- Elevance Health (Mason, OH)
- …formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The ** Provider Auditor ** conducts on-site ... ** Provider Auditor ** _This position will work...** Provider Auditor ** _This position will work a hybrid model...or any combination of education and experience, which would provide an equivalent background. RN, LPN or medical… more
- Highmark Health (Columbus, OH)
- …(Outpatient): Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with ... related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding,… more
- FirstEnergy (Akron, OH)
- …or accounting or finance experience. + Certified Public Accountant (CPA), Certified Internal Auditor (CIA), Certified Information System Auditor ... with a total capacity of more than 3,500 megawatts. **About the Opportunity** The Auditor III/Lead Auditor conducts financial and compliance audits, as well as… more
- Elevance Health (Mason, OH)
- …- Friday 8AM -5PM (local time) The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure ... **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role enables associates to work...preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider … more
- Elevance Health (Mason, OH)
- …formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **DRG CODING AUDITOR ** is responsible for ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This...or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines,… more
- Battelle Memorial Institute (OH)
- …of regulatory practices and other guidance documents. **Preferred Qualifications** + ISO 17025 Auditor + ISO 9001 Certified Internal/Lead Auditor + ... work-life balance and keep motivated. + **Prioritize wellness** : Stay healthy with medical , dental, and vision coverage with wellness incentives and benefits plus a… more
- Datavant (Columbus, OH)
- …As an Auditor , HCC Risk Adjustment Coder, you will review medical records to identify and code diagnoses using a standardized system, ensuring accurate ... severity of a patient's health stats, **You will:** + Provide education through detailed feedback within audits. + ...+ High school diploma or GED equivalent + AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified… more
- Humana (Columbus, OH)
- …us put health first** CenterWell Senior Primary Care (PCO) is a growing provider organization that currently operates about 340+ senior focused primary care centers ... that assure compliance with federal and/or state requirements related to Provider Clinic operations, billing, investigations, and processes. Coordinates site visits… more
- Medical Mutual of Ohio (OH)
- Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million ... To include data documentation, compilation, reconciliation, and research.Works directly external HEDIS/NCQA auditor to resolve any items on Issue Log. + Reviews data… more
- nVent (Solon, OH)
- …in compliance with ISO 9001:2015. + Completion of Exemplar Global lead auditor training for ISO 9001:2015 required. Experience implementing and maintaining ISO ... 9001:2015 certifications across a multi-site, global organization. Additional lead auditor status and knowledge of ISO 14001:2015 and ISO 45001:2018 desired. +… more