• DRG Coding Auditor

    Elevance Health (Atlanta, GA)
    …Clinical Validation Audit setting or hospital coding or quality assurance environment preferred . + Broad knowledge of medical claims billing/payment systems ... be considered._ The **DRG CODING AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of… more
    Elevance Health (06/24/25)
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  • Investigator, Coding SIU

    Molina Healthcare (Atlanta, GA)
    …Licensed registered nurse (RN), Licensed practical nurse (LPN) and/or Certified Coder (CPC, CCS, and/or CPMA) ** Preferred Education** Bachelor's degree ... or identify trends and patterns, and the ability to present those findings. ** Preferred License, Certification, Association** + AAPC Certified Medical CPC, CPMA,… more
    Molina Healthcare (06/19/25)
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  • Primary Care Physician

    CenterWell (Woodstock, 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 (06/21/25)
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  • Primary Care Physician

    CenterWell (Savannah, 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 (05/22/25)
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  • DRG Coding Auditor Principal

    Elevance Health (Atlanta, GA)
    … preferred . + Broad, deep and niche knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, billing ... considered._ The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG)… more
    Elevance Health (06/05/25)
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  • Diagnosis Related Group Clinical Validation…

    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 (06/10/25)
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  • Manager, Compliance Audit & Analysis

    Emory Healthcare/Emory University (Atlanta, GA)
    …background preferred (ie, LPN, RN, etc.). + Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) credentials required. + Certification in ... + Implements policies, strategies, and workflows to ensure accurate medical record documentation, professional billing and coding compliance. +...Health Care Compliance preferred . + Minimum of five (5) years of experience… more
    Emory Healthcare/Emory University (04/30/25)
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  • Physician - CenterWell - Wesley Chapel

    CenterWell (Decatur, 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 (06/06/25)
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  • Provider Reimbursement Adm-CPC

    Elevance Health (Atlanta, GA)
    …background. ** Preferred Skills, Capabilities and Experience:** + Certified Professional Coder (CPC) CEMC and CEDC encouraged. Please be advised that Elevance ... based sponsorship. **Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective… more
    Elevance Health (06/18/25)
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  • Clinical Fraud Investigator II

    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
    Elevance Health (06/21/25)
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