• Provider Auditor (RN/LPN Medical

    Elevance Health (Mason, OH)
    …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Provider Auditor ** conducts on-site reviews of ... **Provider Auditor ** _This position will work a hybrid model...dollar volume of provider. + Analyzes data to select claims to be reviewed, conducts reviews using medical more
    Elevance Health (06/07/25)
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  • DRG Coding Auditor Principal

    Elevance Health (Mason, OH)
    …considered._ The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) ... **DRG Coding Auditor Principal** _Virtual: This role enables associates to...environment preferred. + Broad, deep and niche knowledge of medical claims billing/payment systems provider billing guidelines,… more
    Elevance Health (06/05/25)
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  • Attorney Auditor

    Sedgwick (Cincinnati, OH)
    …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Attorney Auditor ** **This is a fully remote position, and candidates residing in any ... United States are encouraged to apply. As an Attorney Auditor at Sedgwick, you'll have the opportunity to take...opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401K and PTO. + Wellness benefits… more
    Sedgwick (04/09/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Mason, OH)
    …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... and skill development. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical ...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles,… more
    Elevance Health (06/04/25)
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  • Coding Auditor Educator

    Highmark Health (Columbus, OH)
    …(Outpatient): Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or ... related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding,… more
    Highmark Health (05/09/25)
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  • Compliance Auditor - Enterprise Risk

    Bon Secours Mercy Health (Cincinnati, OH)
    …Assists in the review of Bon Secours Mercy Health coding, billing and claims processing policies and procedures for the development of compliance internal monitors ... periodic review and analysis of Bon Secours Mercy Health hospital claims denial reports, operational assessment reports, internal quality control reviews, internal… more
    Bon Secours Mercy Health (05/07/25)
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  • External Audit Facilitator

    Elevance Health (Independence, OH)
    …and audit schedule. + Reviews, negotiates, and approves scope presented by external auditor . + For implementation audits, ensures the claims system is coded ... Audit Facilitator** is responsible for managing the process for claims and customer service audits/quality control reviews, including implementation audits,… more
    Elevance Health (05/23/25)
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  • Manager, Consulting - Legal Bililing Operations

    Wolters Kluwer (Columbus, OH)
    …+ 1+ years of prior supervisory experience, preferably in a legal billing or claims environment. + 5+ years' experience in the legal industry with 3+ years as ... an attorney, paralegal, legal spend analyst, legal bill auditor , legal bill reviewer, or billing coordinator for law firms. + Ability to obtain information from… more
    Wolters Kluwer (05/14/25)
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  • Quality Control Engineer

    Saint-Gobain (Milan, OH)
    …ensure finished goods conform to specified requirements. + Manages the customer claims resolution and corrective action system. + Creates local documentation, such ... + ASQ Certification as a Quality Engineer or Quality Auditor is preferred + Knowledge of Continuous Improvement toolsets...but is not limited to: + Excellent healthcare options: Medical , vision, prescription & dental + Family Focus &… more
    Saint-Gobain (06/04/25)
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