- CRC Insurance Services, Inc. (GA)
- …(United States of America) **Please review the following job description:** Process claims , which includes evaluating policy for coverage; working with the insured, ... adjusters, agents and attorneys on the claim and coordinating the payment of claims . In addition, prepare reports such as loss runs and monthly bordereau.… more
- Elevance Health (Atlanta, GA)
- … chart coding principles, clinical guidelines and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise, ... coding or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement… more
- AutoZone, Inc. (Atlanta, GA)
- **Job Description** As a **Sr. Audit Recovery Auditor** , you will Utilize analytical and forensic email review skills to audit Merchandising negotiations to ... and communicate flawlessly with Merchandising and Vendors to successfully resolve claims and recover all vendor funding dollars due AutoZone. **Responsibilities**… more
- Elevance Health (Atlanta, GA)
- … chart coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise, ... experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …ready, oversee clinical trial and submission support, lead the R&D audit program, engage with regulatory authorities, and maintain clinical data integrity. ... sites, and vendors (including contract research organizations) and ensure that audit results are communicated, and appropriate corrective actions are implemented and… more
- NDCP (Duluth, GA)
- …exposure. The ideal candidate has experience adjusting workers' compensation lost time and medical only claims in an insurance company, third party administrator ... accurately NAICS coded and manage NDCP's annual WC premium audit . + Ensure the timely and accurate completion of...accurate. + Communicate, as needed, with injured employees, third-party claims representatives, medical clinics, etc. to ensure… more
- State of Georgia (Fulton County, GA)
- …AND two (2) years of clinical experience AND one (1) year experience working with medical claims . Preference will be given to applicants who hold a Bachelor's of ... any blatant compliance issues. + Accurately documents findings from audit on standard forms. + Participates in interviews of...experience; additional years of experience in the analysis of medical claims and/or claims data;… more
- Fresenius Medical Center (Jonesboro, GA)
- …or other situations change. + Completes and follows up with paperwork when claims are disputed for non-payment. + Collects necessary documents to completed initial ... work progress on caseloads; Analyzes patient reports from billing systems as an audit check to ensure the correct insurance information is entered into the billing… more
- Elevance Health (Atlanta, GA)
- …Specialist Lead** is responsible for the discovery, validation, recovery, and adjustments of claims overpayments. May do all or some of the following in relation to ... cash receipts, cash application, claims audits, collections, overpayment vendor validation, and ...collecting samples each month from each Recovery Specialists to audit for Quality. + Distributes work to staff and… more
- Highmark Health (Atlanta, GA)
- …OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality ... identified in the audits compliant with regulatory requirements. Provides written audit guidance. Participates with management in the assessment of external … more