- Elevance Health (Mason, OH)
- ** Clinical Provider Auditor I (CPC)** **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, ... an accommodation is granted as required by law.** The ** Clinical Provider Auditor I (CPC)** is responsible...you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies… more
- Elevance Health (Mason, OH)
- ** Clinical Provider Auditor II** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and ... an accommodation is granted as required by law. The ** Clinical Provider Auditor II** is responsible for...you will make an Impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies… more
- Humana (Columbus, OH)
- …our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and ... ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. Job Description **Summary** Works collaboratively with ... the Compliance Manager on creating auditing protocols which align with...protocols which align with Bon Secours Mercy Health's overall compliance audit and compliance responsibilities relative to… more
- Highmark Health (Columbus, OH)
- …with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts ... and modifier systems, missed secondary diagnoses and procedures and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim… more
- UC Health (Cincinnati, OH)
- …an inclusive, equitable and diverse place of employment. The Charge Master Auditor is responsible for executing charge related audits. They assist in evaluating ... compliance related services that resolve charging discrepancies and provide...charging discrepancies and provide charging related outreach education to clinical departments on charging processes and procedures. Instrumental in… more
- WelbeHealth (Columbus, OH)
- …culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by ... clinical documentation within the health records, as well as...as educating our teams on best practices to promote compliance . **Essential Job Duties:** + Assist with retrospective and… more
- Molina Healthcare (Columbus, OH)
- JOB DESCRIPTION Job Summary Provides support for non- clinical healthcare services auditing activities. Responsible for performing audits for non- clinical ... functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide… more
- Medical Mutual of Ohio (OH)
- …(CAHPS) and Health Outcomes Survey (HOS). Supports data capture and reporting of clinical quality of care received by members. Works closely with the Quality team ... To include data documentation, compilation, reconciliation, and research.Works directly external HEDIS/NCQA auditor to resolve any items on Issue Log. + Reviews data… more
- Datavant (Columbus, OH)
- …addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, ... to help shape the future of healthcare from your own workspace! Preferred: Inpatient auditor with 3-5 years of experience at a Trauma Level 1 facility. SMART… more