- Elevance Health (Atlanta, GA)
- …based sponsorship. **Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective ... and accurate reimbursement criteria.** PRIMARY DUTIES: + Review medical record documentation in support of Evaluation and Management CPT codes. + Reviews company… more
- Elevance Health (Atlanta, GA)
- …Related Group Clinical Validation Auditor** 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 (Atlanta, GA)
- …abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. + Researches new healthcare related questions as ... an Associate Degree in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA) and minimum of 4 years related experience, including… more