• Diagnosis Related Group Clinical Validation…

    Elevance Health (Mason, OH)
    …Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential ... recognizing aberrant coding and documentation patterns such as inappropriate billing for readmissions, inpatient admission status, and Hospital-Acquired Conditions… more
    Elevance Health (08/09/25)
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  • DRG Coding Auditor

    Elevance Health (Mason, OH)
    …Technician 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, ... quality assurance environment preferred. + Broad knowledge of medical claims billing /payment systems provider billing guidelines, payer reimbursement policies, … more
    Elevance Health (07/22/25)
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  • Special Investigation Unit (SIU) Coding Review…

    CVS Health (Columbus, OH)
    …more compassionate. And we do it all with heart, each and every day. The Certified Professional Coder (CPC) Manager will oversee a team of medical coders within ... 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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  • Senior Coding Educator

    Humana (Columbus, OH)
    …Qualifications** + High school diploma or equivalent + Must hold AAPC CPC ( Certified Professional Coder ) certification + 2 years or more experience with ... 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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  • Clinical Fraud Investigator Senior

    Elevance Health (Mason, OH)
    …**Minimum Requirements:** + Requires an AS in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA) and minimum of 5 years ... identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to identify opportunities for fraud and abuse… more
    Elevance Health (08/08/25)
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