• Quality Compliance Professional

    Humana (Columbus, OH)
    …internal and external stakeholders. + Provider outreach to close care gaps, audit records to identify improvement opportunities, and abstract data from records to ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ​… more
    Humana (05/30/25)
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  • Revenue Integrity Analyst II

    Intermountain Health (Columbus, OH)
    …and compliant application with charge/coding capture, charge editing, and audit and reimbursement practices. Researches and collaborates on regulation updates ... preceptor, trainer experience is preferred Knowledgeable of CMS Guidelines ( Medicare /Medicaid) To perform this job successfully, an individual must be able… more
    Intermountain Health (05/30/25)
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  • Risk Adjustment Compliance Professional 2

    Humana (Columbus, OH)
    …+ Building working relationships with internal stakeholders and supporting external audit preparation efforts. + Demonstrating an understanding of departmental and ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ​… more
    Humana (05/22/25)
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  • Case Manager

    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
    Cardinal Health (05/21/25)
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  • Lead Clinical Registered Nurse Specialty-…

    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
    Trinity Health (04/24/25)
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