• Claims Auditor I, II & Senior

    Elevance Health (Nashville, TN)
    ** Claims Auditor I, II and Senior**...is designed to advance our strategy but will also lead to personal and professional growth for our associates. ... for employment, unless an accommodation is granted as required by law._ The ** Claims Auditor I** is responsible for pre and post payment and adjudication audits… more
    Elevance Health (11/01/25)
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  • DRG Coding Auditor

    Elevance Health (Nashville, TN)
    **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 (10/25/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Nashville, TN)
    **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually full-time, ... -5PM (local time) The **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** is responsible for...Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes… more
    Elevance Health (10/22/25)
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  • Clinical Provider Auditor II

    Elevance Health (Nashville, TN)
    **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
    Elevance Health (11/01/25)
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  • Risk Adjustment - Risk Management Lead

    Humana (Nashville, TN)
    …part of our caring community and help us put health first** The Risk Management Lead acts as a consultant to the Risk Adjustment team leaders, as programs and ... to evaluate business processes and drive improvements aimed at minimizing risk. The Lead will focus on Project Management and is responsible for oversight of the… more
    Humana (11/01/25)
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  • Billing Representative

    Sedgwick (Nashville, TN)
    …Defines, prepares, reviews and analyzes monthly reports. + Prepares audit lead schedules for outside audit firms. **QUALIFICATIONS** Bachelor's degree or equivalent ... in accounting field preferred. Certified Public Accountant (CPA), Certified Internal Auditor (CIA) or Certified Information Systems Auditor (CISA) certification… more
    Sedgwick (09/19/25)
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