• Quality Reviewer (Aetna SIU)

    CVS Health (Columbus, OH)
    …Fraud, Waste, and Abuse review experience. + Billing and Coding certifications such as CPC (AAPC) and/or CCS (AHIMA). + Knowledge of Behavioral Health policies ... and procedures is a plus. + Experience reviewing Behavioral Health fraud cases. + Understanding of clinical issues related to healthcare. + Strong communication and customer service skills. + Ability to effectively interact with diverse groups of people at… more
    CVS Health (08/08/25)
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  • Auditor, Risk Adjustment (Remote)

    Molina Healthcare (Cincinnati, OH)
    …**Required License, Certification, Association** Active and unrestricted Coding Certification, Active CCS , CCS -P, or CPC credential **Preferred Education** ... Bachelor's Degree in Business Administration, Health Care Management o To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and… more
    Molina Healthcare (07/25/25)
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  • Sr Analyst, Scope Management - Healthcare

    Evolent (Columbus, OH)
    …Oncology Coder (CHONC) + Certified Coding Associate (CCA) + Certified Professional Coder ( CPC ) + Certified Coding Specialist ( CCS ) **To comply with HIPAA ... security standards (45 CFR sec. 164.308 (a) (3)), identity verification may be required as part of the application process. This is collected for compliance and security purposes and only reviewed if an applicant advances to the final interview state.… more
    Evolent (07/18/25)
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  • Senior Client Coding Project Manager

    Datavant (Columbus, OH)
    …+ Minimum 5 years managing coders in an outpatient or inpatient setting. + Current CCS , CRC, or CPC required. + Previous Medicare Advantage Risk Adjustment, CDI, ... Medicaid, Commercial RA, and HEDIS experience. + Familiarity with HIPAA patient privacy requirements. + Excellent communication and organizational skills. + Keen attention to detail. + Advanced problem-solving skills. + Proficient in Microsoft Office and… more
    Datavant (06/28/25)
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  • Profee Coding Consultant (Pediatric - General…

    Datavant (Columbus, OH)
    …Succeed:** + 1+ year of profee coding experience. + AHIMA certified credentials (RHIA, RHIT, CCS ) or AAPC certified credentials ( CPC , CPC -H, COC, CIC or ... CRC). + Strong written and verbal communication skills, adeptness in remote work, and exceptional time management skills. + Experience in computerized encoding and abstracting software. + Required to take and pass annual Introductory HIPAA examination and… more
    Datavant (08/13/25)
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  • Supervisor, HCC Risk Adjustment Coding - Remote

    Datavant (Columbus, OH)
    …assigned. **What you will bring to the table:** + AHIMA certified credentials (RHIA, RHIT, CCS ) or AAPC certified credentials ( CPC , CPC -H, COC, CIC, CRC) + ... Extensive knowledge of ICD -9/10 + 2 years coding experience, required. + People Leader experience managing a team of employees. + Familiarity with HCC coding. + A strong knowledge base of medical terminology, medical abbreviations, pharmacology and disease… more
    Datavant (08/13/25)
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  • Auditor, HCC Risk Adjustment Coding - Full Time…

    Datavant (Columbus, OH)
    …experience + High school diploma or GED equivalent + AHIMA certified credentials (RHIA, RHIT, CCS ) or AAPC certified credentials ( CPC , CPC -H, COC, CIC or ... CRC). + Proficient in ICD-10 coding. + Experienced in HCC coding across Medicare, commercial, and Medicaid sectors. + In-depth knowledge of medical terminology, abbreviations, pharmacology, and disease processes. + Ability to excel in a fast-paced production… more
    Datavant (08/08/25)
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  • HCC Risk Adjustment Auditor - Full Time - Remote

    Datavant (Columbus, OH)
    …+ High school diploma or GED equivalent required + AHIMA certified credentials (RHIA, RHIT, CCS ) or AAPC certified credentials ( CPC , CPC -H, COC, CIC or CRC) ... + A strong knowledge base of medical terminology, medical abbreviations, pharmacology, and disease processes + Ability to work in a fast-paced production environment while maintaining high quality + Must be able to follow instructions, meet deadlines and work… more
    Datavant (08/01/25)
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  • HCC Risk Adjustment Coder - Full Time - Remote

    Datavant (Columbus, OH)
    …leadership. **What you will bring to the table:** + AHIMA certified credentials (RHIA, RHIT, CCS ) or AAPC certified credentials ( CPC , CPC -H, COC, CIC, or ... CRC). + A minimum of 2 years HCC coding experience, while certified. + Full understanding and knowledge of ICD-10, medical terminology, medical abbreviations, pharmacology and disease processes. + Ability to be flexible in the work environment. + Ability to… more
    Datavant (08/01/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Mason, OH)
    …Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder ( CPC ) or Inpatient Coding Credential such as CCS or ... CIC. + Experience with third party DRG Coding and/or Clinical Validation Audits or hospital clinical documentation improvement experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems,… more
    Elevance Health (08/09/25)
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