- 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
- Humana (Columbus, OH)
- …our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and ... a bi-weekly payment for their internet expense. * Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the… 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
- Highmark Health (Columbus, OH)
- …as needed. Attends meetings and interacts with management to resolve issues and provide advice on new programs. Provides guidance to system entities in response to ... and disease processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and assistance from management,… more