Find work in the United States.

6,265,094 jobs across our US network. How we count

Jobs in the United States

25+ jobs

Save this search

Added just now
Maintenance Tech
Resolute Road Hospitality
Goodlettsville, TN
…back-of-house spaces. You’ll work closely with the Maintenance Manager and other team members to ensure timely responses to issues and proactive care for hotel systems. This role is ideal…
Added just now
Ramp Duty Manager
TREGO DUGAN AVIATION OF GRAND ISLAND INC
Pittsburgh, PA
The work of the Ramp Duty Manager includes directing personnel within assigned functional areas which is Ramp Services; overseeing and advising on staffing requirements; monitoring…
Added just now
S
RN FT Nights
ScionHealth
Perris, CA
- $47.54 to $55.7 USD / hour
…patient’s clinical condition with Physicians, Nursing Supervisor/Manager, and co-workers as appropriate. Participates in discharge planning…
Added just now
F
Packaging Materials Procurement Manager
Furmano's
Northumberland, PA
- $80,000 to $100,000 USD / year
Summary: The Packaging Materials Procurement Manager is responsible for the planning, purchasing, and inventory management of packaging materials required to support production schedules…
Added just now
Operations Program Manager
K&L Microwave LLC
Salisbury, MD
Set project direction and make decisions with the Product Line Manager where customer, technical, cost and schedule tradeoffs are considered
Added 1 min ago
Cost Manager / Quantity Surveyor - Data Center Construction
Turner & Townsend
Tysons Corner, VA
Our capabilities include program, project, cost, asset and commercial management, controls and performance, procurement and supply chain, net zero and digital solutions.
Added 1 min ago
Applied Research Lead, AI for Teaching
Stanford
Stanford, CA
You will work closely with the lab’s project manager, who leads our educator and district partnerships, and with technical staff, postdocs, and graduate students who build and validate…
Added 1 min ago
Senior Program Manager - Cooperative Research Programs
The National Academies of Sciences, Engineering, and Medicine
Washington, DC
The Senior Program Manager provides senior-level program management for a complex and diverse portfolio of cooperative transportation research projects. This role has no direct supervisory…
Added 1 min ago
Senior Program Manager - Airports
The National Academies of Sciences, Engineering, and Medicine
Washington, DC
The Senior Program Manager, Airports provides senior-level program management for a complex and diverse portfolio of airport research projects. This role has no direct supervisory…
Added 1 min ago
RB
Certified Medical Coder (Full-Time)
Rocky Boy Health Center
Box Elder, MT
- Full-time
Provide ongoing training and technical assistance to medical providers regarding accurate encounter coding, clinical documentation, and appropriate use of Epic EHR coding functions.
Added 2 mins ago
GM
Maintenance Supervisor - Willowbend Phase 1
Greystar Management Services, LLC
Humble, TX
- $25 to $36 USD / hour
This role oversees and performs technical and mechanical work that ensures the inside and external buildings, ground, amenities, and common areas of the community meet the Company’s…
Added 2 mins ago
GM
Make Ready Specialist - Dalian Monterrey Village
Greystar Management Services, LLC
San Antonio, TX
- $17 to $22 USD / hour
