• Claims and Call Auditor (Call Center…

    CHS (Clearwater, FL)
    …(Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical insurance claims and customer service calls to ... and compliance with appropriate policies, procedures, and regulations + ** Health , Dental, Vision, and Life Insurance as well as...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
    CHS (05/10/25)
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  • Pharmacy Claims Auditor CPhT

    Conduent (Orlando, FL)
    …be part of a culture where individuality is noticed and valued every day. **Pharmacy Claims Auditor CPhT** **Do you have a CPhT certification?** **Would you like ... behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a...For You** Perks and rewards designed for you: + Health and Welfare Benefits: Our health and… more
    Conduent (04/22/25)
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  • DRG Coding Auditor

    Elevance Health (Tampa, FL)
    …considered._ The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit ... **DRG CODING AUDITOR ** **Location** : _This position will work virtually._...or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines,… more
    Elevance Health (05/29/25)
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  • Clinical Provider Auditor II

    Elevance Health (Tampa, FL)
    …formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. ​ The **CLINICAL PROVIDER AUDITOR II** is ... **Clinical Provider Auditor II** **Hybrid 1:** This role requires associates...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment… more
    Elevance Health (05/29/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Tampa, FL)
    …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... and skill development. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical ...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles,… more
    Elevance Health (05/22/25)
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  • Performance Quality Auditor II

    Elevance Health (Tampa, FL)
    **Performance Quality Auditor II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... and ensures essential face-to-face onboarding and skill development. The **PERFORMANCE QUALITY AUDITOR II** is responsible for evaluating the quality of services and… more
    Elevance Health (05/28/25)
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  • Attorney Auditor

    Sedgwick (Jacksonville, FL)
    …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor As an Attorney Auditor at Sedgwick, you'll have the opportunity ... physical, financial and professional needs. **PRIMARY PURPOSE OF THE ROLE** The Attorney Auditor reviews legal and non-legal invoices on behalf of our clients for… more
    Sedgwick (04/09/25)
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  • Inpatient DRG Quality Auditor

    Humana (Tallahassee, FL)
    …Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement, ... part of our caring community and help us put health first** In this role, you will conduct quality...This is a full-time, remote/work-from-home position. **Description** The Inpatient Medical Coding Auditor extracts clinical information from… more
    Humana (05/30/25)
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  • Coding Auditor Educator

    Highmark Health (Tallahassee, FL)
    …(Outpatient): Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or ... **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs...internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of… more
    Highmark Health (05/09/25)
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  • Medical Records Auditor

    Health Advocates Network (Coral Springs, FL)
    Health Advocates Network is hiring a **DME Progress Note Reviewer** **(2 Years Exp Req)** ! This is a full-time contract position at a nationally recognized ... group of clinicians to ensure the documentation is clinically sufficient before claims are submitted to insurance companies for payment. Prioritize workloads to… more
    Health Advocates Network (03/07/25)
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