• Coding Auditor Educator

    Highmark Health (Columbus, OH)
    …activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code ... which supports compliant coding. Interacts with external consultants regarding billing , coding and/or documentation and evaluates their recommendations and/or… more
    Highmark Health (08/08/25)
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  • Claims Coordinator Infusion Intake

    Bon Secours Mercy Health (Cincinnati, OH)
    …**Education:** Associate's degree preferred. **Licensing/Certification:** Certified Professional Coder (CPC) **Required** Certified Outpatient Coder ... : Three (3) years of related experience in medical coding or hospital billing preferred. Many of our opportunities reward* your hard work with: Comprehensive,… more
    Bon Secours Mercy Health (07/19/25)
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  • Patient Account Representative

    Robert Half Accountemps (Canton, OH)
    …documentation and quality. Ideal candidates will have a strong background in medical billing , claims follow-up, and payer relations and must possess a keen attention ... to appropriate accounts. Patient Communication: Communicate with patients regarding billing concerns and collaborate with customer service representatives to ensure… more
    Robert Half Accountemps (08/08/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Mason, OH)
    …recognizing aberrant coding and documentation patterns such as inappropriate billing for readmissions, inpatient admission status, and Hospital-Acquired Conditions ... Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or… more
    Elevance Health (08/13/25)
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  • DRG Coding Auditor

    Elevance Health (Mason, OH)
    …and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder . + Requires 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and ... quality assurance environment preferred. + Broad knowledge of medical claims billing /payment systems provider billing guidelines, payer reimbursement policies, … more
    Elevance Health (08/13/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Columbus, OH)
    …necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical ... an appeal has been submitted, to ensure medical necessity and appropriate/accurate billing and claims processing. + Identifies and reports quality of care issues.… more
    Molina Healthcare (08/08/25)
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  • Nurse Audit Manager

    Humana (Columbus, OH)
    …clinical and coding experience to conduct reviews of provider codes and billing . + Decisions are typically related to resources, approach, and tactical operations ... knowledge. + Experience validating and interpreting medical record documentation to ensure billing for services is complete and accurate. + Certified Professional … more
    Humana (08/13/25)
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  • Special Investigation Unit (SIU) Coding Review…

    CVS Health (Columbus, OH)
    …we do it all with heart, each and every day. The Certified Professional Coder (CPC) Manager will oversee a team of medical coders within the Special Investigations ... focus on meeting state, federal, and company requirements while identifying concerning billing patterns or trends. **Responsibilities:** + Lead and mentor a team of… more
    CVS Health (08/08/25)
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  • Revenue Integrity Analyst II

    Intermountain Health (Columbus, OH)
    **Job Description:** This position is responsible for billing , follow-up, and resolving issues that delay or prevent payment of the patient's account within ... hire. Plus one of the following certifications: Current certification as a coder through AAPC or American Health Information Management Association (AHIMA), or… more
    Intermountain Health (08/13/25)
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  • Senior Coding Educator

    Humana (Columbus, OH)
    …+ High school diploma or equivalent + Must hold AAPC CPC (Certified Professional Coder ) certification + 2 years or more experience with ICD-10 CM guidelines + Prior ... education + Strong knowledge of medical record review + Understanding of billing , claims submission, and related processes + Proficient in Microsoft Word, Excel,… more
    Humana (08/08/25)
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