- Elevance Health (Independence, OH)
- …using medical charts, medical notes, and provider contracts. + Verifies dollar amount on claim is correct in claims system and writes report of the findings ... **Provider Auditor ** _This position will work a hybrid model...itemized bills and providers contracts to ensure that a claim is paid in accordance with the contract, provider… more
- Highmark Health (Columbus, OH)
- … Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or ... and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting… more
- Elevance Health (Mason, OH)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ _This...auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all… more
- Sedgwick (Cleveland, OH)
- …achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work(R) Fortune Best Workplaces in ... Financial Services & Insurance Attorney Auditor ** **This is a fully remote position, and...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- Elevance Health (Mason, OH)
- **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role enables associates to work virtually full-time, with the exception of required ... granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor -RN** is responsible for auditing inpatient medical records to ensure clinical… more
- Humana (Columbus, OH)
- …cycle management (related to billing, coding, collections for Medicare and Medicaid claims ) + Experience with Auditing and monitoring of healthcare records + Must ... compliance, mainly primary care and risk adjustment, pharmacy knowledge a plus + Certified Coder (CPC, CRC, and/or CMC) + Experience with metrics and reporting… more