- Sedgwick (Cleveland, OH)
- …provided to insurance carriers, corporate legal departments and government entities. The auditor will apply client specified billing guidelines and/or Generally ... Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor ** **This is a fully remote position, and...Ability to effectively communicate with law firms to discuss compliance with client's billing requirements. + Effectively… more
- Humana (Columbus, OH)
- …business partners to uphold ethical standards and mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance , by ... data requires an in-depth evaluation of variable factors. As the Senior Clinical Compliance Professional , you will develop and/or evaluate compliance … more
- MetroHealth (Cleveland, OH)
- …records to assess whether the documentation complies with applicable hospital and professional billing rules and regulations. Evaluates medical records to ... 20 health centers.** **Job Summary** **:** **Under the direction of the Compliance Supervisor - Audit (Doc and Coding) Services, conducts coding and documentation… more
- Highmark Health (Columbus, OH)
- …(Outpatient): Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or ... activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code… more
- Elevance Health (Columbus, OH)
- …and abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities for ... **Clinical Provider Auditor II** **Supports the Payment Integrity line of...investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations. + Collaborates… more
- Elevance Health (Mason, OH)
- …and abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities for ... **Clinical Provider Auditor II** This role requires associates to be...investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations. + Collaborates… more
- Datavant (Columbus, OH)
- …complex problems with technology-forward solutions. Datavanters bring a diversity of professional , educational and life experiences to realize our bold vision for ... + Implement process improvements to enhance accuracy, efficiency, and regulatory compliance . + Ensure coding is completed within established turnaround times to… more