- 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...quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer… more
- Elevance Health (Mason, OH)
- …with provider management team by presenting preliminary review results. + Verifies dollar amount on claim is correct in claims system and writes report of ... **Provider Auditor -** FRD > Audit **Hybrid 1:** This...itemized bills and providers contracts to ensure that a claim is paid in accordance with the contract, provider… more
- City of Columbus (Columbus, OH)
- Income Tax Auditor I - EXAM Print (https://www.governmentjobs.com/careers/columbusoh/jobs/newprint/5048861) Apply Income Tax Auditor I - EXAM Salary $28.43 - ... position Job Type Full-time Job Number 25-0660-C1 Department 22 Columbus City Auditor Division Division of Income Tax Opening Date 08/20/2025 Closing Date 9/10/2025… more
- Elevance Health (Mason, OH)
- …preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems , provider billing guidelines, payer ... **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role enables associates to work...Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes… more
- Highmark Health (Columbus, OH)
- …to resolve issues and provide advice on new programs. Provides guidance to system entities in response to external coding audits conducted by the Medicare ... the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems , missed secondary diagnoses and procedures and ensures compliance with DRG/APC structure… more
- Elevance Health (Mason, OH)
- **Clinical Provider Auditor II** This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and connectivity, while providing ... recover, eliminate and prevent unnecessary medical-expense spending. The Clinical Provider Auditor II is responsible for identifying issues and/or entities that may… more
- Elevance Health (Mason, OH)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Hybrid 1** : This role requires associates to be in-office **1-2** days per ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
- Molina Healthcare (Columbus, OH)
- …is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it ... written and verbal + Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using claims processing… more
- Medical Mutual of Ohio (OH)
- …including HEDIS audit submission, Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Health Outcomes Survey (HOS). Supports data capture and ... To include data documentation, compilation, reconciliation, and research.Works directly external HEDIS/NCQA auditor to resolve any items on Issue Log. + Reviews data… more