• Director of Payment Integrity Consulting

    CGI Technologies and Solutions, Inc. (Atlanta, GA)
    …roles, leading projects and teams . 5 years of experience in healthcare claims adjudication, medical coding , DRGs, and/or reimbursement methodologies . 5 ... long-term relationships with key client stakeholders, including executive leadership, claims operations, finance, compliance, and clinical teams. * Lead client… more
    CGI Technologies and Solutions, Inc. (09/25/25)
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  • Inpatient Medical Coding Auditor

    Humana (Atlanta, GA)
    …Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider ... community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from...one of these qualifications for 4 years) * MS-DRG coding /auditing experience * Experience reading and interpreting claims… more
    Humana (09/24/25)
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  • Medical Coding Appeals Analyst

    Elevance Health (Atlanta, GA)
    …not eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical ... issues and to audit claims adjudication for accuracy. + Perform pre-adjudication claims reviews to ensure proper coding was used. + Prepares correspondence… more
    Elevance Health (09/12/25)
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  • Coding Auditor Educator-Inpatient

    Highmark Health (Atlanta, GA)
    …for education/training of facility healthcare professionals in use of coding guidelines and practices, proper documentation techniques, medical terminology ... **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data… more
    Highmark Health (09/20/25)
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  • Billing & Coding Specialist

    Ortho Sport and Spine Physicians (Atlanta, GA)
    …DUTIES: Remain HIPAA and OSHA compliant. Translate patient information and alphanumeric medical code entries. Electronic "clean" claims submissions to Insurance ... account payments. Sort and file paperwork. Analyzing and correcting coding errors. Ensure healthcare facilities are reimbursed...for all procedures. Follow Up on accepted or denied claims . Review denied claims for denial reasons… more
    Ortho Sport and Spine Physicians (07/13/25)
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  • Medical Claims Processor - Remote

    Cognizant (Atlanta, GA)
    …High School Diploma or equivalent is required + A minimum of 1 years of medical claims processing is required + Facets experience is highly preferred + Knowledge ... Claims Processors to join our growing team. The ** Medical ** ** Claims Processor** is responsible for the...of physician practice and hospital coding , billing, and medical terminology, CPT, HCPCS,… more
    Cognizant (10/10/25)
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  • Patient Support Medical /Biller…

    IQVIA (Atlanta, GA)
    **Patient Support Medical Claims Processing ​ Representative** _Contract Remote Role - Location (Open to Remote US)_ As the only global provider of commercial ... a 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative** to join our...or equivalent + Experience in claim processing required + Medical Billing Certification required + Coding Certification… more
    IQVIA (07/29/25)
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  • Mgr II Grievance/Appeals- Medical…

    Elevance Health (Atlanta, GA)
    …+ Serves as a resource for complex issues and interpretation of claims , provider contracts and data, eligibility, member contracts, benefits, clinical decisions, ... experience and a minimum of 3 years of management experience in the healthcare industry; or any combination of education and experience which would provide an… more
    Elevance Health (10/11/25)
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  • Sr. Product Manager - Claims Management

    Waystar (Atlanta, GA)
    …understand the vocabulary used in hospital & professional revenue cycle operations, including healthcare coding such as DRGs, CPT/HCPC, Revenue Codes, APG and ... reports, and assessing strengths and weaknesses of competitors + Studying healthcare industry standards and staying up-to-date on industry changes and compliance… more
    Waystar (08/08/25)
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  • Specialist, Config Oversight ( healthcare…

    Molina Healthcare (GA)
    …or equivalent combination of education and experience **PREFERRED EXPERIENCE:** 3+ years healthcare Medical claims auditing **PHYSICAL DEMANDS:** Working ... to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of...within the core processing system (QNXT). * Conducts focal healthcare Medical claim audits on samples of… more
    Molina Healthcare (09/24/25)
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