Elevance Health

The AI Audit Analyst is responsible for conducting risk assessments, reviews, special projects, and other activities on Artificial Intelligence (AI) solutions for the enterprise, across all lines of business and functions, to ensure Elevance Health develops and deploys AI technologies consistent with our internal standards, policies, contracts, laws, and regulations. This position is an exciting opportunity to provide valuable insights to the AI business to improve the effectiveness of risk management, monitoring, and governance processes. How you will make an impact: Assists the development and execution of high-quality risk assessments of AI solutions. Perform reviews of AI solutions, testing for compliance to Elevance Health standards, policies, and regulations. Identify risks and collaborate with AI system team leadership and business management on testing and evaluation procedures, which includes working with the AI business on process, controls, documentation, and...

Elevance Health is looking for an AI Audit Analyst in Chicago, Illinois, responsible for conducting risk assessments and reviews of AI solutions across all business lines. This role involves ensuring compliance with standards while offering insights to improve risk management processes. The ideal candidate will have an AA/AS degree in Information Technology or related fields along with at least 4 years of audit experience. Certification such as CISA or CPA is preferred. This position supports a hybrid work model that requires being onsite regularly. #J-18808-Ljbffr

Elevance Health is seeking a Clinical Provider Auditor II to identify potential fraud and abuse risks in claims and medical records. This role involves in-depth review, documentation, and collaboration with the Special Investigation Unit to strengthen payment accuracy. The position requires an AA/AS with 3+ years in medical coding/auditing, including 1+ year in fraud/waste/abuse, and coding certifications (CPC/CCS/CPMA). Hybrid work with in-person training is available. #J-18808-Ljbffr

Elevance Health is seeking a Sr Coding Analyst to review, audit, and code medical records for reimbursement, training and compliance. Primary duties include auditing medical documentation for ICD-9 and CPT coding, querying physicians when documentation is unclear, and training others on coding guidelines and billing procedures. The role emphasizes accuracy, education and timely support to providers. #J-18808-Ljbffr

Elevance Health seeks a Clinical Auditor Principal to audit inpatient medical records using DRG-based methodologies across lines of business. This senior role emphasizes advanced ICD-10 coding, policy compliance, and independent work output. The position supports hybrid/virtual work with in-person onboarding and regular office presence as needed. Candidates should have RHIA, RHIT, CCS, CIC or CCDS and substantial auditing experience. #J-18808-Ljbffr

Elevance Health is seeking a DRG Coding Auditor to audit inpatient medical records and generate recoverable claims across lines of business, ensuring accurate DRG assignment with MS-DRG and APR-DRG methodologies. You will apply ICD-10 guidelines and clinical documentation principles in medical record reviews, supporting high-quality recoveries and audit findings while collaborating with hospitals and internal teams. The role offers hybrid/remote work with required in-person training. #J-18808-Ljbffr

Sign On Bonus: $1,500; paid in two installments: $500 at the time of hire and $1,000 after one year of service. DRG Coding Auditor - MS-DRG and APR-DRG Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development . Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and its...

Sign On Bonus: $1,500; DRG Coding Auditor - MS-DRG and APR-DRG Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and its clients. Also responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending...

Sign On Bonus: $1,500; paid in two installments: $500 at the time of hire and $1,000 after one year of service. DRG Coding Auditor - MS-DRG and APR-DRG Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development . Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of...

Sign On Bonus: $1,500; paid in two installments: $500 at the time of hire and $1,000 after one year of service. DRG Coding Auditor - MS-DRG and APR-DRG Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development . Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of...

Carelon Medical Coding/Auditing Manager - Behavioral HealthSupports Payment Integrity & Behavioral HealthLocation: Hybrid 2. This role requires associates to be in-office 3-4 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered.Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending.A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and...

Sign On Bonus: $1,500; paid in two installments: $500 at the time of hire and $1,000 after one year of service. DRG Coding Auditor - MS-DRG and APR-DRG Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development . Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of...

Sign On Bonus: $1,500; paid in two installments: $500 at the time of hire and $1,000 after one year of service. DRG Coding Auditor - MS-DRG and APR-DRG Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development . Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of...

Elevance Health is seeking a DRG Coding Auditor to audit inpatient medical records and generate recoverable claims across lines of business, ensuring accurate DRG assignment with MS-DRG and APR-DRG methodologies. You will apply ICD-10 guidelines and clinical documentation principles in medical record reviews, supporting high-quality recoveries and audit findings while collaborating with hospitals and internal teams. The role offers hybrid/remote work with required in-person training. #J-18808-Ljbffr

Anticipated End Date: 2026-10-12 Position Title: DRG Coding Auditor - MS-DRG and APR-DRG Job Description: Sign On Bonus: $1,500; paid in two installments: $500 at the time of hire and $1,000 after one year of service. DRG Coding Auditor - MS-DRG and APR-DRG Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development . Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The DRG Coding Auditor is responsible for auditing inpatient...

Registered Nurse - Diagnosis Related Group Coding Auditor Principal – Carelon Payment Integrity Location: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate, and prevent unnecessary medical-expense spending. The DRG Coding 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. Specializes in review of DRG coding via medical records and attending physician’s statements provided by acute care hospitals on paid DRG,...