- Cardinal Health (Columbus, OH)
- …for reporting any payer issues to the appropriate team + Must self- audit activities to ensure accuracy and efficiency for the program **_Qualifications_** + ... benefit investigations, prior authorizations, and appeals, preferred + Knowledge of Medicare , Medicaid and Commercially insured payer common practices and policies,… more
- Molina Healthcare (OH)
- …MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the ... + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management… more
- Trinity Health (Columbus, OH)
- …, a college of nursing (https://www.mccn.edu/) , a Medicare Advantage plan (https://www.medigold.com/) , and extensive outreach and ... the standards, procedures and guidelines of the Organization. **Responsibilities** + Audit charts monthly to ensure Clinical Staff are correctly documenting on… more