DRG Clinical Auditor Principal (US) Elevance HealthDRG Clinical Auditor Principal (US)Mason, OhioSpecializes in review of DRG coding via medical record and attending physician’s statement provided by acute care hospitals on paid DRG, especially on very complex coding cases that are paid using APS-DRG, APR-DRG, AP-DRG, MS-DRG or TRICARE methodology and findings may be so complex and advanced that disputes or appeals may only be reviewed by other DRG Coding Audit Principals (or Executives). The DRG Clinical Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, and its clients.
Medical Claims Biller Onsite GlobalchannelmanagementMedical Claims Biller OnsiteMason, OhioPartner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system. The Medical Claims Biller is responsible for monitoring insurance carrier adjudication of medical claims for one or more doctor practices.
Remote PB Medical Coder - Neurology Clinic GuidehouseRemote PB Medical Coder - Neurology ClinicAkron, OhioRemoteCompensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. The Remote Neurology Clinic Coder reviews clinical documentation and diagnostic results to assign accurate ICD-10, CPT, and HCPCS codes for billing, reporting, and compliance.
Billing Specialist Unison HealthBilling SpecialistToledo, OhioThe role ensures accurate billing of all direct service staff activities to the appropriate payers, monitoring and resolving outstanding client balances, posting of payments, updating client accounts with insurance activity and maintaining accurate financial records. Provide professional customer service by responding to billing inquiries, preparing statements, and maintaining accurate financial documentation.
Charge Master Analyst Sutter HealthCharge Master AnalystColumbus, OH$106,745.60–$160,118.40 / yearPosition Overview: Serves as a subject matter expert for Charge Description Master (CDM) regulatory requirements and guidelines and payer contractual obligations in order to ensure CDM line items are aligned with current billing, coding regulations, guidelines, and contractual obligations. Maintains the CDM data elements (billing description, Current Procedural Terminology/Healthcare Procedure Coding System codes, revenue codes for Inpatient/Outpatient and appropriate modifiers) in the CDM software.
Accounts Receivable Support Specialist Wingspan Care GroupAccounts Receivable Support SpecialistShaker Heights, OHJOB SUMMARY: The AR Support Specialist plays a pivotal role in supporting Wingspan Care Group’s revenue cycle operations by providing flexible coverage across accounts receivable, cash application, denial management, and non-Medicaid billing functions for five behavioral health agencies. Cash Application Support: Perform weekly cash application tasks (~4 hours/week), including posting $0 ERAs (835s) and processing payments (checks, EFTs, ACHs) across multiple systems (e.g., Netsmart, Great Plains), supporting the Cash Application Specialist.
Billing Specialist MindlanceBilling SpecialistDublin, OHRemoteThe Billing Specialist is responsible for performing day-to-day billing activities for Urology, Radiation Oncology and Imaging services. " Working knowledge of CPT, ICD-10-CM, and HCPCS coding related to Urology, Radiation Oncology and Imaging services.
Provider Auditor Senior - Payment Integrity Complex and Clinical Audit Elevance Health IncProvider Auditor Senior - Payment Integrity Complex and Clinical AuditMason, OHHow you will make an impact: Selects providers to be reviewed based on historical results of other reviews with providers, network management input and dollar volume of provider. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
Medical Billing Data Analyst North Central Mental Health Services, Inc.Medical Billing Data AnalystColumbus, OH$27This role requires strong analytical skills, attention to billing detail and the ability to reconcile financial and claims data across multiple payer sources. Full-time Medical Billing Data Analyst to support accurate charge capture, detailed data entry, claim reconciliation and compliance with payer and federal guidelines.
Remote PB Medical Coder - Neurology Clinic Guidehouse IncRemote PB Medical Coder - Neurology ClinicAkron, OHRemote$44,000–$74,000 / yearCompensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. What You Will Do: The Remote Neurology Clinic Coder reviews clinical documentation and diagnostic results to assign accurate ICD-10, CPT, and HCPCS codes for billing, reporting, and compliance.
