- Molina Healthcare (Columbus, GA)
- …different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding /billing (UB04/1500 form). * Advanced understanding of key managed ... executive level strategy and leadership for team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data… more
- CVS Health (Atlanta, GA)
- …Experience in healthcare fraud, waste and abuse + Knowledge of Medicaid healthcare claims adjudication (QNXT) & regulatory reporting + Experience with data ... and is ideal for a data professional with strong coding skills in SQL and Python who can transform...skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud, waste,… more
- Grant Thornton (Atlanta, GA)
- …excel. The ideal candidate will have exceptional expertise and experience in healthcare providers, specifically hospitals, academic medical centers, and ... of successfully managing projects related to revenue cycle optimization, including billing, coding , reimbursement, and claims processing, with a focus on… more
- Molina Healthcare (Savannah, GA)
- …better health, more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data ( medical , pharmacy and ancillary) to ... Education** Master's Degree **Preferred Experience** * Preferred experience in healthcare medical economics and/or strong financial analytics background… more
- Molina Healthcare (Augusta, GA)
- …better health, more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data ( medical , pharmacy and ancillary) to ... Education** Master's Degree **Preferred Experience** + Preferred experience in healthcare medical economics and/or strong financial analytics background… more
- Grant Thornton (Atlanta, GA)
- …of 4 years of direct experience with diverse life sciences companies or healthcare providers, including hospitals, academic medical centers, healthcare ... projects related to revenue cycle optimization, including patient access, revenue integrity, coding , claims processing, billing, and reimbursement, with a focus… more
- Molina Healthcare (Atlanta, GA)
- …fraud, abuse, and over utilization by providers and recipients. The position will review claims data, medical records, and billing data from all types of ... healthcare providers that bill Medicaid/Medicare/Marketplace. **KNOWLEDGE/SKILLS/ABILITIES** + Ensure investigators...well as Marketplace + Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems +… more
- Molina Healthcare (Columbus, GA)
- …will work on set schedule) Looking for a RN with experience with appeals, claims review, and medical coding . JOB DESCRIPTION Job SummaryProvides support ... * Processes requests within required timelines. * Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner.… more
- Molina Healthcare (Macon, GA)
- …for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). + Medical Coding certification. To all current Molina employees: If you are interested ... recoveries in a managed care or payer environment. + In-depth knowledge of medical and hospital claims processing, including CPT/HCPCS, ICD, and modifier usage.… more
- Humana (Atlanta, GA)
- …that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer ... and judgment. May apply intermediate mathematical skills. **Where you Come In** The Medical Coding Coordinator extracts clinical information from a variety of … more