• Investigator

    Highmark Health (Atlanta, GA)
    …to prevent further improper payments.Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. + Responsible for ... to internal and external law enforcement and regulatory agencies, Credentialing or Medical Review Committee. + Engages in delivery of audit results and overpayment… more
    Highmark Health (09/10/25)
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  • Compliance Audit Manager

    Cardinal Health (Atlanta, GA)
    …detection and correction of documentation, coding, and billing errors and/or medical necessity of services billed. Particular areas of focus include: evaluation ... physicians, physician leadership, senior leadership, management, and staff; physician and coder education; and the making of recommendations for corrective action to… more
    Cardinal Health (08/27/25)
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  • Primary Care Physician

    CenterWell (Stone Mountain, GA)
    …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... accordance with standards of care. . Follows level of medical care and quality for patients and monitors care...in a timely manner working with a quality- based coder to optimize coding specificity. . Follows policy and… more
    CenterWell (08/29/25)
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  • Nurse Audit Senior (Operating Room)

    Elevance Health (Atlanta, GA)
    …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending." The **Nurse Audit Senior** is responsible for identifying, ... make an impact:** + Investigates potential fraud and over-utilization by performing medical reviews via prepayment claims review and post payment auditing. +… more
    Elevance Health (09/30/25)
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  • Primary Care Physician

    CenterWell (Scottdale, GA)
    …treats center patients in accordance with standards of care. + Follows level of medical care and quality for patients and monitors care using available data and ... limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care. + Acts as...in a timely manner working with a quality- based coder to optimize coding specificity. + Follows policy and… more
    CenterWell (08/09/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Atlanta, GA)
    …(CDI, MS-DRG, AP-DRG and APR-DRG)** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs ... you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of … more
    Elevance Health (09/23/25)
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  • HIM ProFee Auditing Specialist FT

    Datavant (Atlanta, GA)
    …**What You Will Do:** + Performs Professional Fee coding audits of medical records and abstracts using ICD-10-CM, CPT, HCPCS, and modifiers and appropriate ... to ensure departmental workflow and case resolution + Provides coder education via the auditing process + Function in...EMRs **What We Offer:** + Benefits for Full-Time employees: Medical , Dental, Vision, 401k Savings Plan w/match, 2 weeks… more
    Datavant (09/13/25)
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  • Outpatient Audit Specialist

    Datavant (Atlanta, GA)
    …I&I** **What You Will Do:** + Performs Outpatient Facility coding audits of medical records and abstracts using ICD-10-CM, CPT, HCPCS, and modifiers and appropriate ... to ensure departmental workflow and case resolution + Provides coder education via the auditing process + Function in...EMRs **What We Offer:** + Benefits for Full-Time employees: Medical , Dental, Vision, 401k Savings Plan w/match, 2 weeks… more
    Datavant (09/13/25)
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  • Inpatient Audit Specialist

    Datavant (Atlanta, GA)
    …cases concurrently to ensure optimal workflow and turnaround time + Provides coder education via the auditing process + Function in a professional, efficient, ... EMRs. **What We Offer:** + Benefits for Full-Time employees: Medical , Dental, Vision, 401k Savings Plan w/match, 2 weeks...exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its… more
    Datavant (08/13/25)
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  • Inpatient Audit Specialist

    Datavant (Atlanta, GA)
    …cases concurrently to ensure optimal workflow and turnaround time + Provides coder education via the auditing process + Function in a professional, efficient, ... EMRs. **What We Offer:** + Benefits for Full-Time employees: Medical , Dental, Vision, 401k Savings Plan w/match, 2 weeks...exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its… more
    Datavant (07/29/25)
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