Program Integrity Working Title: External Auditor 1 (PN:20042146) Job Overview: The Ohio Department of Medicaid is seeking a candidate with an interest in auditing to be a part of our Provider ...
Program Integrity Working Title: External Auditor 1 (PN:20042146) Job Overview: The Ohio Department of Medicaid is seeking a candidate with an interest in auditing to be a part of our Provider ...
Medicaid Eligibility Specialist - Bilingual Spanish (Cincinnati)
Cincinnati, OH · On-site
$19 - $21/hr
Medical
Dental
Vision
Life
Retirement
PTO
Utilize tools, including computer programs, when indicated * Monitor all applicants who are ... Must have high integrity * Have a positive attitude and demonstrate teamwork Competencies To ...
Medicaid Eligibility Specialist - Bilingual Spanish (Cincinnati)
Cincinnati, OH · On-site
$19 - $21/hr
Medical
Dental
Vision
Life
Retirement
PTO
Utilize tools, including computer programs, when indicated * Monitor all applicants who are ... Must have high integrity * Have a positive attitude and demonstrate teamwork Competencies To ...
Medicaid Eligibility Specialist - Bilingual Spanish (Cincinnati)
$19 - $21/hr
Medical
Dental
Vision
Life
Retirement
PTO
Utilize tools, including computer programs, when indicated * Monitor all applicants who are ... Must have high integrity * Have a positive attitude and demonstrate teamwork Competencies To ...
Medicaid Eligibility Specialist - Bilingual Spanish (Cincinnati)
$19 - $21/hr
Medical
Dental
Vision
Life
Retirement
PTO
Utilize tools, including computer programs, when indicated * Monitor all applicants who are ... Must have high integrity * Have a positive attitude and demonstrate teamwork Competencies To ...
Medicaid Eligibility Specialist - Bilingual Spanish (Cincinnati)
Cincinnati, OH · On-site
$19 - $21/hr
Medical
Dental
Vision
Life
Retirement
PTO
Utilize tools, including computer programs, when indicated * Monitor all applicants who are ... Must have high integrity * Have a positive attitude and demonstrate teamwork Competencies To ...
Medicaid Eligibility Specialist - Bilingual Spanish (Cincinnati)
Cincinnati, OH · On-site
$19 - $21/hr
Medical
Dental
Vision
Life
Retirement
PTO
Utilize tools, including computer programs, when indicated * Monitor all applicants who are ... Must have high integrity * Have a positive attitude and demonstrate teamwork Competencies To ...
External Auditor 1
Columbus, OH · On-site
Medical
Dental
Vision
Life
PTO
Program Integrity Working Title : External Auditor 1 (PN:20042146) Job Overview : The Ohio Department of Medicaid is seeking a candidate with an interest in auditing to be a part of our Provider ...
External Auditor 1
Columbus, OH · On-site
Medical
Dental
Vision
Life
PTO
Program Integrity Working Title : External Auditor 1 (PN:20042146) Job Overview : The Ohio Department of Medicaid is seeking a candidate with an interest in auditing to be a part of our Provider ...
Lead Director, Healthcare Medicaid Risk Adjustment Analytics
Wyoming, OH · On-site
$100 - $231.54/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Revenue Integrity Informatics is seeking a Lead Director - Revenue Integrity ... Align risk adjustment programs with state Medicaid models (e.g., CDPS, CRG, or state‑specific ...
Lead Director, Healthcare Medicaid Risk Adjustment Analytics
Wyoming, OH · On-site
$100 - $231.54/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Revenue Integrity Informatics is seeking a Lead Director - Revenue Integrity ... Align risk adjustment programs with state Medicaid models (e.g., CDPS, CRG, or state‑specific ...
Program Manager -Compliance
Columbus, OH · On-site
Medical
Dental
Vision
Retirement
PTO
Participates in appropriate State Medicaid/Medicare task force meetings, or other collaborative ... Works closely with state and federal program integrity organizations, and the NBI MEDIC or other ...
Program Manager -Compliance
Columbus, OH · On-site
Medical
Dental
Vision
Retirement
PTO
Participates in appropriate State Medicaid/Medicare task force meetings, or other collaborative ... Works closely with state and federal program integrity organizations, and the NBI MEDIC or other ...
Housing Director
Columbus, OH · On-site
$60K - $70K/yr
Medical
Dental
Vision
Retirement
... CARF-accredited, Medicaid-funded behavioral health and substance use disorder treatment ... program integrity. This role requires on-call availability for housing emergencies, behavioral ...
Housing Director
Columbus, OH · On-site
$60K - $70K/yr
Medical
Dental
Vision
Retirement
... CARF-accredited, Medicaid-funded behavioral health and substance use disorder treatment ... program integrity. This role requires on-call availability for housing emergencies, behavioral ...
