- Elevance Health (Independence, OH)
- ** Claims Auditor II ** **Location :** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... for employment, unless an accommodation is granted as required by law._ The ** Claims Auditor II ** is responsible for audits of high dollar claims… more
- Elevance Health (Mason, OH)
- **Clinical Provider Auditor II ** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and ... is granted as required by law. The **Clinical Provider Auditor II ** is responsible for identifying issues...abuse. **How you will make an Impact:** + Examines claims for compliance with relevant billing and processing guidelines… more
- Elevance Health (Columbus, OH)
- **Clinical Provider Auditor II ** **Supports the Payment Integrity line of business** **Hybrid 1** : This role requires associates to be in-office **1-2** days ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II ** is responsible for identifying issues and/or entities… more
- City of Columbus (Columbus, OH)
- …to advise contractors on compliance with City tax requirements; + May assist Auditor II 's with conducting field audits to research businesses and locations ... Income Tax Auditor I - EXAM Print (https://www.governmentjobs.com/careers/columbusoh/jobs/newprint/5048861) Apply ...to determine the factual and mathematical basis for the claims and responds by approving, disapproving, or adjusting the… more
- Highmark Health (Columbus, OH)
- …coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure ... + Validates the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems, missed secondary diagnoses and...Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician… more
- Medical Mutual of Ohio (OH)
- …remote opportunity. Eastern Time Zones preferred.** **Responsibilities** **HEDIS Analyst II ** + Coordinates and collaborates interdepartmentally to produce the ... To include data documentation, compilation, reconciliation, and research.Works directly external HEDIS/NCQA auditor to resolve any items on Issue Log. + Reviews data… more