- Emory Healthcare/Emory University (Atlanta, GA)
- …Reporting to the Director, Compliance Audit and Analysis, the Sr. Compliance Auditor will develop and execute audit, monitoring, and education for both facility ... and professional billing , coding and documentation programs that ensure compliance with regulatory standards. Continuously evaluate facility/professional billing … more
- Emory Healthcare/Emory University (Atlanta, GA)
- …leadership programs + And more! **Description** The Professional Coding Compliance Auditor develops and executes audit, monitoring, and education for professional ... billing , coding and documentation programs that confirm compliance, identifies...programs that confirm compliance, identifies reimbursement implications, and provides billing providers with relevant and timely information regarding audit… more
- Elevance Health (Atlanta, GA)
- **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role enables associates to work virtually full-time, with the exception of required ... granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor -RN** is responsible for auditing inpatient medical records to ensure clinical… more
- Elevance Health (Atlanta, GA)
- **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ _This role enables associates to work virtually full-time, with the exception of required in-person training ... recover, eliminate and prevent unnecessary medical-expense spending. The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records and generating… more
- Elevance Health (Columbus, GA)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** _Location:_ **Virtual:** This role enables associates to work virtually ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more
- Elevance Health (Atlanta, GA)
- **Provider Auditor ** _This position will work a hybrid model (remote and office), 1 time per week. The Ideal candidate will live within 50 miles of one of our ... to recover, eliminate and prevent unnecessary medical-expense spending. The **Provider Auditor ** conducts on-site reviews of medical charts, medical notes, itemized… more
- Highmark Health (Atlanta, GA)
- …activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code ... which supports compliant coding. Interacts with external consultants regarding billing , coding and/or documentation and evaluates their recommendations and/or… more
- Humana (Atlanta, GA)
- …federal and/or state requirements related to Provider Clinic operations, billing , investigations, and processes. Coordinates site visits for regulators, coordinates ... more years of healthcare experience in revenue cycle management (related to billing , coding, collections for Medicare and Medicaid claims) + Experience with Auditing… more
- Molina Healthcare (Augusta, GA)
- …conducting various audits including, but not limited to; vendor, focal, audit the auditor . Confirm that documentation is clear and concise to ensure accuracy in ... in order to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims....& ABILIITIES:** + Minimum 2 years as an operational auditor for at least one core operations function +… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …laws, regulations, and industry standards, focusing on compliance risk areas and billing practices, while also providing ongoing educational support, and fostering a ... other stakeholders to ensure accurate and compliant reporting of industry standard billing , coding and documentation standards (ICD10, CPT, E/M, HCPCS, CDI, HCC,… more