- Elevance Health (Atlanta, GA)
- ** Claims Auditor I** **Virtual:** This role...and post payment and adjudication audits of high dollar claims for limited lines of business, claim ... an accommodation is granted as required by law._ The ** Claims Auditor ** **I** is responsible for pre...dollar claims while maintaining acceptable levels of claims inventory and age. + Ensures claim … more
- Elevance Health (Atlanta, GA)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ __ This...Audit setting or hospital coding or quality assurance environment preferred . + Broad knowledge of medical claims … more
- AutoZone, Inc. (Atlanta, GA)
- **Job Description** As a **Sr. Audit Recovery Auditor ** , you will Utilize analytical and forensic email review skills to audit Merchandising negotiations to recover ... 3rd Party vendors to recover less than 10% behind Senior Auditor . Negotiate and communicate flawlessly with Merchandising and Vendors to successfully… 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)
- **Clinical Provider Auditor II** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and connectivity, ... is granted as required by law. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities...abuse. **How you will make an Impact:** + Examines claims for compliance with relevant billing and processing guidelines… more
- BayCare Health System (Atlanta, GA)
- …7:00 AM to 3:30 PM + **Days:** Monday - Friday The Inpatient Coding Auditor is a full-time remote position. _Sign on bonuses available!_ Responsibilities + The ... Inpatient Coding Auditor performs inpatient encounter audits and evaluates compliance related...Performs special audits for specific issues within facility Inpatient claims . + Acts as the Liaison for coding issues… more
- Highmark Health (Atlanta, GA)
- …communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong education/training background ... and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting… more
- Humana (Atlanta, GA)
- …cycle management (related to billing, coding, collections for Medicare and Medicaid claims ) + Experience with Auditing and monitoring of healthcare records + Must ... and regulations governed by the Department of Insurance and CMS ** Preferred Qualifications** + Compliance regulations knowledge and compliance auditing experience +… more
- Molina Healthcare (Macon, GA)
- …updates/changes within claims processing system . + Experience using claims processing system (QNXT). ** PREFERRED EDUCATION:** Bachelor's Degree or ... including, but not limited to; vendor, focal, audit the auditor . Confirm that documentation is clear and concise to...equivalent combination of education and experience ** PREFERRED EXPERIENCE:** 3+ years Healthcare Claims Adjudication… more