- Elevance Health (Richmond, VA)
- …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...quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer… more
- Elevance Health (Richmond, VA)
- …with provider management team by presenting preliminary review results. + Verifies dollar amount on claim is correct in claims system and writes report of ... **Provider Auditor -** FRD > Audit **Hybrid 1:** This...itemized bills and providers contracts to ensure that a claim is paid in accordance with the contract, provider… more
- Elevance Health (Richmond, VA)
- …preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems , provider billing guidelines, payer ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This...Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes… more
- Highmark Health (Richmond, VA)
- …to resolve issues and provide advice on new programs. Provides guidance to system entities in response to external coding audits conducted by the Medicare ... the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems , missed secondary diagnoses and procedures and ensures compliance with DRG/APC structure… more
- Elevance Health (Norfolk, VA)
- **Clinical Provider Auditor II** This role requires associates to be in-office **1 - 2** days per week, fostering collaboration and connectivity, while providing ... recover, eliminate and prevent unnecessary medical-expense spending. The Clinical Provider Auditor II is responsible for identifying issues and/or entities that may… more
- Elevance Health (Roanoke, VA)
- **Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Hybrid 1** : This role requires associates to be in-office **1-2** days per ... recover, eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor II** is responsible for identifying issues and/or entities that… more