• Provider Auditor (RN/LPN Medical

    Elevance Health (Miami, 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 (08/01/25)
    - 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 (08/08/25)
    - 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 (06/14/25)
    - 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 (08/08/25)
    - Related Jobs
  • HCC Risk Adjustment Auditor - Full Time…

    Datavant (Tallahassee, FL)
    …vision 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 ... a diagnosis level + Answer rebuttals entered on the auditor by coders and or auditors + Participate in...by coders and or auditors + Participate in weekly coding project review meetings + Any other tasks asked… more
    Datavant (08/01/25)
    - Related Jobs
  • Auditor , Risk Adjustment (Remote)

    Molina Healthcare (Miami, FL)
    …**Job Qualifications** **Required Education** Associates degree. **Required Experience** 3 Years in coding and medical record chart review and experience with ... Required Li **Required License, Certification, Association** Active and unrestricted Coding Certification, Active CCS, CCS-P, or CPC credential **Preferred… more
    Molina Healthcare (07/25/25)
    - Related Jobs
  • Coding Quality Audit Reviewer

    HCA Healthcare (Jacksonville, 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 (06/21/25)
    - Related Jobs
  • Quality Senior Analyst

    CVS Health (Tallahassee, FL)
    …CRC (Certified Risk Adjustment Coder) required. + CPMA (Certified Professional Medical Auditor ) **or** CDEO (Certified Documentation Expert Outpatient) ... Qualifications** + Minimum of 5 years recent and related experience in medical record documentation review, diagnosis coding , and/or auditing. + Experience… more
    CVS Health (08/08/25)
    - Related Jobs
  • Practice Transformation Associate

    CVS Health (Tallahassee, FL)
    …analyzing and sharing provider performance metrics related to quality, clinical outcomes, coding , and utilization used to support ABH programs. They will be a ... of an internal, cross-functional team of clinical, analytics, provider relations and medical personnel. The PTA will work both internally and externally with some… more
    CVS Health (07/12/25)
    - Related Jobs