Top 9 Forensics assessment specialist Jobs in Ohio

BEHAVIORAL HEALTH COMPLIANCE & MEDICAID AUDIT CONSULTANT
Dreamsafer LLC —Ohio
- $40,588.67 - $87,418.62 a year
- Temporary
- Remote
- Background check
- HIPAA
- Mid-level
Quick Apply
4d
Child Welfare Caseworker 1-3 CARE House
Montgomery County, OH —Dayton, OH
- $49,774.40 - $80,433.60 a year
- Weekends as needed
- Experience working with individuals with developmental disabilities
- Clean driving record
- Pass drug screening
- Wellness program
- Health savings account
Security Specialist (Senior to Staff Level)
AEP Service Corporation —Columbus, OH
- $87,633 - $177,503 a year
- Full-time
- Computer science
- Computer Science
- High school diploma or GED
- Tuition reimbursement
2d
Security Operations IR/OT
AEP Service Corporation —Columbus, OH
- $98,993 - $128,688 a year
- Full-time
- Management
- High school diploma or GED
- Analysis skills
- Tuition reimbursement
1d
RN SANE - PRN
Wooster Community Hospital —Wooster, OH
- Weekends as needed
- Nursing
- Anatomy knowledge
- Surgery
Quick Apply
ICU Float RN, Full Time, Days, 7a-7p
Wooster Community Hospital —Wooster, OH
- $33.86 - $46.39 an hour
- Weekends as needed
- Nursing
- Anatomy knowledge
- Surgery
Quick Apply
7d
ICU RN Float Nights, Full Time, 7p-7a
Wooster Community Hospital —Wooster, OH
- $33.86 - $46.39 an hour
- Weekends as needed
- Nursing
- Anatomy knowledge
- Surgery
Quick Apply
7d

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Security Specialist (Senior to Staff Level)
AEP Service Corporation —Columbus, OH
Bachelor's degree OR Associates degree with 2 years relevant experience in system administration/help desk/security (cyber or physical) OR High School Diploma/…
$87,633 - $177,503 a year
2d
Security Operations IR/OT
AEP Service Corporation —Columbus, OH
Bachelor's degree or associate degree with 2 years relevant experience in system administration/help desk/security (cyber or physical) OR High School Diploma/…
$98,993 - $128,688 a year
1d

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forensics assessment specialist jobs near ohio

BEHAVIORAL HEALTH COMPLIANCE & MEDICAID AUDIT CONSULTANT

Dreamsafer LLC
Ohio

Quick Apply

Job Details

Temporary | Contract
$40,588.67 - $87,418.62 a year
4 days ago

Qualifications

Quality control corrective actions
Investigations regulatory compliance
Managed care
Audit report preparation
Medical Coding Certification
HIPAA
Healthcare documentation compliance audits
Medical billing compliance checks
Internal investigations
Inspection reporting and documentation
Audit Reporting
Financial records review
Healthcare privacy protection
Medical credentialing
Health information regulatory compliance
Regulatory readiness in healthcare
Healthcare fraud detection compliance audits
Audit risk assessments
Medicaid regulations
Medicaid
Investigative reports
Reporting on compliance risks
Investigating compliance violations
Insurance claims auditing
Clinical documentation standards
Healthcare claims compliance audits
Documentation review
Hospital experience
Healthcare coding compliance audits

Full Job Description

Compensation: Competitive project-based or hourly compensation, based on verified experience and the agreed scope

ABOUT DREAMSAFER

DreamSafer LLC is a youth behavioral-health organization serving children, adolescents, and families. We are seeking an experienced independent consultant to conduct a confidential Phase One compliance, documentation, billing, staffing, credentialing, and payment-integrity assessment.

This position is intended for a specialist with direct experience in behavioral-health Medicaid compliance, managed-care audits, Special Investigations Unit matters, prepayment or post-payment reviews, and documentation-to-claim auditing.

This is not a general administrative compliance position. The selected consultant must be able to independently examine evidence, identify material risks, and produce a defensible written assessment.

