• DRG Coding Auditor

    Elevance Health (Tampa, FL)
    …of the following: AA/AS or minimum of 5 years of experience in claims auditing, quality assurance , or recovery auditing. + Requires at least one of the following ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ _​_ _This.../ Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge… more
    Elevance Health (07/22/25)
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  • Claims and Call Auditor (Call Center QC)

    CHS (Clearwater, FL)
    …diploma or equivalent is required + Experience in medical customer service, quality assurance , or insurance training is preferred. **Certificates, Licenses, ... **Overview** ** ** **Claims and Call Auditor (Call Center QC) - Clearwater, FL** **...and procedures. + Reviews Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) to determine proper… more
    CHS (06/14/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (FL)
    …state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance , or clinical documentation improvement, and a minimum of 5 years ... **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role enables associates to work...formulate detailed audit findings letters. + Maintains accuracy and quality standards as established by audit management. + Identifies… more
    Elevance Health (07/17/25)
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  • Senior Inpatient Medical Coding Auditor…

    Humana (Tallahassee, FL)
    …in determining objectives and approaches to assignments. + Reviewing staff monthly QA review variances + Daily inventory monitoring and assignment of escalated ... benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also...need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families,… more
    Humana (06/26/25)
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  • National Manager, Delegation Oversight

    Molina Healthcare (Orlando, FL)
    …Access). + Knowledge of applicable state and federal law; National Committee for Quality Assurance (NCQA) standards. + Ability to independently manage multiple ... of delegated functions. + Reports on Delegation Oversight activities to Quality Improvement and Corporate Compliance Committees as applicable. + Manages department… more
    Molina Healthcare (07/09/25)
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  • Audit Specialist - Orlando - On-Site

    AssistRx (Orlando, FL)
    …details of audit agenda and evidence requests with Operations, Account Management, Quality Assurance , Tech Org, and other applicable departments. + Partners ... a key liaison between internal departments and external clients to uphold quality , legal, compliance, and operational standards. + Negotiates audit calendar with… more
    AssistRx (07/18/25)
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