- Humana (Columbus, OH)
- …looking is an experienced and well-grounded medical coding auditor to quality review the inpatient hospital claims for proper reimbursement, handle provider ... community and help us put health first** In this role, you will conduct quality reviews of coding processes within the Claims Cost Management organization,… more
- 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 (Mason, OH)
- … AUDITOR ** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines ... **DRG CODING AUDITOR ** **Location** : _This position will work virtually._...AA/AS or minimum of 5 years of experience in claims auditing, quality assurance, or recovery auditing.… more
- 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
- 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
- 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
- Humana (Columbus, OH)
- …cycle management (related to billing, coding, collections for Medicare and Medicaid claims ) + Experience with Auditing and monitoring of healthcare records + Must ... need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel,… more
- Elevance Health (Columbus, OH)
- **Performance Quality Analyst III ( Claims ** ) **Location** : This role requires associates to be in-office 1 days per week, fostering collaboration and ... adaptable workplace. Alternate locations may be considered. The **Performance Quality Analyst III ( Claims ** ) is responsible...you will make an impact** : + Acts as auditor in charge for audits and special projects, producing… more
- 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
- 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