PRIMARY RESPONSIBILITIES

The consultant will:

Review relevant payer, audit, payment-integrity, prepayment-review, denial, recoupment, or SIU correspondence.
Develop a written, risk-based sampling plan before beginning substantive testing.
Review selected client records and corresponding claims.
Compare billed services against assessments, treatment plans, progress notes, authorizations, provider credentials, supervision records, service locations, dates, durations, units, codes, modifiers, and rendering-provider information.
Evaluate medical necessity, documentation sufficiency, timeliness, signatures, staff qualifications, supervision, credentialing, enrollment, and authorization controls.
Review intake, referral, admission, consent, assessment, treatment-planning, service-delivery, billing, correction, void, refund, and denial-management workflows.
Examine selected employee and contractor files for qualifications, background screening, exclusion screening, training, supervision, and role assignment.
Review relevant policies, procedures, internal audits, corrective actions, compliance monitoring, and quality-assurance processes.
Identify urgent payer, regulatory, repayment, overpayment, credentialing, privacy, or documentation risks.
Distinguish verified facts from preliminary concerns, missing information, assumptions, and professional recommendations.
Preserve original records and audit trails. The consultant may not alter, backdate, delete, or reconstruct records.
Present findings to DreamSafer leadership in a clear and practical manner.

REQUIRED PHASE ONE DELIVERABLES

The consultant must provide:

An initial information and document request.
A written sampling and testing plan.
Written notice of urgent or time-sensitive risks discovered during the engagement.
A complete evidence-linked diagnostic report.
A prioritized issue register identifying each finding, supporting evidence, risk level, applicable requirement when known, and recommended action.
A practical remediation roadmap separating immediate, short-term, and longer-term corrective actions.
An evidence and sample index showing the records and claims reviewed.
A clear disclosure of testing limitations, missing information, and uncompleted scope items.
One factual-correction and clarification round.
A final leadership findings meeting.

The Phase One report must be complete and usable without requiring DreamSafer to retain the consultant for a second phase.

REQUIRED QUALIFICATIONS

At least five years of healthcare compliance, program-integrity, auditing, revenue-integrity, or payment-integrity experience.
Direct experience with behavioral-health Medicaid providers.
Demonstrated experience with MCO SIU investigations, prepayment reviews, post-payment audits, payment holds, recoupments, or similar payer matters.
Experience conducting claim-to-document audits.
Strong knowledge of medical necessity, service-plan requirements, authorizations, provider qualifications, supervision, credentialing, billing controls, and Medicaid documentation standards.
Ability to produce detailed, evidence-supported written reports.
Experience developing corrective-action plans and compliance-monitoring tools.
Strong understanding of HIPAA, minimum-necessary access, secure document handling, and Business Associate Agreements.
Ability to provide verifiable professional references directly related to Medicaid audits, SIU matters, or payment-integrity work.
No undisclosed conflict involving DreamSafer’s payers, vendors, competitors, or related parties.

PREFERRED QUALIFICATIONS

Experience with Ohio Medicaid, the Ohio Department of Medicaid, OhioMHAS, or Ohio Medicaid managed-care organizations.
Experience with CareSource, Humana, Molina, Buckeye Health Plan, UnitedHealthcare, or similar Medicaid MCOs.
Behavioral-health program-integrity or provider-audit experience.
Experience reviewing TBS, CPST, PSR, psychotherapy, case-management, or comparable behavioral-health services.
CHC, CHPC, CCEP, CPMA, CPC, CFE, CPA, RN, LISW, LPCC, attorney, or comparable compliance, auditing, coding, financial, or clinical qualification.
Experience with CARF, Joint Commission, state certification, accreditation, or corrective-action monitoring.
Prior work with healthcare counsel, forensic auditors, Medicaid agencies, MCOs, or provider compliance departments.

Pay: $40,588.67 - $87,418.62 per year

Work Location: Remote

Quick Apply

Refine Your Search

forensics assessment specialist jobs in ohio

BEHAVIORAL HEALTH COMPLIANCE & MEDICAID AUDIT CONSULTANT

Child Welfare Caseworker 1-3 CARE House

Security Specialist (Senior to Staff Level)

Security Operations IR/OT

RN SANE - PRN

ICU Float RN, Full Time, Days, 7a-7p

ICU RN Float Nights, Full Time, 7p-7a

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