• Nurse Audit Senior - Payment Integrity Complex…

    Elevance Health (Mason, OH)
    …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Nurse Audit Senior** will be responsible for ... make an impact:** + Investigates potential fraud and over-utilization by performing medical reviews via prepayment claims review and post payment auditing +… more
    Elevance Health (10/29/25)
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  • Outpatient Audit Specialist PRN- 1,000 Sign…

    Datavant (Columbus, OH)
    …Profee ED **What You Will Do:** + Performs Outpatient Facility coding audits of medical records and abstracts using ICD-10-CM, CPT, HCPCS, and modifiers and ... to ensure departmental workflow and case resolution + Provides coder education via the auditing process + Function in...EMRs **What We Offer:** + Benefits for Full-Time employees: Medical , Dental, Vision, 401k Savings Plan w/match, 2 weeks… more
    Datavant (11/12/25)
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  • Senior Coding Specialist

    Cleveland Clinic (Cleveland, OH)
    …Professional Coding policies accurately and in a timely manner. + Review medical documentation and assign CPT, ICD-10, HCPCS II codes, and modifiers based ... on documentation and payor requirements across all patient encounters and medical and surgical specialties. + Adapt to frequent assignment changes to support the… more
    Cleveland Clinic (11/07/25)
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  • Auditor, HCC Risk Adjustment Coding - Full Time…

    Datavant (Columbus, OH)
    …experiences to realize our bold vision for healthcare. As an Auditor, HCC Risk Adjustment Coder , you will review medical records to identify and code ... across Medicare, commercial, and Medicaid sectors. + In-depth knowledge of medical terminology, abbreviations, pharmacology, and disease processes. + Ability to… more
    Datavant (11/07/25)
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  • Associate Specialist, Appeals & Grievances

    Molina Healthcare (Columbus, OH)
    …of appeals according to state, federal and Molina guidelines. * Requests and obtains medical records , notes, and/or detailed bills as appropriate to assist with ... Completion of a health care related vocational program (ie, certified coder , billing, or medical assistant). To all current Molina employees: If you are… more
    Molina Healthcare (11/15/25)
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  • Specialist, Appeals & Grievances

    Molina Healthcare (OH)
    …to determine appropriate appeals and grievance outcomes. * Requests and reviews medical records , notes, and/or detailed bills as appropriate; formulates ... health care related vocational program in health care (ie, certified coder , billing, or medical assistant). To all current Molina employees: If you are… more
    Molina Healthcare (11/15/25)
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  • Specialist, Appeals & Grievances

    Molina Healthcare (Cleveland, OH)
    …**Provider No Surprise Act** cases outcomes. . * Requests and reviews medical records , notes, and/or detailed bills as appropriate; formulates conclusions ... health care related vocational program in health care (ie, certified coder , billing, or medical assistant). To all current Molina employees: If you are… more
    Molina Healthcare (11/09/25)
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  • Coding Education Instructor

    Cleveland Clinic (Cleveland, OH)
    …meetings to communicate new coding-related findings. + Identify elements of a medical record's structure and content and code abstracting. + Lead training sessions ... on current coding information in the medical field. + Maintain knowledge of ICD10, HCPCS and...**OR** Certified Coding Specialist (CCS) + **OR** Certified Professional Coder (CPC) + Advanced level ICD-10-CM, HCPCS, and CPT… more
    Cleveland Clinic (11/14/25)
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