• Inpatient Audit Specialist

    Datavant (Atlanta, GA)
    …you will be instrumental in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding ... Academic/Trauma Level 1 facility. **What You Will Do:** + Performs Inpatient Facility coding audits according to scope of work, for the purpose of Onboarding,… more
    Datavant (07/29/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Columbus, GA)
    …on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding . **Job Summary** Utilizing clinical knowledge and experience, ... decision making pertinent to clinical experience + Documents clinical review summaries, bill audit findings and ...two years of experience in Claims Auditing, Medical Necessity Review and Coding experience + Familiar with… more
    Molina Healthcare (09/06/25)
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  • Director, Prospective + Concurrent Risk Adjustment…

    Datavant (Atlanta, GA)
    …and acting on undiagnosed conditions (prospective suspecting) and ensuring risk adjustment coding accuracy in near real-time (concurrent review ). You will manage ... regulations and best practices related to prospective risk capture and concurrent review . **Compliance & Quality :** + Partner with Legal, Compliance, and… more
    Datavant (08/08/25)
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  • Vendor Resource Management Team Lead

    HCA Healthcare (Augusta, GA)
    …the monthly random, focus, prebill review , and Ad Hoc quality review process + Submits and reviews coding appeals as appropriate **What qualifications ... with vendor management including monitoring processes and services for improvement, coding quality , trending/analyzing data, creating and presenting education,… more
    HCA Healthcare (09/27/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Atlanta, GA)
    …letters. + Maintains accuracy and quality standards as established by audit management. + Identifies potential documentation and coding errors by recognizing ... the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How...clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding… more
    Elevance Health (09/23/25)
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  • Inpatient Medical Coder - PRN - Up to $1,000 Sign…

    Datavant (Atlanta, GA)
    …preferably within an academic medical facility. + Experience with significant level of coding quality review feedback + Experience in computerized encoding ... codes from patient records, ensuring precision and adherence to documentation + Oversee and audit the work of Level 1 & 2 Coders, where applicable + Champion… more
    Datavant (09/24/25)
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  • Director of Payment Integrity Consulting

    CGI Technologies and Solutions, Inc. (Atlanta, GA)
    …on various payment integrity domains, including pre-payment review , post-payment audit , FWA detection and prevention, coding accuracy, clinical integrity, ... on various payment integrity domains, including pre-payment review , post-payment audit , FWA detection and prevention, coding accuracy, clinical integrity,… more
    CGI Technologies and Solutions, Inc. (09/25/25)
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  • Manager/AD, Global Pharmacovigilance

    Boehringer Ingelheim (Duluth, GA)
    …The position holder is recognized as a Subject Matter Expert in Pharmacovigilance Data/ Quality and case review by internal and external colleagues and acts ... the collection, review , and approval of Global PV procedures and quality documents (SOPs/Guidelines). + Participates in the drafting, review and… more
    Boehringer Ingelheim (09/18/25)
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  • Associate Medical Director, Pharmacovigilance…

    Sumitomo Pharma (Atlanta, GA)
    …Characteristics (SmPC), and Canadian Product Monograph (PM) + Ensures timely and quality review and assessment of ICSRs, including seriousness, expectedness, ... safety narratives, adverse event coding , concomitant medication coding , and causality statements....study team meetings and governance committees. + Performs aggregate review of post-marketing safety data in support of safety… more
    Sumitomo Pharma (08/15/25)
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  • Licensed Practical Nurse/Licensed Vocational Nurse…

    STG International (Milledgeville, GA)
    …facility surveys (inspections) made by authorized government agencies as requested. + Audit nursing documentation in the clinical record for appropriate and relevant ... + Attend and contribute in facility "triple check" process for reviewing coding for accuracy. + Perform administrative duties such as completing medical forms,… more
    STG International (07/30/25)
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