Claims Auditor & Process Improvement Specialist
South Florida Community Care Network Llc
South Florida Community Care Network LLC in Sunrise, FL is seeking a full-time Claims Analyst to support accurate and timely claims payment through pre-payment audits, analysis, and payment integrity activities. You will review professional and facility claims, identify discrepancies, and work with internal teams to resolve issues and improve processing. The role requires 5–7 years of claims experience (Associates preferred) and knowledge of ICD-10-CM, CPT, DRG coding, and fee schedules. #J-18808-Ljbffr South Florida Community Care Network Llc
$500 per month
...year of service.DRG Coding Auditor - MS-DRG and APR-DRGVirtual:... ...generating high quality recoverable claims for the benefit of the... ..., high value concept and or process improvement and efficiency... ...Technician, CCS as a Cert Coding Specialist, CIC as a Certified Inpatient...Process improvementClaimsFull timeTemporary workWork experience placementWork at officeLocal area1 day per week- ...FDOT) Office of Inspector General is seeking an Auditor (Management Review Specialist) in Tallahassee. The role conducts performance audits... ...evidence, and prepare findings with actionable recommendations to improve accountability and processes. #J-18808-Ljbffr OtherProcess improvementWork at office
$23.73 - $35.6 per hour
...to ask for an accommodation or an alternative application process. Claims Auditor I Doral, FL, US 10 days ago Requisition ID: 1520 Salary Range... ...quality, identify discrepancies, and support continuous improvement initiatives. Key Responsibilities Primary duties may...Process improvementClaimsHourly pay- ...to their clients. As an RCM Specialist II, you will serve as a trusted... ...-solving and continuous improvement. The ideal candidate embraces... ...seeks opportunities to optimize processes, and thrives in a... ...unpaid insurance and healthcare claims with a focus on accuracy and...Process improvementClaimsWork at office
- ...accommodation or an alternative application process. Post Charge Off Recovery Specialist Full Time Clerical Temple Terrace,... ...of engagement, growth, process improvement and community volunteerism. What’... .... Collects on and/or files Small Claims cases internally or coordinates...Process improvementClaimsFull timeTemporary workWork at officeRemote work
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- Florida Orthopaedic Institute seeks a Revenue Support Cycle Specialist to cover billing, insurance follow-up, and claims processing remotely. The role involves reviewing CPT/ICD-10 codes, ensuring timely filing, and resolving denials with accuracy in the practice management...ClaimsRemote jobWork at officeMonday to Friday
$79.7k - $105.48k
...function implements strategies and processes to ensure adherence to... ...Job Summary The Compliance Auditor is responsible for conducting... ...Compliance Auditor performs detailed claim reviews, identifies coding... ...develops recommendations for improvement, and delivers education to...ClaimsFull timeTemporary workLocal areaImmediate startRemote workFlexible hours- Molina Healthcare is seeking a Senior Claims Examiner in the United States (Florida) to provide senior-level support for claims examination... ...for incorrect coding, abuse, fraud, waste, overpayments, and processing errors. The role requires managing a caseload, procuring...Claims
- ...Auditor - 55000011 Join FDOT and be part of the team that works as one to improve safety, enhance mobility and inspire innovation in the... ...Auditor (Management Review Specialist-SES) to join the Performance... ..., integrity and process improvement in the department...Process improvementWork at office
- Duties include auditing high value claim shippers, locating high value packages in the center or hub and ensuring proper handling. May also contact destination hubs or centers to notify them of the status of high value packages. Additional duties may include performing...ClaimsEarly shift
- Solis-Health-Plans in Doral, FL is seeking a Claims Auditor I to perform pre- and post-payment audits of Medicare-related claims within... ...with claim examiners to identify discrepancies and improve processes. Minimum qualifications include a high school diploma and several...Claims
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$48.54k - $62.81k
