- Highmark Health (Columbus, OH)
- …OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and ... identified in the audits compliant with regulatory requirements. Provides written audit guidance. Participates with management in the assessment of external … more
- CenterWell (Columbus, OH)
- …at the division and market level; Partners with Clinical Documentation Improvement, Audit , and Education to develop programs to improve clinical documentation. + ... development and compliance with coding standards. + Partner with analytics and audit to identify coder errors and develop plans to address deficiencies/specific… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans._** **Responsibilities** ... of the corporate forecast, audited financial statements, regulatory reporting and/or audit schedules. . Reviews certain account reconciliations prepared by staff… more
- Trinity Health (Columbus, OH)
- …**Shift:** **Description:** **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other ... variety of professional roles including information technology, financial analysis, audit , provider relations and more. **About the job:** Reconciliation Analyst… more
- Bon Secours Mercy Health (Oberlin, OH)
- …accounts and assures that all forms are completed accurate, timely to meet audit standards and provides statistical data to Patient Access leadership. Patient Access ... and distributes patient education documents, such as Important Message from Medicare , Important Message from Tricare, Observation Forms, MOON form, Consent forms,… more
- Option Care Health (Columbus, OH)
- …expert in health care compliance including, but not limited to FWA, Medicare & Medicaid billing requirements, and interactions with healthcare professionals. Lead or ... teams. Collaborate across all functions including Operations, Market Access, Internal Audit , Legal, Clinical & Quality, Human Resources and Finance and others… more
- Evolent (Columbus, OH)
- …of utilization review determinations, including appeals. + Provides input into audit processes including development of questions. + Reviews statistical sample of ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or… more
- Trinity Health (Columbus, OH)
- …care reimbursement. **Why MediGold?** MediGold (https://medigold.com/) is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare ... wide variety of professional roles including information technology, financial analysis, audit , provider relations and more. **About the job:** Senior Decision… more
- Datavant (Columbus, OH)
- …materials + Provide support to client relations for trainings needed for client audit findings + Research and analysis of coding error trends What you will ... and understanding of HCC mapping and models + Experience with coding Medicare , Commercial and Medicaid risk adjustment charts + Understanding of Medicare… more
- WTW (North Canton, OH)
- …leading direct-to-consumer insurance services business, specializing in the distribution of Medicare Advantage, Medicare Supplement and Life & Supplemental ... ensure proper handling in the financial statements. + Assist with external audit requests. + Identify opportunities for process improvement and assist in… more