• Auditor - Billing/ Claims

    UC Health (Cincinnati, OH)
    …an inclusive, equitable and diverse place of employment. The Charge Master Auditor is responsible for executing charge related audits. They assist in evaluating ... compliance related services that resolve charging discrepancies and provide charging related outreach education to clinical departments on charging processes and procedures. Instrumental in working Infusion related edits and providing education to our Infusion… more
    UC Health (07/03/25)
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  • Attorney Auditor

    Sedgwick (Cleveland, OH)
    …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor ** **This is a fully remote position, and candidates residing in any ... United States are encouraged to apply. As an Attorney Auditor at Sedgwick, you'll have the opportunity to take...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
    Sedgwick (07/09/25)
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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 (07/25/25)
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  • DRG Coding Auditor

    Elevance Health (Mason, OH)
    **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ _​_ _This role enables associates to work virtually full-time, with the exception of required in-person training ... recover, eliminate and prevent unnecessary medical-expense spending. The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records and generating… more
    Elevance Health (07/22/25)
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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 ... granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor -RN** is responsible for auditing inpatient medical records to ensure clinical… more
    Elevance Health (08/01/25)
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  • Clinical Provider Auditor II

    Elevance Health (Mason, OH)
    **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** _Location:_ **Virtual:** This role enables associates to work virtually ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
    Elevance Health (08/01/25)
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  • Provider Auditor (RN/LPN Medical Coder…

    Elevance Health (Independence, OH)
    **Provider Auditor ** _This position will work a hybrid model (remote and office), 1 time per week. The Ideal candidate will live within 50 miles of one of our ... to recover, eliminate and prevent unnecessary medical-expense spending. The **Provider Auditor ** conducts on-site reviews of medical charts, medical notes, itemized… more
    Elevance Health (08/01/25)
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  • Coding Auditor Educator

    Highmark Health (Columbus, OH)
    …Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician coding and/or ... and communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong education/training background… more
    Highmark Health (05/09/25)
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  • Senior Nurse Auditor - Payment Integrity…

    Elevance Health (Mason, OH)
    …of utilization and/or fraudulent activities by health care providers through prepayment claims review, post payment auditing, and provider record review. **How you ... fraud and over-utilization by performing medical reviews via prepayment claims review and post payment auditing . Correlates review...well as other areas of the company relative to claims reviews and their status . Analyzes and trends… more
    Elevance Health (07/30/25)
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  • Sr Compliance RCM & Coding Auditor

    Humana (Columbus, OH)
    …cycle management (related to billing, coding, collections for Medicare and Medicaid claims ) + Experience with Auditing and monitoring of healthcare records + Must ... be able to work core business hours on EST time between (9am-5pm). + Willingness to travel up to 10% to conduct audits at site locations. + Ability to manage multiple or competing priorities and meet deadlines + Must be passionate about contributing to an… more
    Humana (07/29/25)
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