• Vendor Resource Management Manager

    HCA Healthcare (Savannah, GA)
    …educated + Reviews all official data quality standards, coding guidelines, company policies and procedures, and clinical/ medical resources to assure ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
    HCA Healthcare (09/27/25)
    - Related Jobs

  • Mgr II Grievance/Appeals- Medical Coding

    Elevance Health (Atlanta, GA)
    …support overall QI program and meet regulatory compliance/accreditation and the company standards. + Hires, trains, coaches, counsels, and evaluates performance of ... background. **Preferred Skills, Capabilities and Experience:** + Certified Professional Coder -AAPC Please be advised that Elevance Health only accepts resumes… more
    Elevance Health (09/24/25)
    - Related Jobs

  • HIM - Inpatient Coding Supervisor (remote)

    Guidehouse (Atlanta, GA)
    …by analyzing documentation and discussing correct code assignment. + Reviews medical records flagged through the SMART (Inpatient and Outpatient tools) software ... for patterns of coding errors and opportunities for coder and /or clinical education. + Serves as a...any other EHR + Knowledge of Anatomy, Physiology and Medical Terminology The annual salary range for this position… more
    Guidehouse (08/19/25)
    - Related Jobs

  • 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, ... impact:** + Investigates potential fraud and over-utilization by performing medical reviews via prepayment claims review and post payment...service operations as well as other areas of the company relative to claims reviews and their status. +… more
    Elevance Health (09/30/25)
    - Related Jobs

  • 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)
    - Related Jobs

  • 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)
    - Related Jobs

  • 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)
    - Related Jobs

  • 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)
    - Related Jobs

  • HIM ProFee Auditing Specialist FT

    Datavant (Atlanta, GA)
    Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the ... Will Do:** + Performs Professional Fee coding audits of medical records and abstracts using ICD-10-CM, CPT, HCPCS, and...to ensure departmental workflow and case resolution + Provides coder education via the auditing process + Function in… more
    Datavant (09/13/25)
    - Related Jobs

  • Outpatient Audit Specialist

    Datavant (Atlanta, GA)
    Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the ... Will Do:** + Performs Outpatient Facility coding audits of medical records and abstracts using ICD-10-CM, CPT, HCPCS, and...to ensure departmental workflow and case resolution + Provides coder education via the auditing process + Function in… more
    Datavant (09/13/25)
    - Related Jobs