- Zurich NA (Columbus, OH)
- …workstreams + Experience in a transactional, operational or customer service environment + Quality auditing experience + Knowledge of the insurance industry and ... Sr Supplier Medical Process Specialist 128416 Zurich North America is seeking am...continuous process and system enhancements to improve operational efficiencies, quality and/or timeliness. At Zurich North America Claims… more
- Elevance Health (Cincinnati, OH)
- …at least one of the following: AA/AS or minimum of 15 years of experience in claims auditing , quality assurance, or recovery auditing . + Requires at ... spending. The **DRG Coding Auditor Principal** is responsible for auditing inpatient medical records on claims paid...and generate audit findings letters. + Validates accuracy and quality standards as set by audit management for the… more
- Elevance Health (Mason, OH)
- …at least one of the following: AA/AS or minimum of 5 years of experience in claims auditing , quality assurance, or recovery auditing . + Requires at ... auditing inpatient medical records and generating high quality recoverable claims for the benefit of...Health Information Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder. +… more
- Elevance Health (Mason, OH)
- …in applicable state(s). + Requires a minimum of 10 years of experience in claims auditing , quality assurance, or clinical documentation improvement, and a ... The **Diagnosis Related Group Clinical Validation Auditor-RN** is responsible for auditing inpatient medical records to ensure clinical documentation supports the… more
- Molina Healthcare (OH)
- …review, medical claims review, long-term services and supports (LTSS), claims auditing , medical necessity review and/or coding experience, or equivalent ... appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care. **ESSENTIAL JOB DUTIES:** + Facilitates… more
- OhioHealth (Columbus, OH)
- …with other primary users in clinical and non-clinical roles as necessary regarding Claims Processing, Quality Metrics and Data Integrity. Serves as subject ... management, staff education, responses to breaches, business continuity planning, auditing , and information security risk management. **Minimum Qualifications:** High… more