Conduct onsite reviews of Ohio Medicaid provider locations throughout the state. * Travel daily to provider sites and complete assigned review schedules. * Execute ODM-approved site review checklists ...
Conduct onsite reviews of Ohio Medicaid provider locations throughout the state. * Travel daily to provider sites and complete assigned review schedules. * Execute ODM-approved site review checklists ...
Care Review Nurse
Columbus, OH · On-site
Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum ...
Care Review Nurse
Columbus, OH · On-site
Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum ...
Care Review Nurse
Columbus, OH · On-site
Care Review Nurse Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business ...
New
Care Review Nurse
Columbus, OH · On-site
Care Review Nurse Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business ...
New
Credit Review Officer
Columbus, OH · On-site
Performs and/or assists with credit reviews for quality, accuracy, and compliance with regulations, seeking guidance from senior staff or management when necessary. Conducts independent detailed ...
Credit Review Officer
Columbus, OH · On-site
Performs and/or assists with credit reviews for quality, accuracy, and compliance with regulations, seeking guidance from senior staff or management when necessary. Conducts independent detailed ...
Credit Review Officer
Columbus, OH · On-site +1
Performs and/or assists with credit reviews for quality, accuracy, and compliance with regulations, seeking guidance from senior staff or management when necessary. Conducts independent detailed ...
Credit Review Officer
Columbus, OH · On-site +1
Performs and/or assists with credit reviews for quality, accuracy, and compliance with regulations, seeking guidance from senior staff or management when necessary. Conducts independent detailed ...
Specialist, Utilization Review
Columbus, OH · On-site
Communicate with physicians to schedule peer to peer reviews. Accurately report denials. SUPERVISORY RESPONSIBILITIES: Manage the work of others, including planning, assigning, scheduling and ...
Specialist, Utilization Review
Columbus, OH · On-site
Communicate with physicians to schedule peer to peer reviews. Accurately report denials. SUPERVISORY RESPONSIBILITIES: Manage the work of others, including planning, assigning, scheduling and ...
Credit Review Officer
Powell, OH · On-site +1
Performs and/or assists with credit reviews for quality, accuracy, and compliance with regulations, seeking guidance from senior staff or management when necessary. Conducts independent detailed ...
Credit Review Officer
Powell, OH · On-site +1
Performs and/or assists with credit reviews for quality, accuracy, and compliance with regulations, seeking guidance from senior staff or management when necessary. Conducts independent detailed ...
Specialist, Utilization Review
Columbus, OH · On-site
Communicate with physicians to schedule peer to peer reviews. Accurately report denials. SUPERVISORY RESPONSIBILITIES: Manage the work of others, including planning, assigning, scheduling and ...
Specialist, Utilization Review
Columbus, OH · On-site
Communicate with physicians to schedule peer to peer reviews. Accurately report denials. SUPERVISORY RESPONSIBILITIES: Manage the work of others, including planning, assigning, scheduling and ...
Credit Review Officer
Columbus, OH · On-site
Performs and/or assists with credit reviews for quality, accuracy, and compliance with regulations, seeking guidance from senior staff or management when necessary. Conducts independent detailed ...
Credit Review Officer
Columbus, OH · On-site
Performs and/or assists with credit reviews for quality, accuracy, and compliance with regulations, seeking guidance from senior staff or management when necessary. Conducts independent detailed ...
Specialist, Utilization Review
Columbus, OH · On-site
Communicate with physicians to schedule peer to peer reviews. Accurately report denials. SUPERVISORY RESPONSIBILITIES: Manage the work of others, including planning, assigning, scheduling and ...
Specialist, Utilization Review
Columbus, OH · On-site
Communicate with physicians to schedule peer to peer reviews. Accurately report denials. SUPERVISORY RESPONSIBILITIES: Manage the work of others, including planning, assigning, scheduling and ...
Reviews behavioral health cases to determine medical necessity and appropriateness of care, ensuring compliance with established guidelines and policies. Performs pre-certifications, pre ...
Reviews behavioral health cases to determine medical necessity and appropriateness of care, ensuring compliance with established guidelines and policies. Performs pre-certifications, pre ...
