Top 21 Medicare fraud Jobs in Ohio

Audit Specialist
Akron Children's Hospital —Akron, OH
- Full-time
- CPA
- 5 years
- HIPAA
Senior Investigator, Special Investigations Unit (Aetna SIU)
CVS Health —Ohio
- $46,988 - $112,200 a year
- Full-time
- Remote
- Research
- Mid-level
- 3 years
- Health insurance
- Dental insurance
Investigator, Special Investigations Unit (Aetna SIU)
CVS Health —Columbus, OH
- $43,888 - $93,574 a year
- Full-time
- Microsoft Word
- Spanish
- Microsoft Excel
- Health insurance
- Dental insurance
Compact RN Care Coach - Remote | High Performance
CircleLink Health —Ohio
- Email
- Remote
- Nursing
- RN License
- Mid-level
Quick Apply
Pharmacy Network Manager (Aetna)
CVS Health —Ohio
- $54,300 - $159,120 a year
- Full-time
- Remote
- Bachelor's degree
- Fair chance
- Senior level
- Health insurance
- Dental insurance
10d
Medicare Sales Representative II-2
CareSource —Ohio
- $47,400 - $76,000 a year
- Weekends as needed
- Bilingual
- Microsoft Excel
- Up to 50% travel
Workers Compensation Return to Work Claim Professional
The Travelers Companies, Inc. —Cleveland, OH
- $67,000 - $110,600 a year
- Hybrid work
- Writing skills
- Mid-level
- High school diploma or GED
- Wellness program
- Paid holidays
Medicare Sales Representative - Base Salary + Commission Opportunities (Must Reside in Ohio)
CareSource —Ohio
- $47,400 - $76,000 a year
- Weekends as needed
- Bilingual
- High school diploma or GED
- Travel
- Flexible schedule
Workers' Compensation Delegated Claims Audit Specialist
MSIG North America —Cincinnati, OH
- Full-time
- Microsoft Excel
- Mid-level
- Analysis skills
Illinois Licensed Registered Nurse Care Coach - Remote
CircleLink Health —Ohio
- $15 an hour
- Email
- Remote
- RN License
- Computer literacy
- English
Quick Apply
Territory Manager - Cincinnati, OH
BioTAB Healthcare —Cincinnati, OH
- Full-time
- Background check
- Clean driving record
- Hospital
Quick Apply
14d
DIRECTOR - INTERNAL AUDIT
Aultman Health Foundation —Canton, OH
- 8 hour shift
- 6 years
- CPA
- Writing skills
Nurse Practitioner- Cincinnati/Montgomery, OH- Hybrid Remote
DAVITA —Cincinnati, OH
- $118,000 - $135,000 a year
- Full-time
- Hybrid work
- Microsoft Word
- CPR Certification
- Microsoft Outlook
- Continuing education credits
- Health insurance
Patient Service Representative I
The Urology Group —Cincinnati, OH
- Full-time
- OSHA
- HIPAA
- High school diploma or GED
- Profit sharing
- Health savings account
Quick Apply
1d
Regional Director of Therapy Services
PACS —Alexandria, OH
- Full-time
- CPR Certification
- Doctoral degree
- BLS Certification
Quick Apply
Social Service Assistant
Riverview Post Acute —South Point, OH
- Part-time
- Experience working with individuals with disabilities
- Basic math
- Mid-level
Quick Apply
General Counsel ( In House)
Primary Health Solutions —Hamilton, OH
- Computer literacy
- Writing skills
- HIPAA
Quick Apply
Investment Advisor Support Specialist
Parkmont Retirement Solutions —Fremont, OH
- $30,809.27 - $51,189.66 a year
- Full-time
- Writing skills
- Mid-level
- Office
- Health insurance
- Paid time off
Quick Apply
3d
Licensed Social Worker
Marion Valley Post Acute —Marion, OH
- Full-time
- Skilled nursing facility
- Experience working with individuals with disabilities
- Basic math
Quick Apply
Medicaid Medical Review RN (Medical Reviewer III)
CoventBridge Group —United States
- $65,000 - $70,000 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- RN License
- Paid holidays
- Disability insurance
14d

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medicare fraud jobs near ohio

Audit Specialist

Akron Children's Hospital
Akron, OH

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Job Details

Full-time

Qualifications

Bachelor's degree

Full Job Description

Job Description

Job Requisition Number 32843

Full-Time, Days

Onsite

The Healthcare Compliance Senior Auditor plays a critical role in supporting Akron Children's Hospital's mission by ensuring adherence to all applicable healthcare laws, regulations, and internal policies. Reporting to the Compliance Manager, this position is responsible for planning and executing in-depth compliance audits, analyzing risk exposures, and guiding corrective actions to promote a culture of integrity and continuous improvement. In addition, this role will include developing critical components of the Compliance Program such as policies, procedures, training modules, and monitoring systems, and ensuring adherence to regulatory requirements and industry benchmarks.

Responsibilities:

Duties and Responsibilities

Plan, conduct, and oversee compliance audits in areas including finance, operations, and research.
Analyze audit results to identify root causes and risks; draft concise reports outlining organizational exposure and actionable management plans with assigned responsibilities.
Support drafting, refining, and maintaining compliance documentation aligned with federal and state healthcare regulations.
Design and deliver compelling compliance training sessions to staff, clinical providers, and leadership; ensure staff understand reporting mechanisms and expectations.
Conduct periodic risk assessments, monitoring, and auditing to proactively identify vulnerabilities.
Lead investigations, corrective action plan development, and timely resolution of compliance incidents.
Mentor guest auditors; manage projects and ensure quality assurance.
Work cross-functionally with leadership and team members, including clinical departments, to integrate compliance into day-to-day operations.

Technical Expertise

Expert knowledge of healthcare regulatory frameworks (e.g., HIPAA, Medicare/Medicaid, fraud & abuse statutes).
Proficient in audit methodologies, controls evaluation, and corrective action implementation.
Analytical mindset with strong report writing and presentation skills.
Skilled in audit procedures, data analytics, and compliance training.
Proficient in Epic, Excel, Word, and healthcare billing systems.
Strong communication and organizational skills.

Other information:

Education and Experience

1. Education: Bachelor's degree required
2. Certification: CHC (Certified in Healthcare Compliance), CPA (Certified Public Accountant), CIA (Certified Internal Auditor), CFE (Certified Fraud Examiner) preferred.
3. Years of relevant experience: Minimum 5 years in healthcare compliance, audit, or related roles required.

FTE: 1.000000

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Refine Your Search

medicare fraud jobs in ohio

Audit Specialist

Senior Investigator, Special Investigations Unit (Aetna SIU)

Investigator, Special Investigations Unit (Aetna SIU)

Compact RN Care Coach - Remote | High Performance

Pharmacy Network Manager (Aetna)

Medicare Sales Representative II-2

Workers Compensation Return to Work Claim Professional

Medicare Sales Representative - Base Salary + Commission Opportunities (Must Reside in Ohio)

Workers' Compensation Delegated Claims Audit Specialist

Illinois Licensed Registered Nurse Care Coach - Remote

Territory Manager - Cincinnati, OH

DIRECTOR - INTERNAL AUDIT

Nurse Practitioner- Cincinnati/Montgomery, OH- Hybrid Remote

Patient Service Representative I

Regional Director of Therapy Services

Social Service Assistant

General Counsel ( In House)

Investment Advisor Support Specialist

Licensed Social Worker

Medicaid Medical Review RN (Medical Reviewer III)

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