• DRG Coding Auditor Principal

    Elevance Health (Mason, 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 least one of ... **DRG Coding Auditor Principal** _Virtual: This role enables associates to...Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology,… more
    Elevance Health (06/05/25)
    - Related Jobs

  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Mason, OH)
    …applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum ... **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
    Elevance Health (06/04/25)
    - Related Jobs

  • Coding Auditor Educator

    Highmark Health (Columbus, OH)
    …and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, ... processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and assistance from management, designs and… more
    Highmark Health (05/09/25)
    - Related Jobs

  • Compliance Auditor - Enterprise Risk

    Bon Secours Mercy Health (Cincinnati, OH)
    …Coordinates periodic review and analysis of Bon Secours Mercy Health hospital claims denial reports, operational assessment reports, internal quality control ... Bon Secours Mercy Health, we are dedicated to continually improving health care quality , safety and cost effectiveness. Our hospitals, care sites and clinicians are… more
    Bon Secours Mercy Health (05/07/25)
    - Related Jobs

  • Quality Control Engineer

    Saint-Gobain (Milan, OH)
    …a Quality Engineer or Process Engineer is preferred + ASQ Certification as a Quality Engineer or Quality Auditor is preferred + Knowledge of Continuous ... ensure finished goods conform to specified requirements. + Manages the customer claims resolution and corrective action system. + Creates local documentation, such… more
    Saint-Gobain (06/04/25)
    - Related Jobs

  • External Audit Facilitator

    Elevance Health (Independence, OH)
    …**External Audit Facilitator** is responsible for managing the process for claims and customer service audits/ quality control reviews, including implementation ... + Reviews, negotiates, and approves scope presented by external auditor . + For implementation audits, ensures the claims... auditor . + For implementation audits, ensures the claims system is coded accurately by independently developing and… more
    Elevance Health (05/23/25)
    - Related Jobs

  • Manager, Consulting - Legal Bililing Operations

    Wolters Kluwer (Columbus, OH)
    …of Excellence ("LBACOE"), which consists of Legal Invoice Analysts, Quality Assurance Analysts, Operations Support Specialists, Managers, Associate Directors, and ... as needed. Further your responsibility is for the creation and implementation of quality assurance methodologies, subject to approval by management, as well as the… more
    Wolters Kluwer (05/14/25)
    - Related Jobs