- Emory Healthcare/Emory University (Atlanta, GA)
- …of Compliance and Compliance Operations, Compliance and Privacy Operations, Compliance and Audit Analysis, and Compliance Audit and Analysis. + Provides ... and updating privacy and compliance policies + Supports regulatory and internal audit requests and documentation + Assists with compliance review of Business… more
- Highmark Health (Atlanta, GA)
- …or Medical Review Committee. + Engages in delivery of audit results and overpayment negotiations.Responsible for recovery/ savings of misappropriated funds paid ... for proactive and investigative purposes to comply with internal audit and regulatory requirements. **ESSENTIAL RESPONSIBILITIES** + Performs investigations into… more
- Banner Health (GA)
- …researching authoritative reference information from a variety of sources. 2. Reviews medical records. Performs an audit of clinical documentation to ensure ... you. **Requirements:** + **5 years recent experience in acute-care Inpatient facility-based medical coding (clearly reflected in your attached resume);** + **DRG and… more
- Elevance Health (Atlanta, GA)
- …claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy. + Prepares correspondence to providers ... not eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical… more
- Aveanna Healthcare (Atlanta, GA)
- …FriendBack Job Details Requisition #: 207353 Location: Atlanta, GA 30339 Category: Medical Billing/Collections Salary: $19.00 - $22.00 per hour Position Details Join ... any and all guarantors for services provided. This is inclusive of claims to commercial, Medicare, Medicaid and private pay accounts. Essential Job Functions… more
- Sunrise Senior Living (Acworth, GA)
- …internal business controls. + Process and manage unemployment and worker's compensation claims and update claim activity as necessary. + Clearly communicate and ... completed for each business area. + Assist in providing audit materials and information as requested. + Meet business...also offer benefits and other compensation that include: + Medical , Dental, Vision, Life, and Disability Plans + Retirement… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …with Sales and Marketing on sample allocation and planning. + Support audit readiness and compliance reviews. **Operational Efficiency & Field Partnership** + ... with states and local laws. **Company benefits** : Comprehensive medical , dental, vision, prescription drug coverage, company provided basic...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Aveanna Healthcare (Atlanta, GA)
- …any and all guarantors for services provided. This is inclusive of claims to commercial, Medicare, Medicaid and private pay accounts. Essential Job Functions ... correct and update EMR. Works with Biller to ensure claims are refiled and/or billed to the second insurance...Computer literate and ability to type, file and maintain audit records. Preferences List Other Skills/Abilities Must be able… more
- Molina Healthcare (Savannah, GA)
- …the likelihood of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, ... programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and...+ Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager… more
- Mass Markets (GA)
- …+ Maintain compliance with internal policies, accounting standards (GAAP/IFRS), and audit requirements. + Monitor and improve accounting processes and systems to ... and external audits by preparing required documentation and responding to audit inquiries. + Collaborate with FP&A, operations, and other cross-functional teams… more