De Novo, a boutique staffing and recruitment agency, is currently seeking a personal injury attorney with discovery review experience to work directly with one of our clients. This is a contract to ...
Quick apply
De Novo, a boutique staffing and recruitment agency, is currently seeking a personal injury attorney with discovery review experience to work directly with one of our clients. This is a contract to ...
Care Review Clinician
Columbus, OH · On-site
Care Review Clinician Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and ...
New
Care Review Clinician
Columbus, OH · On-site
Care Review Clinician Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and ...
New
Care Review Clinician
Columbus, OH · On-site
Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum ...
Care Review Clinician
Columbus, OH · On-site
Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum ...
Suitability Review Specialist
Delaware, OH · Remote
$73K - $122K/yr
Conduct reviews, monitoring activities, and audits to identify unusual, suspicious, or potentially non-compliant activity; investigate findings and escalate concerns as appropriate. * Provide ...
Suitability Review Specialist
Delaware, OH · Remote
$73K - $122K/yr
Conduct reviews, monitoring activities, and audits to identify unusual, suspicious, or potentially non-compliant activity; investigate findings and escalate concerns as appropriate. * Provide ...
Reviews medical records/case file, writes a decision that is clear, concise, and impartial and supports the determination made, and documents review * Makes sound, independent decisions based on ...
Reviews medical records/case file, writes a decision that is clear, concise, and impartial and supports the determination made, and documents review * Makes sound, independent decisions based on ...
Care Review Processor
Columbus, OH · On-site
Care Review Processor Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and ...
New
Care Review Processor
Columbus, OH · On-site
Care Review Processor Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and ...
New
De Novo, a boutique staffing and recruitment agency is currently seeking a Discovery Review Contract Attorney with experience in the area of personal injury and/or mass tort/class action to work ...
Quick apply
De Novo, a boutique staffing and recruitment agency is currently seeking a Discovery Review Contract Attorney with experience in the area of personal injury and/or mass tort/class action to work ...
Psychologist Reviewer - ABA
Columbus, OH · On-site
$93K - $167K/yr
Psychologist Reviewer - ABA Work location - Virtual This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and ...
Psychologist Reviewer - ABA
Columbus, OH · On-site
$93K - $167K/yr
Psychologist Reviewer - ABA Work location - Virtual This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and ...
Utilization Review Clinician (RN) - Behavioral Health
Columbus, OH · On-site
$23.76 - $51.49/hr
Prefer candidates that have experience with ASAM, MCG or previous experience with Utilization Reviews. SCHEDULE: Monday thru Friday 8:00AM to 5:00PM EST (Rotating weekends and Holiday schedules are ...
Utilization Review Clinician (RN) - Behavioral Health
Columbus, OH · On-site
$23.76 - $51.49/hr
Prefer candidates that have experience with ASAM, MCG or previous experience with Utilization Reviews. SCHEDULE: Monday thru Friday 8:00AM to 5:00PM EST (Rotating weekends and Holiday schedules are ...
Reviews information
See salary details
$6.25 - $13.46
2% of jobs
$13.46 - $20.67
19% of jobs
$21.50 is the 25th percentile. Wages below this are outliers.
$20.67 - $27.88
36% of jobs
$27.88 - $35.10
14% of jobs
$36.61 is the 75th percentile. Wages above this are outliers.
$35.10 - $42.31
20% of jobs
$42.31 - $49.52
2% of jobs
$49.52 - $56.73
1% of jobs
$56.73 - $63.94
1% of jobs
$63.94 - $71.15
3% of jobs
$71.15 - $78.37
2% of jobs
$78.37 - $85.58
0% of jobs
$6
$35
$85
How much do reviews jobs pay per hour?
