• Medical Director - Medicare Appeals

    CVS Health (Atlanta, GA)
    …Hearings / Special Projects and Committee participation when needed. The Medical Director will provide clinical , coding , and reimbursement expertise as ... / Pediatrics (Med / Peds) Board Certification. In the Medical Director role, you will provide oversight...directing case management when necessary. The Medical Director will act as a business and clinical more
    CVS Health (08/08/25)
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  • Senior Director Hospital Coding

    Intermountain Health (Atlanta, GA)
    …may offer a sign-on and/or a relocation bonus when applicable. As the Senior Director of Hospital Coding , you will: + Cultivate exceptional relationships and ... **Job Description:** The Senior Director of HIM (Health Information Management) holds a...with diverse stakeholders including across revenue cycle, executive leaders, clinical teams, medical staff and DTS. +… more
    Intermountain Health (08/30/25)
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  • Manager, Risk Adjustment Coding Support

    Evolent (Atlanta, GA)
    …The Risk Adjustment Coding Manager plays a crucial role in ensuring accurate medical coding and compliance with risk adjustment models. **What You will Be ... coding questions and issues. + Collaborate with the coding director to develop policies, procedures, and...healthcare administration, or a related field. + **Certification in medical coding (CRC- Certified Risk Adjustment Coder)… more
    Evolent (08/14/25)
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  • Clinical Documentation and Claims Integrity…

    Elevance Health (Atlanta, GA)
    ** Clinical Documentation and Claims Integrity Director ** **Location:** Alternate locations may be considered. This position will work a hybrid model (remote and ... of life through home-care and community based services. The ** Clinical Document Improvement Director ** is responsible for...of related experience, including 3 years of hands-on HCC coding , chart review, and RAF calculations; or any combination… more
    Elevance Health (08/14/25)
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  • Sr Compliance RCM & Coding Auditor

    Humana (Atlanta, GA)
    …with business partners to uphold ethical standards and mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance, by ... data requires an in-depth evaluation of variable factors. As the Senior Clinical Compliance Professional, you will develop and/or evaluate compliance policies and… more
    Humana (08/23/25)
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  • Medical Director - Florida

    Humana (Atlanta, GA)
    **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and… more
    Humana (07/29/25)
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  • Associate Medical Director

    Sumitomo Pharma (Atlanta, GA)
    …seeking a dynamic, highly motivated, and experienced individual for the position of **Associate Medical Director .** The Associate Medical Director will ... Serious Adverse Event Reports (SAEs), and Product Complaints (PCs) + Contributes to medical safety of clinical trials, including monitoring of clinical more
    Sumitomo Pharma (08/15/25)
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  • Director , Prospective + Concurrent Risk…

    Datavant (Atlanta, GA)
    …to deliver complex healthcare technology solutions. + Solid understanding of clinical suspecting, concurrent coding workflows, risk adjustment models (eg, ... requirements, medical record standards, and regulatory guidance impacting concurrent coding or risk adjustment. + Product experience integrating into EHRs or… more
    Datavant (08/08/25)
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  • Dialysis Clinical Manager Registered Nurse…

    Fresenius Medical Center (Loganville, GA)
    **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture...advance your career into an Area Team Lead or Director of Operations role. **Our culture:** We believe our… more
    Fresenius Medical Center (08/01/25)
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  • Medical Records Coder III Outpatient

    BayCare Health System (Atlanta, GA)
    …missing documentation and monitors bill hold reports. + Strong utilization of medical terminology and anatomy. + Assists Manager/ Director with mentoring/training ... of Coder I and Coder II team members and clinical practice students from various colleges. + Performs other...of Outpatient Facility Coding + Strong CPT coding Equal Opportunity Employer Veterans/Disabled **Position** Medical more
    BayCare Health System (08/08/25)
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