...Transportation Working Title: AUDITOR - 55000011 Pay Plan: SES... ...team that works as one to improve safety, enhance mobility and... ...an Auditor (Management Review Specialist-SES) to join the Performance... ...accountability, integrity and process improvement in the department...Process improvementFull timeWork at office- ...Transportation's Office of Inspector General seeks an Auditor (Management Review Specialist) to conduct performance audits that evaluate... ...findings and recommendations to promote accountability and process improvement. The successful candidate will work within the OneFDOT...Process improvementWork at office
- ...while also assisting with documentation improvement, audits, and quality initiatives across... ...trends in documentation issues and suggest process improvements Collaborate with coding,... ...billing, and clinical staff to support clean claims Collaborate and assist our...Process improvementClaimsFull timeWork at office
$57k - $65k
...ask for an accommodation or an alternative application process. Grievance & Appeals Auditor I Doral, FL, US 30+ days ago Requisition ID: 1521 Salary... ...standards, while identifying opportunities for process improvement and risk mitigation. Key Responsibilities Primary...Process improvement$31.2 - $40.56 per hour
...coders, clinical department and / or physicians for documentation improvement on a monthly, quarterly and on an as needed basis.Create consistency and efficiency in outpatient or inpatient claims processing and data collection to optimize APC, ASC or DRG reimbursement....ClaimsRemote jobLocal area- Summary Oversee system improvements, selection and implementation of technological advances within the scope of the quality system. Establish... ...or regulatory compliance. Perform quality system and business process audits as assigned. Analyze existing processes and implements...Process improvementHourly pay
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- ...and technical support to Revenue Optimization Auditors. Serve as a primary Subject Matter Expert (SME) for audit processes, coding and billing questions, departmental... ...processes, and identified opportunities for improvement.New Hire Training & Onboarding: Support the onboarding...Process improvementRemote jobWork at office
- ...About the job Specialist, Data Entry Junior (Remote) CHECK YOUR EMAIL, INCLUDING YOUR SPAM FOLDER, FOR INSTRUCTIONS AFTER APPLYING... ...and adhere to data security protocols. Contribute to process improvement initiatives to enhance data entry efficiency. #J-18808-Ljbffr...Process improvementRemote work
- ...seeking a Billing & Collections Specialist to join our team. This is an... ...Submit and manage insurance claims (electronic and paper)... ...accurately and timely Post payments, process adjustments, and reconcile... ...Contribute to continuous process improvement What We’re Looking For...Process improvementClaims
- Billing and Coding Auditor Banyan Treatment Centers is seeking a detail-oriented and experienced Billing and... .... This critical role ensures the integrity of our claims processes and supports continuous quality improvement, staff education, and adherence to payer regulations...ClaimsFull timeWork experience placementWork at officeRemote workFlexible hours
- ...our website . JOB SUMMARY: This is a Tax Auditor I position in the General Tax... ...Program's, Refunds and Revenue Accounting Process, Refunds Unit. The incumbent independently... ...reports to ensure correct processing of refund claims by the Department. MINIMUM REQUIREMENTS:...ClaimsH1bMonday to Friday
- ...to ask for an accommodation or an alternative application process. Medical Coding Auditor Full Time Staff South Florida Community Care Network, LLC... ...the Medical Coding Auditor ensures appropriate coding on claims paid and maintains compliance documentation of any fraud,...ClaimsFull timeContract workWork at officeRemote work
- ...returnsPrepare estimated tax payments and extensionsIdentify and execute process improvement initiativesProviding technical and analytical support for... ...agencies regarding filings, compliance, and other claims • Prepares tax calculations to support tax controversy analyses...Process improvementClaimsFor contractorsLocal areaRelocation
- JOB SUMMARY: The Revenue Cycle Specialist is responsible for accurately assigning medical codes to eye care procedures, conducting... ...audits to ensure compliance with coding guidelines, and processing insurance claims. This role analyzes medical records to identify...ClaimsWork at officeShift work
- Humana is seeking an Internal Auditor to join our Internal Audit team in the United States. You will evaluate the efficiency and effectiveness of Humana's operational processes, execute audit plans, and prepare management reports with risk-based recommendations. You will...Process improvement
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