PATIENT FINANCIAL COUNSELOR
Dayton, OH · On-site
$18.25 - $23.75/hr
The FC uses financial systems to document data and conducts procedures to assist the patient in filing for Medicaid and/or other public assistance programs. Integrity, good judgment, and trust are ...
PATIENT FINANCIAL COUNSELOR
Dayton, OH · On-site
$18.25 - $23.75/hr
The FC uses financial systems to document data and conducts procedures to assist the patient in filing for Medicaid and/or other public assistance programs. Integrity, good judgment, and trust are ...
PATIENT FINANCIAL COUNSELOR
Dayton, OH · On-site
$18.25 - $23.75/hr
The FC uses financial systems to document data and conducts procedures to assist the patient in filing for Medicaid and/or other public assistance programs. Integrity, good judgment, and trust are ...
PATIENT FINANCIAL COUNSELOR
Dayton, OH · On-site
$18.25 - $23.75/hr
The FC uses financial systems to document data and conducts procedures to assist the patient in filing for Medicaid and/or other public assistance programs. Integrity, good judgment, and trust are ...
PATIENT FINANCIAL COUNSELOR
$18.25 - $23.75/hr
The FC uses financial systems to document data and conducts procedures to assist the patient in filing for Medicaid and/or other public assistance programs. Integrity, good judgment, and trust are ...
PATIENT FINANCIAL COUNSELOR
$18.25 - $23.75/hr
The FC uses financial systems to document data and conducts procedures to assist the patient in filing for Medicaid and/or other public assistance programs. Integrity, good judgment, and trust are ...
PATIENT FINANCIAL COUNSELOR
$18.25 - $23.75/hr
The FC uses financial systems to document data and conducts procedures to assist the patient in filing for Medicaid and/or other public assistance programs. Integrity, good judgment, and trust are ...
PATIENT FINANCIAL COUNSELOR
$18.25 - $23.75/hr
The FC uses financial systems to document data and conducts procedures to assist the patient in filing for Medicaid and/or other public assistance programs. Integrity, good judgment, and trust are ...
Program Coordinator
Toledo, OH · On-site
$44K - $56K/yr
This position is responsible for the integrity, timeliness, and accuracy of assigned cardiac ... Medicaid CMS, the Ohio Department of Health (ODH), The Joint Commission (TJC), and specialty ...
Program Coordinator
Toledo, OH · On-site
$44K - $56K/yr
This position is responsible for the integrity, timeliness, and accuracy of assigned cardiac ... Medicaid CMS, the Ohio Department of Health (ODH), The Joint Commission (TJC), and specialty ...
Licensed Social Worker (Cleveland, OH / Field-based)
Cleveland, OH · On-site
Medical
Retirement
HIPAA, rules and regulations of Ohio Department of Medicaid and Ohio Department of Aging, relevant ... integrity and reporting related to the SFC programs and the ability to triage issues to the ...
Licensed Social Worker (Cleveland, OH / Field-based)
Cleveland, OH · On-site
Medical
Retirement
HIPAA, rules and regulations of Ohio Department of Medicaid and Ohio Department of Aging, relevant ... integrity and reporting related to the SFC programs and the ability to triage issues to the ...
Licensed Social Worker - Part Time (Cleveland, OH / Field-based)
Cleveland, OH · On-site
Medical
Retirement
HIPAA, rules and regulations of Ohio Department of Medicaid and Ohio Department of Aging, relevant ... integrity and reporting related to the SFC programs and the ability to triage issues to the ...
Licensed Social Worker - Part Time (Cleveland, OH / Field-based)
Cleveland, OH · On-site
Medical
Retirement
HIPAA, rules and regulations of Ohio Department of Medicaid and Ohio Department of Aging, relevant ... integrity and reporting related to the SFC programs and the ability to triage issues to the ...
HIPAA, rules and regulations of Ohio Department of Medicaid and Ohio Department of Aging, relevant ... integrity and reporting related to the SFC programs and the ability to triage issues to the ...
HIPAA, rules and regulations of Ohio Department of Medicaid and Ohio Department of Aging, relevant ... integrity and reporting related to the SFC programs and the ability to triage issues to the ...
Licensed Social Worker (Westlake, OH / Field-based)
Westlake, OH · On-site
Medical
Retirement
HIPAA, rules and regulations of Ohio Department of Medicaid and Ohio Department of Aging, relevant ... integrity and reporting related to the SFC programs and the ability to triage issues to the ...
Licensed Social Worker (Westlake, OH / Field-based)
Westlake, OH · On-site
Medical
Retirement
HIPAA, rules and regulations of Ohio Department of Medicaid and Ohio Department of Aging, relevant ... integrity and reporting related to the SFC programs and the ability to triage issues to the ...
