- Elevance Health (Atlanta, GA)
- …considered._ The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) ... of business, and its clients. Specializes in review of DRG coding via medical record and attending physician's statement provided by acute care hospitals on paid… more
- Molina Healthcare (Atlanta, GA)
- …trends and patterns, and the ability to present those findings. **Preferred License, Certification , Association** + AAPC Certified Medical CPC, CPMA, CPCO or ... for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position uses information from a tip, member benefits, and… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …risk areas. + Implements policies, strategies, and workflows to ensure accurate medical record documentation, professional billing and coding compliance. + Serves as ... is compliant with government and payor guidelines. + Analyzes and reviews medical record documentation and billing data for all pertinent internal and external… more
- Elevance Health (Atlanta, GA)
- …**Minimum Requirements:** + Requires an Associate Degree in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA) and ... abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. + Researches new healthcare related questions as… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …ensuring the accuracy of DRGs. This individual will: + Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits the ... + Reviews discrepancies between the Clinical Documentation Specialist (CDS) DRG and the Coder DRG. + Reviews non-CC/MCC records to determine if record was miscoded… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …Bachelors degree required. + Current Certified Coding Specialist (CCS) or Certified Professional Coder certification required. + Minimum of five to seven (5-7) ... billing, coding, and documentation requirements, Federal and State regulations, medical necessity, clinical best practices, and facility/professional billing issues.… more