• DRG Coding Auditor

    Elevance Health (Mason, OH)
    …** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company , for all lines of ... **DRG CODING AUDITOR ** **Location** : _This position will work virtually._...and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside… more
    Elevance Health (05/29/25)
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  • Performance Quality Auditor II

    Elevance Health (Columbus, OH)
    **Performance Quality Auditor II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... and ensures essential face-to-face onboarding and skill development. The **PERFORMANCE QUALITY AUDITOR II** is responsible for evaluating the quality of services and… more
    Elevance Health (05/28/25)
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  • Attorney Auditor

    Sedgwick (Cleveland, OH)
    …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor As an Attorney Auditor at Sedgwick, you'll have the opportunity ... Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. +...professional needs. **PRIMARY PURPOSE OF THE ROLE** The Attorney Auditor reviews legal and non-legal invoices on behalf of… more
    Sedgwick (04/09/25)
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  • Inpatient DRG Quality Auditor

    Humana (Columbus, OH)
    …Coding Quality Team is looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper ... this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization, including offshore and vendor partners, with a focus… more
    Humana (05/30/25)
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  • Diagnosis Related Group Clinical Validation…

    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 ... onboarding and skill development. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure… more
    Elevance Health (05/22/25)
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  • Coding Auditor Educator

    Highmark Health (Columbus, OH)
    ** Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding ... and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting… more
    Highmark Health (05/09/25)
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  • External Audit Facilitator

    Elevance Health (Independence, OH)
    …and audit schedule. + Reviews, negotiates, and approves scope presented by external auditor . + For implementation audits, ensures the claims system is coded ... Audit Facilitator** is responsible for managing the process for claims and customer service audits/quality control reviews, including implementation audits,… more
    Elevance Health (05/23/25)
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  • Quality Specialist

    CVS Health (Columbus, OH)
    …passionate about transforming health care. As the nation's leading health solutions company , we reach millions of Americans through our local presence, digital ... all with heart, each and every day. **Position Summary** Claim Audit Quality Analysts need to have a wide...review. A candidate must become subject matter experts in claims , plan documents, eligibility, coverages, and quirks of multiple… more
    CVS Health (05/30/25)
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  • Manager, Consulting - Legal Bililing Operations

    Wolters Kluwer (Columbus, OH)
    …+ 1+ years of prior supervisory experience, preferably in a legal billing or claims environment. + 5+ years' experience in the legal industry with 3+ years as ... an attorney, paralegal, legal spend analyst, legal bill auditor , legal bill reviewer, or billing coordinator for law firms. + Ability to obtain information from… more
    Wolters Kluwer (05/14/25)
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  • Manufacturing Quality Engineer

    Saint-Gobain (Milan, OH)
    …culture is made up of these core values: Trust, Empowerment, & Collaboration. Our company encourages diversity and inclusion in all its forms while our products make ... ensure finished goods conform to specified requirements. + Manages the customer claims resolution and corrective action system. + Creates local documentation, such… more
    Saint-Gobain (05/13/25)
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