- Remote No Experience Hotel Reviewer
- Remote Weather Analyst
- Work From Home Regulatory Compliance Analyst
- Document Review Analyst
- Remote Korean Language Attorney
- Non Exempt Medical Legal Record Reviewer
- Medical Records Field Reviewer
- Japanese Language Document Review
- Work From Home Ediscovery Document Review Attorney
- Freelance Remote Medical Reviewer
- Assistant Remote Document Reviewer
- Contract Chinese Document Review
- Flex Schedule Medical Document Reviewer
- Remote Document Review Analyst
- Contract Document Review
- Remote Document Review Manager
- Remote Korean Document Review
- Contract Arabic Document Review
- Remote Mandarin Document Review
- Online Remote Document Reviewer

$25/hr
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 20 days ago
Job description
Onsite Reviewer - Ohio (5 Openings)
Locations:
- Columbus
- Cleveland
- Akron/Canton
- CincinnatiÂ
Employment Type: Full-Time
Pay Rate: $25.00 per hour
About the Role:
The Onsite Reviewer plays a critical role in ensuring Ohio Medicaid providers deliver legitimate services, maintain compliance with Ohio Administrative Code requirements, and operate from approved service locations. Using a comprehensive site review checklist approved by the Ohio Department of Medicaid (ODM), the Onsite Reviewer conducts independent, in-person provider assessments while collaborating with a larger quality assurance team.
This position requires extensive daily travel throughout Ohio, with occasional overnight stays based on assigned territories and schedules.
Key Responsibilities- Conduct onsite reviews of Ohio Medicaid provider locations throughout the state.
- Travel daily to provider sites and complete assigned review schedules.
- Execute ODM-approved site review checklists and conduct provider interviews in accordance with established protocols.
- Assess provider operations, documentation practices, and regulatory compliance requirements.
- Document site visit findings accurately, thoroughly, and professionally using proper grammar, punctuation, and objective observations.
- Submit completed reviews within established quality assurance and compliance deadlines.
- Analyze collected information and provide recommendations regarding provider enrollment or continued participation in Medicaid programs.
- Maintain strict confidentiality regarding provider information, findings, and review outcomes.
- Meet established productivity, quality, and customer service performance standards.
- Work independently while effectively managing priorities, deadlines, and travel schedules.
- Address provider questions and concerns professionally and identify opportunities for process improvement.
- Utilize technology, tablets, and reporting systems to document and complete reviews.
- Represent the organization professionally during all provider interactions.
- Bachelor's Degree required.
- Valid driver's license with an acceptable driving record.
- Current automobile insurance.
- Willingness and ability to travel extensively throughout Ohio.
- Experience using tablets/iPads and Microsoft Office applications.
- Strong written communication, documentation, and dictation skills.
- Excellent organizational, time management, and analytical skills.
- Demonstrated ability to work independently with minimal supervision.
- Professional demeanor with strong interpersonal, listening, and communication skills.
Minimum of two (2) years of experience in one or more of the following areas:
- Public Health
- Critical Care
- Home Health
- Long-Term Care (LTC)
- Behavioral Health or Mental Health Services
- Developmental Disabilities Services
- Children's Services
- Elder Care Services
- Community Social Services
In addition, experience in one or more of the following is preferred:
- Medicaid programs
- Provider monitoring or auditing
- Compliance reviews
- Third-party billing
- Provider training and education
- Healthcare operations
- Quality assurance
Successful candidates will be:
- Honest, dependable, and self-motivated.
- Comfortable working independently in the field.
- Detail-oriented with strong investigative and observational skills.
- Skilled at analyzing information and making objective recommendations.
- Able to maintain professionalism while navigating challenging situations.
- Customer-focused with excellent problem-solving abilities.
SSO offers a competitive benefits package that may include:
- Medical Insurance
- Dental Insurance
- Vision Insurance
- 401(k) with Employer Match
- Paid Time Off (PTO)
- Paid Holidays
- Flexible Spending Accounts (FSA)
- Employee Assistance Program (EAP)
- Additional Employee Perks
Keywords Search
Ohio Medicaid, Healthcare Compliance, Provider Review, Site Auditor, Healthcare Auditor, Field Reviewer, Quality Assurance, Medicaid Provider Enrollment, Regulatory Compliance, Home Health, Long-Term Care, Public Health, Behavioral Health, Provider Monitoring, Healthcare Operations, Field-Based Position, Statewide Travel, Documentation Review, Healthcare Inspection, Medicaid Compliance.