- Elevance Health (Atlanta, GA)
- … Auditor ** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs billed and reimbursed. ... DRG Clinical (RN) Validation Auditor **Virtual** :...years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of… more
- CGI Technologies and Solutions, Inc. (Atlanta, GA)
- **Remote Senior Inpatient Auditor - MS-DRG & Clinical Validation** **Category:** Analytics and Emerging Digital Technologies **Main location:** United States, ... **Employment Type:** Full Time **Position Description:** CGI is seeking a high-caliber MS-DRG Auditor to join our Healthcare Compliance Team. In this role, you will… more
- Humana (Atlanta, GA)
- …and appropriateness of procedure codes based on services rendered + Review medical documentation for clinical indicators to ensure specific procedures meet ... our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct… more
- Centene Corporation (Atlanta, GA)
- …strongly preferred. **Position Purpose:** Lead medical record audits, monitor and analyze clinical documentation , and modify business processes to measure member ... outcomes. Assess provider performance and quality of care through clinical case reviews. + Lead clinical audits...care through clinical case reviews. + Lead clinical audits for provider medical records both remotely via… more
- Humana (Atlanta, GA)
- …and receives guidance where needed. Follows established guidelines/procedures. + Review medical documentation for clinical indicators to ensure procedures meet ... our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure correct… more
- Elevance Health (Atlanta, GA)
- …a Certified Coding Specialist, CIC as a Certified Inpatient Coder, or Certified Clinical Documentation Specialist (CCDS). + Requires minimum of 10 years ... **DRG Coding Auditor Principal** **_Virtual: _** _ _ This role...Clinics, and the ICD-10 Alphabetic and Tabular Indices), complex clinical guidelines and maintaining objectivity in the performance of… more
- Elevance Health (Atlanta, GA)
- …for all lines of business, and its clients. Also responsible for performing clinical reviews of medical records and other documentation to evaluate issues ... **Build the Possibilities. Make an Extraordinary Impact.** **Title** : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) **Virtual: ** _ _ This role enables… 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 reimbursement implications, and...all pertinent internal and external audits. + Collaborates with clinical and administrative staff and leadership to ensure audit… more
- HCA Healthcare (Augusta, GA)
- …want to join an organization that invests in you as an Inpatient Coding Quality Auditor ? At Parallon, you come first. HCA Healthcare has committed up to $300 million ... and Qualifications** As a work from home Inpatient Coding Auditor , you will be responsible for performing internal quality...coding practices and to improve the quality of physician documentation within the body of the medical record to… more
- Houston Methodist (GA)
- …appropriate, utilizing the established physician query process. Provides assistance to Clinical Documentation Management Program (CDMP) with appropriate MS-DRG ... At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in...and procedure to outpatient and/or inpatient encounters based upon documentation within the electronic medical record while maintaining compliance… more