Provider Auditor Senior - Payment Integrity Complex And Clinical Audit Elevance HealthProvider Auditor Senior - Payment Integrity Complex And Clinical AuditMason, OHHow you will make an impact: Selects providers to be reviewed based on historical results of other reviews with providers, network management input and dollar volume of provider. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
Hospital Appeals-Billing Specialist | Memorial Health Memorial HealthHospital Appeals-Billing Specialist | Memorial HealthMarysville, OhioServes as a liaison between Patient Financial Services and Emergency Department SANE coordinator to ensure billing is accurate and appropriate for claims submission to the Ohio State Attorney General’s Office. Manage all retro authorizations when the Current Procedural Terminology (CPT) code on the claim does not match the code that was authorized with the payor; work queue Precert CPT not on Code Integration.
Prior Authorization Specialist Riverhills Healthcare IncPrior Authorization SpecialistCincinnati, OH$18–$22 / hourSuperior verbal and written skills are a must, as are sound judgement, maturity, and the ability to establish good rapport with employees, patients, physicians, and vendors. Monitor schedules for insurance coverage changes, oversee specialty pharmacy orders, and maintain/update the ordering spreadsheet.
NewHospital Appeals-Billing Specialist | Memorial Health Memorial HospitalHospital Appeals-Billing Specialist | Memorial HealthMarysville, OHServes as a liaison between Patient Financial Services and Emergency Department SANE coordinator to ensure billing is accurate and appropriate for claims submission to the Ohio State Attorney General's Office. Manage all retro authorizations when the Current Procedural Terminology (CPT) code on the claim does not match the code that was authorized with the payor; work queue Precert CPT not on Code Integration.
Sr Claims Processor SummaCare IncSr Claims ProcessorAkron, OH$20.51–$24.61 / hourSummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2026 by the Centers for Medicare and Medicaid Services (CMS). Applies cost-containment techniques when working with vendor partners to minimize claim costs while ensuring adherence to plan-specific and line-of-business processing rules.
BILLING QA COMPLIANCE SPEC Premier Health PartnersBILLING QA COMPLIANCE SPECMoraine, OHGeneral Summary/Responsibilities: Under the general direction of the Supervisor Patient Financial Services this employee is responsible for the review of Inpatient and Outpatient accounts for billing and coding compliance for Patient Financial Services (PFS). The specialist is also responsible for understanding reimbursement aspects of the revenue cycle and will work to ensure Premier Health receives the appropriate reimbursement for charges billed.
Patient Financial Advocate Firstsource Solutions LtdPatient Financial AdvocateCincinnati, OHThe Patient Financial Advocate is responsible for screening patients on-site at hospitals for eligibility assistance programs either bedside or in the ER. Essential Duties and Responsibilities: Review the hospital census or utilize established referral method to identify self-pay patients consistently throughout the day.
Regional Patient Advocate Firstsource Solutions LtdRegional Patient AdvocateCleveland, OH$23–$27 / hourThe Patient Financial Advocate is responsible for screening patients on-site at hospitals for eligibility assistance programs either bedside or in the ER. Essential Duties and Responsibilities: Review the hospital census or utilize established referral method to identify self-pay patients consistently throughout the day.
Patient Financial Advocate Firstsource SolutionsPatient Financial AdvocateWarrensville Heights, OHThe Bilingual Patient Financial Advocate is responsible for screening patients on-site at hospitals for eligibility assistance programs either bedside or in the ER. Essential Duties and Responsibilities: Review the hospital census or utilize established referral method to identify self-pay patients consistently throughout the day.
Regional Patient Advocate Firstsource SolutionsRegional Patient AdvocateCleveland, OH$23–$27 / hourThe Patient Financial Advocate is responsible for screening patients on-site at hospitals for eligibility assistance programs either bedside or in the ER. Essential Duties and Responsibilities: Review the hospital census or utilize established referral method to identify self-pay patients consistently throughout the day.