Ensures that vacant units meet the established quality standards for re-leasing by performing technical and mechanical
Added 2 mins ago
A
Lead Administrative Assistant - Health Sciences
ACCS
Tanner, AL
- $22.61 to $31.35 USD / hour
Added 2 mins ago
A
Computer Technician I
ACCS
Mobile, AL
- $31,698 to $46,854 USD / year
Assist the Help Desk Manager with enhancing the integration of new instructional technology for academic support. The Computer Technician will provide technical support to faculty/staff and…
Added 2 mins ago
Americas Import Trade Compliance Specialist
HPE
Spring, TX
…business issues within established policies. Serves as a trusted technical advisor to management and business partners, recommends policy and control enhancements, and leads complex…
Added 3 mins ago
Architect Project Manager
WSP
Tempe, AZ · Phoenix, AZ · San Diego, CA · Chicago, IL · Las Vegas, NV · Dallas, TX · Austin, TX · Houston, TX · Tampa, FL · Las Vegas, NM
Must demonstrate ability to perform thorough technical reviews in support of the office’s Quality Control program.
Added 3 mins ago
Global Recruiting Specialist
Revenue Management Solutions
Tampa, FL
…hiring experience from the first conversation with a hiring manager to a new hire’s first…
Added 3 mins ago
IG
Principal Project Manager
Insight Global
Lafayette, CO
- From $75 USD / hour
Strong Project/Program Management experience leading complex, cross-functional technical or operational projects
Added 3 mins ago
Commercial Property Claims Manager
Applied Underwriters
Omaha, NE
…commercial, specialty, and excess lines. The role provides technical guidance, operational leadership, and performance management. As a subject matter expert on coverage, valuation,…
Added 3 mins ago
CO
Associate Planner
City of Anacortes
Anacortes, WA
- $37.68 to $44.99 USD / hour
Serves as project manager and conducts development application review process which determines permit application completeness and conformance with comprehensive plans and applicable…
Added 3 mins ago
Customer Operations & Automation Manager
SimpliGov LLC
Remote, United States
The Customer Operations & Automation Manager builds the AI-first operating system behind SimpliGov's customer team, redesigning how Customer Success works internally so government customers…
Added 3 mins ago
Vehicle Operator Instructor
Mlt Systems
Camp Pendleton, CA
At MLT, we create solutions by empowering our people to fulfill their passion for service. In support of Program Manager Advanced Amphibious Assault, we are seeking a Vehicle Operator…
Added 3 mins ago
Vehicle Operator Instructor
Mlt Systems
Camp Lejeune, NC
At MLT, we create solutions by empowering our people to fulfill their passion for service. In support of Program Manager Advanced Amphibious Assault, we are seeking a Vehicle Operator…
Added 3 mins ago
Vehicle Maintenance Instructor
Mlt Systems
Camp Lejeune, NC
…proficiency with AAV/ACV system and confirm to the Training Manager they are “Ready to Train” ten (10) days prior to any instruction; assist the Training Manager by collecting student…
Added 3 mins ago
Vehicle Maintenance Instructor
Mlt Systems
Camp Pendleton, CA
…proficiency with AAV/ACV system and confirm to the Training Manager they are “Ready to Train” ten (10) days prior to any instruction; assist the Training Manager by collecting student…

