• Claims Quality Auditor

    Centene Corporation (Tallahassee, FL)
    …of claims to source documents and identify incorrect payments. + Conduct quality audits of claims , pre and post payments, utilizing appropriate sources of ... related field or equivalent experience. 2+ years of medical or pharmacy claims processing, training or auditing experience. Knowledge of claim software systems,… more
    Centene Corporation (10/17/25)
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  • Claims and Call Auditor (Call Center…

    CHS (Clearwater, FL)
    **Overview** ** ** ** Claims and Call Auditor (Call Center QC) - Clearwater, FL** ** ** **Summary** The Claims & Call Auditor audits processed medical ... equivalent is required + Experience in medical customer service, quality assurance, or insurance training is strongly preferred. **Certificates,...and lifting up to thirty (30) pounds. ** ** ** Claims and Call Auditor (Call Center QC)… more
    CHS (09/13/25)
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  • Claims Auditor (remote)

    Cognizant (Tallahassee, FL)
    ** Claims Auditor ** (remote) This is a...part of a team: + Monitor, evaluate and score claims against established quality assurance instruments and ... perform the following duties and work as part of our established claims adjudication team. We are seeking highly motivated healthcare professionals with **auditing… more
    Cognizant (10/16/25)
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  • Auditor , Food Safety & Food Quality

    Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
    … Certification preferred (ie American Society for Quality - Certified HACCP Auditor , Certified Quality Auditor , Certified Supplier Quality ... BH Audit Team with performing Food Safety & Product Quality audits at different venues to include but not...COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety &… more
    Boar's Head Brand/Frank Brunckhorst Co., LLC (09/18/25)
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  • Performance Quality Auditor I

    Elevance Health (FL)
    **Performance Quality Auditor I** **Location:** _Virtual:_ This role enables associate to work virtually full-time, with the exception of required in-person ... accommodation is granted as required by law. The **Performance Quality Auditor I** is responsible for evaluating...Included are processes related to enrollment and billing and claims processing, as well as customer service written and… more
    Elevance Health (10/02/25)
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  • Inpatient Medical Coding Auditor

    Humana (Tallahassee, FL)
    …Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider ... caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns… more
    Humana (09/24/25)
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  • Independent Adjuster Auditor

    Sedgwick (Orlando, FL)
    …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Independent Adjuster Auditor As an Independent Adjuster Auditor at Sedgwick, you'll have the ... professional needs. **PRIMARY PURPOSE** **OF THE ROLE** The Independent Adjuster Auditor reviews Independent Adjuster and other Non-Legal Vendor invoices on behalf… more
    Sedgwick (09/16/25)
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  • DRG Coding Auditor

    Elevance Health (Tampa, FL)
    … AUDITOR ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ _​_ This...AA/AS or minimum of 5 years of experience in claims auditing, quality assurance, or recovery auditing.… more
    Elevance Health (10/13/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Tampa, FL)
    …applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This...Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes… more
    Elevance Health (09/23/25)
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  • Government Operations Consultant II

    MyFlorida (Tallahassee, FL)
    …for Florida's health care system to be the most cost-effective, transparent, and high- quality health care system in the nation. Agency Objectives: HIGH QUALITY ... healthcare decisions. COST-EFFECTIVE Leveraging Florida's buying power in delivering high quality care at the lowest cost to taxpayers. POSITION OVERVIEW: This… more
    MyFlorida (10/16/25)
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