Per Diem / PRN Social Work - Home Health Licensed Clinical Social Worker
Cleveland, OH · On-site
Medical
Retirement
HIPAA, rules and regulations of Ohio Department of Medicaid and Ohio Department of Aging, relevant ... integrity and reporting related to the SFC programs and the ability to triage issues to the ...
Per Diem / PRN Social Work - Home Health Licensed Clinical Social Worker
Cleveland, OH · On-site
Medical
Retirement
HIPAA, rules and regulations of Ohio Department of Medicaid and Ohio Department of Aging, relevant ... integrity and reporting related to the SFC programs and the ability to triage issues to the ...
Licensed Social Worker (Westlake, OH / Field-based)
Medical
Retirement
HIPAA, rules and regulations of Ohio Department of Medicaid and Ohio Department of Aging, relevant ... integrity and reporting related to the SFC programs and the ability to triage issues to the ...
Licensed Social Worker (Westlake, OH / Field-based)
Medical
Retirement
HIPAA, rules and regulations of Ohio Department of Medicaid and Ohio Department of Aging, relevant ... integrity and reporting related to the SFC programs and the ability to triage issues to the ...
Licensed Social Worker - Part Time (Rocky River, OH / Field-based)
Rocky River, OH · On-site
Medical
Retirement
HIPAA, rules and regulations of Ohio Department of Medicaid and Ohio Department of Aging, relevant ... integrity and reporting related to the SFC programs and the ability to triage issues to the ...
Licensed Social Worker - Part Time (Rocky River, OH / Field-based)
Rocky River, OH · On-site
Medical
Retirement
HIPAA, rules and regulations of Ohio Department of Medicaid and Ohio Department of Aging, relevant ... integrity and reporting related to the SFC programs and the ability to triage issues to the ...
Medicaid Program Integrity information
What is the difference between Medicaid Program Integrity vs Medicaid Claims Examiner?
| Aspect | Medicaid Program Integrity | Medicaid Claims Examiner |
|---|---|---|
| Primary Focus | Detecting and preventing fraud, waste, and abuse in Medicaid programs | Reviewing and processing Medicaid claims for accuracy and compliance |
| Required Credentials | Typically healthcare or compliance certifications, knowledge of Medicaid policies | Healthcare or claims processing certifications, attention to detail |
| Work Environment | Regulatory agencies, government offices, compliance departments | Insurance companies, healthcare providers, government Medicaid offices |
Medicaid Program Integrity professionals focus on safeguarding Medicaid funds by identifying fraudulent activities, while Medicaid Claims Examiners primarily verify claims for accuracy and proper coding. Both roles require healthcare knowledge and certifications but differ in their core responsibilities and work settings.
What are popular job titles related to Medicaid Program Integrity jobs in Ohio?
For Medicaid Program Integrity jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Medicaid Program Integrity jobs in Ohio look for?
The top searched job categories for Medicaid Program Integrity jobs in Ohio are:
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Cities in Ohio with the most Medicaid Program Integrity job openings:

Full-time
Posted 7 days ago
Job description
What You Will Do At ODM:
Office:Â Legal Counsel
Bureau:Â Program Integrity
Working Title:Â External Auditor 1Â (PN:20042146)
Job Overview:Â
The Ohio Department of Medicaid is seeking a candidate with an interest in auditing to be a part of our Provider Compliance unit. The Provider Compliance unit is part of Program Integrity (BPI) which focuses on fraud, waste and abuse related activities. This position is located in Franklin County and will require travel to provider sites. As an External Auditor 1, your responsibilities will include:
- Conducting routine financial, compliance and operational audits
- Operating accounting and auditing software (e.g. spreadsheets, word processors, databases)
- Analyzing confidential records and information stored in the department's various data systems
- Working collaboratively with other BPI reviewers and/or ODM professionals to analyze provider payment claims and coding to identify potential of fraud, waste, and abuse
- Analyzing health care providers records related to billing activities and the quality of care when conducting on site reviews
- Preparing audit reports and recommendations for corrective actions plans
- Maintaining favorable relations with internal and external customers
3 yrs. exp. in auditing or accounting which must have included 18 mos. auditing exp. in accordance with auditing standards or in accordance with prescribed management policies &/or procedures as specified on agency position description.Â
-Or completion of undergraduate core coursework in accounting, business administration, computer science or related field; 12 mos. exp. in auditing or accounting which must have included auditing.Â
-Or equivalent of Minimum Class Qualifications for Employment noted above.Â
Job Skills: Auditing
  Technical Skills: Auditing; Accounting and Finance
  Professional Skills: Attention to Detail, Analyzation, Collaboration, Critical Thinking, Goal Setting, Interpreting Data, Priority Setting, Results Oriented, Verbal Communication, Written Communication