Remote Nurse Audit Specialist — Fraud & Claims Review
Mason, Warren County, Ohio, 45040, USA
Listed on 2026-10-20
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Nursing
Elevance Health is seeking a Nurse Audit professional to identify and analyze aberrant utilization and potential fraud through prepayment and post-payment claims reviews. You will monitor patterns, correlate findings with actions, and collaborate with service operations to enhance claims integrity and cost control.
The role requires an AS in nursing with an active RN license and 2+ years of clinical nursing experience; CPT/HCPCS and ICD-9 knowledge is highly valued.
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This posting is for the Remote Nurse Audit Specialist — Fraud & Claims Review role at Elevance Health (Anthem), based in Mason, OH, United States.
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