- Elevance Health (Mason, OH)
- ** Clinical Provider Auditor I - Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering ... an accommodation is granted as required by law._ **Carelon Payment Integrity** is a proud member of the Elevance...to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Provider Auditor I** will… 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 ... an accommodation is granted as required by law. The ** Clinical Provider Auditor II** is...conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately document determinations… more
- Elevance Health (Mason, OH)
- …of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing guidelines, payer reimbursement policies, and ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG...or any combination of education and experience, which would provide an equivalent background. **Preferred Skills, Capabilities and Experiences:**… more
- Elevance Health (Mason, OH)
- …quality assurance environment preferred. + Broad knowledge of medical claims billing/ payment systems provider billing guidelines, payer reimbursement policies, ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This...an accommodation is granted as required by law._ Carelon Payment Integrity is a proud member of the Elevance… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …reports, internal quality control reviews, internal and external third party claims payment peer analysis systems to detect provider -billing trends, potential ... Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. Job Description **Summary** Works collaboratively with… more