- CareSource (Dayton, OH)
- …within the CareSource network using reports generated from administrative, case management and chart audit data to identify and disseminate best practices and to ... identify and address outlier practices whose performance does not meet program standards. Develop and implement quality improvement activities, using data from the MCMH and Maternal Child Case Management programs Identify populations within CareSource… more
- CareSource (Dayton, OH)
- …Dayton HQ office and 1 day remote. Essential Functions: Drive, enhance, track, audit , and report on medical record retrieval processes Create, review, revise, and ... new team members Ensure retrieved medical records' accuracy is confirmed via audit Ensure vendor performance meets operational goals and adheres to contractual… more
- Cardinal Health (Columbus, OH)
- …and conducts investigations to resolve ethics and compliance issues. **Compliance Audit Manager** Reporting to the Compliance Director, this position supervises and ... (technical) services. This position will also support the Director with transactional audit diligence and integration planning, as well as the development and… more
- Molina Healthcare (Cleveland, OH)
- …Adjustment, is responsible for the implementation, monitoring, and oversight of all chart collection for Risk Adjustment, RADV, or Risk Adjustment-like projects, and ... other state specific audit projects and deliverables related to accurate billing and...training, onboarding for CDA team members, vendor management for chart collection vendors, Supplemental data, and chart … more
- Elevance Health (Cincinnati, OH)
- …Group (DRG) methodology, including case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines ... appeals may only be reviewed by other DRG Coding Audit Principals (or Executives). **How you will make an...and audits claims by integrating advanced or convoluted medical chart coding principles (found in the Official Coding Guidelines,… more
- Elevance Health (Mason, OH)
- …will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines and objectivity in the performance of medical ... audit activities. + Draws on advanced ICD-10 coding expertise,...guidelines, and industry knowledge to substantiate conclusions. + Utilizes audit tools and auditing workflow systems and reference information… more
- Elevance Health (Mason, OH)
- …make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of medical ... audit activities. + Draws on advanced ICD-10 coding expertise,...guidelines, and industry knowledge to substantiate conclusions. + Utilizes audit tools, auditing workflow systems and reference information to… more
- Cleveland Clinic (Akron, OH)
- …appointment schedule. + Collect information from patients, process insurance claims and audit collections. + Receive incoming calls to the department and assist or ... information under the correct patient account number and place in patient chart . + Obtain blood specimens by various venipuncture and micro collection techniques.… more
- CenterWell (Columbus, OH)
- …Lead Special Projects for onshore and offshore coding teams. + Participate in chart reviews to identify educational opportunities. + Conduct research as needed. + ... Participate in Payer calls/ chart reviews. + May participate in provider education programs...in Microsoft Office Suite (Word, Excel, PowerPoint) and relevant coding/ audit software + Strong business acumen with proven strategic… more
- CBRE (Columbus, OH)
- …consulting opportunities based on knowledge of the department's pricing platform. + Audit monthly pricing worksheets and enter allocations into PeopleSoft. + Review ... backgrounds and skillsets of our people. At CBRE, you have the opportunity to chart your own course and realize your potential. We welcome all applicants. **Our… more
