention to** **detail** **and have** **a passion for healthcare ? Do you have a solid background in medical… more
- Humana (Tallahassee, FL)
- … auditing experience + Ability to analyze large data sets + Knowledge of healthcare compliance , mainly primary care and risk adjustment, pharmacy knowledge a ... conducts compliance related audits to assess internal controls, examining healthcare records and processes, and analyzing and reporting risks. + Influence… more
- Prime Therapeutics (Tallahassee, FL)
- …fuels our passion and drives every decision we make. **Job Posting Title** Internal Auditor - Remote **Job Description** The staff Internal Auditor supports the ... business processes and internal audit methodologies. The staff Internal Auditor plays a key role in identifying control gaps,...not limited to Internal Controls, Audit, Risk Assessments or Compliance + Must be eligible to work in the… more
- TEKsystems (Orlando, FL)
- …Outpatient Facility Auditor is integral to maintaining coding accuracy and compliance with our standards. This role involves conducting detailed audits of coding ... delivering quarterly educational sessions on code updates and rule changes. The auditor collaborates closely with the coding team, providing continuous education and… more
- Elevance Health (Tampa, FL)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** _Location:_ **Virtual:** This role enables associates to work virtually ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
- Molina Healthcare (Miami, FL)
- …Develop and implement processes and procedures to ensure accuracy, completeness, and compliance with Centers for Medicare and Medicaid Services (CMS) regulations and ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more
- Highmark Health (Tallahassee, FL)
- …with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts ... and modifier systems, missed secondary diagnoses and procedures and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim… more
- Humana (Tallahassee, FL)
- …the following: Inpatient medical coding, analytics, health record security and privacy, HIPAA compliance , and data governance. + Hold at least one of the following ... benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more