• Medical Review Nurse (RN)

    Molina Healthcare (GA)
    …applicable software program(s) proficiency. **PREFERRED QUALIFICATIONS:** + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case ... Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care certifications. + Nursing experience in critical care, emergency medicine, medical/surgical or pediatrics. + Billing… more
    Molina Healthcare (09/06/25)
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  • Inpatient DRG Coding Auditor

    Emory Healthcare/Emory University (Atlanta, GA)
    …+ Reviews discrepancies between the Clinical Documentation Specialist (CDS) DRG and the Coder DRG. + Reviews non-CC/MCC records to determine if record was miscoded ... or if additional documentation is needed. + Works with Coders and CDSs to draft and initiate physician queries. + Performs reviews in a timely manner to maintain DNFB target of 4 days. + Provides Coding development with coordination of educational and training… more
    Emory Healthcare/Emory University (09/05/25)
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