• Manager , DRG Coding & Validation…

    Molina Healthcare (Columbus, OH)
    **Job Description** **Job Summary** The Manager , Clinical DRG Coding & Validation must have an extensive background in either facility-based nursing and/or ... inpatient coding and has a high level of understanding in...and APR-DRG with a broad knowledge of medical claims billing /payment systems provider billing guidelines, payer reimbursement… more
    Molina Healthcare (06/14/25)
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  • DRG Coding Auditor

    Elevance Health (Mason, OH)
    …/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred. + Knowledge ... **DRG CODING AUDITOR** **Location** : _This position will work...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (06/24/25)
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  • DRG Coding Auditor Principal

    Elevance Health (Mason, OH)
    …/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology strongly preferred Please ... **DRG Coding Auditor Principal** _Virtual: This role enables associates...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (06/05/25)
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  • Coding Auditor Educator

    Highmark Health (Columbus, OH)
    …performing audits and research related to special projects and providing coverage for coding manager (s). (10%) + Depending on location provides or arranges for ... activities. Reviews medical records to determine data quality and accuracy of coding , billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II… more
    Highmark Health (05/09/25)
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  • Medical Billing Specialist II

    Premier Health (Moraine, OH)
    …follow up on submitted claims that are unpaid, rejected, or denied. The Medical Billing Specialist reports to the A/R Manager within the Centralized Billing ... **Centralized Billing Office** **FT/ DAYS/ 80 hours per pay**...experience. 3. Knowledgeable about third party billingregulations and CPT/ICD coding . 4. Proficient computer and data entry skills. 5.… more
    Premier Health (06/14/25)
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  • Configuration Management Manager

    CVS Health (Columbus, OH)
    …skills * Analytical and creative problem-solving abilities **Preferred Qualifications** Clinical Coding Experience - Content Manager Claim Processing Medicaid ... legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation Data query and analysis skills **Education**… more
    CVS Health (06/01/25)
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  • Manager , Research Business Services…

    OhioHealth (Columbus, OH)
    …audits. Oversees bill hold process in EPIC. Identify process gaps and potential billing and coding inaccuracies and working with interdisciplinary teams to ... a centralized research office supporting all research activities at OhioHealth. The Manager of Research Business Services will drive results and provide daily… more
    OhioHealth (06/07/25)
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  • Field Reimbursement Manager - East Region

    Otsuka America Pharmaceutical Inc. (Columbus, OH)
    …in benefit verifications, prior-authorization requirements, or equivalent experience in patient access, billing , and coding in rare disease + Strong knowledge of ... **Position Summary** The Field Reimbursement Manager (FRM) serves as the subject-matter expert on...related to access, coverage, reimbursement processes, claims submissions, and coding requirements + Analyze payer criteria and provide product… more
    Otsuka America Pharmaceutical Inc. (05/23/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Mason, OH)
    …Identifies potential documentation and coding errors by recognizing aberrant coding and documentation patterns such as inappropriate billing for ... medical claims billing and payment systems, provider billing guidelines, payer reimbursement policies, and coding ...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (06/10/25)
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  • Practice Manager II - St. Joseph Warren…

    Bon Secours Mercy Health (Youngstown, OH)
    …care sites and clinicians are recognized for clinical and operational excellence. **Practice Manager - St. Joseph Warren Weight Loss Center - Physician Office** The ... Practice Manager 2 anticipates, plans, organizes, and directs the operations...including work queues, copays, daily cash drawer, bank deposits, coding compliance, etc. Meets with Practice Administrator and MHP… more
    Bon Secours Mercy Health (06/03/25)
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