Default - MMO

Clinical Auditor

Cleveland, OH, United States

Apply About employer

Applications open in a new tab.

Job details

Posting language: English
Posted: Nov 4, 2026

Original job description

Medical Mutual employees must submit their applications through MySource.

Note: This is a remote role. Seeking applicants that reside within 50 miles of the Brooklyn, Ohio office. Certified Medical Coder (CPC, CCS, or equivalent) credential preferred.

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 members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.

Job Summary:

Working under general supervision, audits complex outpatient, inpatient and professional claim irregularities, overpayments and provider appeals from a clinical coding perspective, applying coding guidelines. Analyzes provider billing for abnormalities, questionable billing practices and proper coding combinations from a clinical and coding perspective and documents denial reasoning or erroneous activity.

Responsibilities:

Clinical Auditor

Audits outpatient, inpatient and professional claims from a clinical and coding perspective applying coding guidelines and edits. Assesses for inappropriate billing combinations, inherent charges, provider supporting documentation, etc.
Documents audit results including denial reasons, erroneous activities, etc. and updates systems accordingly.
Maintains knowledge in coding and billing guidelines and trends.
Reviews provider appeals applying coding guidelines or edits.
Identifies edits to adjudication system that are not working properly or need to be installed so claims can be processed. Works with more senior levels to implement changes.
Interacts with internal or external auditors or vendors on claim coding updates, procedure changes, etc.
Discusses consult findings with Physician Reviewers and reviews edit updates and questions with payment recovery staff.
Performs other duties as assigned

Senior Clinical Auditor

Audits outpatient, inpatient and professional claims from a clinical and coding perspective applying coding guidelines and edits. Assesses for inappropriate billing combinations, inherent charges, provider supporting documentation, etc
Documents audit results including denial reasons, erroneous activities, etc. and updates systems accordingly.
Identifies additional opportunities for recovery and avoidance. Researches opportunities to better control medical spending and presents ideas to management.
Researches and maintains knowledge in coding and billing guidelines and trends. Participates in implementation of new or updated policies and processes.
Reviews provider appeals applying coding guidelines or edits.
Identifies edits to adjudication system that are not working properly or need to be installed so claims can be processed. Works with lead or manager to implement changes.
Orients, trains, assists and reviews work of more junior level staff.
Interacts with internal or external auditors or vendors on claim coding updates, procedure changes, etc.
Discusses consult findings with Physician Reviewers and reviews edit updates and questions with payment recovery staff.
Performs other duties as assigned.

Qualifications:

Clinical Auditor

Education and Experience:

Graduate of a registered nursing program approved by the Ohio State Nursing Board. Bachelor’s Degree preferred.
In lieu of RN, Bachelor of Science in medical related field.
3 years as a Clinical Auditor or equivalent combination of clinical and medical auditing experience.

Professional Certification(s):

Certified Medical Auditor (if not certified required to obtain within 24 months of hire).
Certified Coder preferred.

Technical Skills and Knowledge:

Knowledge of ICD codes.
Knowledge of procedure codes.
Knowledge of Revenue Codes, HCPC Codes and CPT codes
Knowledge of industry standard billing rules and regulations for professional claims billing, outpatient claims billing and inpatient claims billing.
Knowledge of insurance regulations.
Knowledge of coding and auditing techniques.
Good written communication skills.
Intermediate Microsoft Office and claims adjudications systems skills

Senior Clinical Auditor

Education and Experience:

Graduate of a registered nursing program approved by the Ohio State Nursing Board. Bachelor’s Degree preferred.
In lieu of RN, Bachelor of Science in medical related field.
5 years as a Clinical Auditor or equivalent combination of clinical and medical auditing experience.

Professional Certification(s):

Certified Coder or Certified Medical Auditor (if not certified required to obtain within 24 months of hire).

Technical Skills and Knowledge:

Strong knowledge of ICD codes.
Strong knowledge of procedure codes.
Strong knowledge of Revenue Codes, HCPC Codes and CPT codes.
Strong knowledge of industry standard billing rules and regulations for professional claims billing, outpatient claims billing and inpatient claims billing.
Strong knowledge of insurance regulations.
Strong knowledge of coding and auditing technique.
Strong written communication skills.
Intermediate to advanced Microsoft Office and claims adjudications systems skills.

Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:

A Great Place to Work:

We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
Employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
Discounts at many places in and around town, just for being a Medical Mutual team member.
The opportunity to earn cash rewards for shopping with our customers.
Business casual attire, including jeans.

Excellent Benefits and Compensation:

Employee bonus program.
401(k) with company match up to 4% and an additional company contribution.
Health Savings Account with a company matching contribution.
Excellent medical, dental, vision, life and disability insurance - insurance is what we do best, and we make affordable coverage for our team a priority.
Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:

Career development programs and classes.
Mentoring and coaching to help you advance in your career.
Tuition reimbursement up to $5,250 per year, the IRS maximum.
Diverse, inclusive and welcoming culture with Business Resource Groups.

About Medical Mutual:

Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.

There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.

We’re not just one of the largest health insurance companies based in Ohio, we’re also the longest running. Founded in 1934, we’re proud of our rich history with the communities where we live and work.

We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.

Apply About employer

Report this job