• Diagnosis Related Group Clinical Validation…

    Elevance Health (FL)
    …is granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This...an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and… more
    Elevance Health (09/30/25)
    - Related Jobs
  • Provider Auditor (Certified Medical

    Elevance Health (Tampa, FL)
    …and experience, which would provide an equivalent background. RN, LPN or medical coding certification strongly preferred. **Preferred Skills, Capabilities, and ... Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Provider Auditor ** conducts on-site...Experiences:** + Medical coding certification is highly preferred. +… more
    Elevance Health (09/24/25)
    - Related Jobs
  • Quality Auditor & Educator

    AdventHealth (Daytona Beach, FL)
    …Daytona Beach, FL 32117 **The role you'll contribute:** The inpatient or outpatient coding team Quality Auditor (QA)/Educator supports the operations of the ... as well as supporting on-going quality assurance needs for coding staff. They will review medical records and documentation for coding accuracy, providing… more
    AdventHealth (08/07/25)
    - Related Jobs
  • Clinical Provider Auditor II

    Elevance Health (Tampa, FL)
    …related questions as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations. + ... Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Provider Auditor II...+ Requires a AA/AS and minimum of 3 years medical coding /auditing experience, including minimum of 1… more
    Elevance Health (09/30/25)
    - Related Jobs
  • Claims and Call Auditor (Call Center QC)

    CHS (Clearwater, FL)
    …experience is preferred + Knowledge of medical terminology + Knowledge of medical coding systems + Knowledge of Medicaid/Medicare Guidelines + Knowledge of ... (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance claims and customer service calls to ensure… more
    CHS (09/13/25)
    - Related Jobs
  • Clinical Provider Auditor II

    Elevance Health (Miami, FL)
    …related questions as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations. + ... Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Provider Auditor II**...+ Requires a AA/AS and minimum of 4 years medical coding /auditing experience, including minimum of 1… more
    Elevance Health (09/06/25)
    - Related Jobs
  • Claims Auditor II

    Elevance Health (Tampa, FL)
    **Claims Auditor II** **Location :** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... for employment, unless an accommodation is granted as required by law._ The **Claims Auditor II** is responsible for audits of high dollar claims across the stop… more
    Elevance Health (09/09/25)
    - Related Jobs
  • Cardiac Cath Lab Auditor

    AdventHealth (Tampa, FL)
    …charges, CPT coding , and national coverage decisions in conjunction with medical charts to ensure compliance with Medicare, Medicaid and other third party payers ... an acceptable manner and in a reasonable amount of time . The Clinical Auditor is responsible for assigned operational areas. **The value you'll bring to the team:**… more
    AdventHealth (09/26/25)
    - Related Jobs
  • Coding Quality Audit Reviewer

    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 ... guidelines and policy + Demonstrates and applies expert level knowledge of medical coding practices and concepts + Participates on special reviews or projects +… more
    HCA Healthcare (09/27/25)
    - Related Jobs
  • Inpatient Audit Specialist

    Datavant (Tallahassee, FL)
    …will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, ... of healthcare from your own workspace! Preferred: Strong IP Auditor 3+ years experience, Cerner/3M a plus. Must have...topics. **What You Will Do:** + Performs Inpatient Facility coding audits according to scope of work, for the… more
    Datavant (08/13/25)
    - Related Jobs