- 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 ... Friday 8AM -5PM (local time) The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
- Elevance Health (Mason, OH)
- **Clinical Provider Auditor II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required inperson training sessions, ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II i** s responsible for identifying issues and/or entities that… more
- Elevance Health (Mason, OH)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Virtual:** This role enables associates to work virtually full-time, with the ... 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 (Mason, OH)
- …is granted as required by law. The **Business Analyst II- Pharmacy Benefit Auditor ** is responsible for analyzing pharmacy benefit coding systems against ... member-centered, lasting pharmacy care._ **Title** : **Business Analyst II- Pharmacy Benefit Auditor ** **Hybrid** - This role requires associates to be in-office 1 -… more
- Datavant (Columbus, OH)
- …for healthcare. **What We're Looking For:** As an HCC (Hierarchical Condition Category) Auditor you will review medical records that have been coded in a ... a diagnosis level + Answer rebuttals entered on the auditor by coders and or auditors + Participate in...by coders and or auditors + Participate in weekly coding project review meetings + Any other tasks asked… more
- 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
- MetroHealth (Cleveland, OH)
- …**:** **Under the direction of the Compliance Supervisor - Audit (Doc and Coding ) Services, conducts coding and documentation audits of MetroHealth (MHS) medical ... ensure the execution of an effective compliance program, including training on coding and documentation rules. Upholds the mission, vision, values, and customer… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …Job Functions** + Assists in the review of Bon Secours Mercy Health coding , billing and claims processing policies and procedures for the development of compliance ... Mercy Health's public status. + Develops educational content on documentation, coding , and trending of non-compliant activities to enhance compliance proficiency and… more
- Molina Healthcare (Cincinnati, OH)
- …payment in all markets * Performs monthly audit on internal Molina Coding Specialists * Audits external Molina Vendors. **Job Qualifications** **Required Education** ... Associates degree. **Required Experience** 3 Years in coding and medical record chart review and experience with risk adjustment data validation Required Li… more
- CVS Health (Columbus, OH)
- …highlighting findings, recommendations, and areas of concern to be delivered to coding resources. + Adhere to stringent timelines consistent with project deadlines ... to vendors, providers and other team members for questions regarding ICD coding and documentation requirements. + Comprehensive knowledge of coding guidelines… more