- Axis (Alpharetta, GA)
- …upon request for candidates taking part in the selection process. **Job Description: Senior Claims Specialist ** AXIS is seeking a Senior Claims Specialist ... Claims team reporting to the Manager of Casualty Claims . This position requires senior claims management...plus. **What will you do in this role?** + Auditing of Third-Party Administrators to ensure reserve adequacy. +… more
- UNUM (Atlanta, GA)
- …services. + Maintain Individual and Team performance metrics + Complete thorough Quality Assurance via review of metrics, auditing of calls, coaching/performance ... (UNUM Group's) portfolios to provide benefits education, retention of policies, quality assurance, technical support and assist with other project initiatives. **Job… more
- Elevance Health (Atlanta, GA)
- …at least one of the following: AA/AS or minimum of 5 years of experience in claims auditing , quality assurance, or recovery auditing . + Requires at ... auditing inpatient medical records and generating high quality recoverable claims for the benefit of...Health Information Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder. +… more
- Banner Health (GA)
- …different focuses (Facility vs Profee)._ In this **Inpatient Facility-based HIMS Coding Quality Associate** position, you bring your **5 years of acute care ... team that values growth and development! This is a Quality position, not a day-to-day coding production role but...in your attached resume);** + **DRG and PCS Coding, Auditing experience;** + **Bachelors degree or equivalent;** + **Must… more
- Elevance Health (Atlanta, GA)
- …in applicable state(s). + Requires a minimum of 10 years of experience in claims auditing , quality assurance, or clinical documentation improvement, and a ... The **Diagnosis Related Group Clinical Validation Auditor-RN** is responsible for auditing inpatient medical records to ensure clinical documentation supports the… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …networks; manage relationships with providers, negotiate contracts (where necessary), and ensure quality of care. CLAIMS MANAGEMENT: + Oversee TPA claim ... processing, ensure accurate and timely payment of claims , and identify areas for cost reduction. COMPLIANCE..., and identify areas for cost reduction. COMPLIANCE AND AUDITING : + Maintain compliance with regulatory requirements, conduct internal… more
- Highmark Health (Atlanta, GA)
- …analytical and communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong ... and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs,… more