- Elevance Health (Mason, OH)
- …related questions as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations. + ... Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Provider Auditor II**...+ Requires a AA/AS and minimum of 4 years medical coding /auditing experience, including minimum of 1… more
- Datavant (Columbus, OH)
- …vision 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 (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
- MetroHealth (Cleveland, OH)
- …of the Compliance Supervisor - Audit (Doc and Coding ) Services, conducts coding and documentation audits of MetroHealth (MHS) medical records to assess ... **Location:** **METROHEALTH MEDICAL CENTER** **Biweekly Hours:** **80.00** **Shift:** **8a-4:30pm** **The...execution of an effective compliance program, including training on coding and documentation rules. Upholds the mission, vision, values,… 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)
- …**Job Qualifications** **Required Education** Associates degree. **Required Experience** 3 Years in coding and medical record chart review and experience with ... Required Li **Required License, Certification, Association** Active and unrestricted Coding Certification, Active CCS, CCS-P, or CPC credential **Preferred… more
- CVS Health (Columbus, OH)
- …CRC (Certified Risk Adjustment Coder) required. + CPMA (Certified Professional Medical Auditor ) **or** CDEO (Certified Documentation Expert Outpatient) ... Qualifications** + Minimum of 5 years recent and related experience in medical record documentation review, diagnosis coding , and/or auditing. + Experience… more
- Elevance Health (Mason, OH)
- …verbal inquiries. **How you will make an impact:** + Assists higher level auditor /lead on field work as assigned, including performing special audits and targeted ... and post implementation audits of providers, claims processing and payment, benefit coding , member and provider inquiries, enrollment & billing transactions and the… more
- Elevance Health (Mason, OH)
- …verbal inquiries. **How you will make an impact:** + Assists higher level auditor /lead on field work as assigned, including performing special audits and targeted ... and post implementation audits of providers, claims processing and payment, benefit coding , member and provider inquiries, enrollment & billing transactions and the… more