- Molina Healthcare (Atlanta, GA)
- …with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG with a broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement ... in reimbursement guidelines specifically related to MS-DRG, AP-DRG and APR-DRG payment systems . Key participant in the development and implementation of the DRG… more
- Elevance Health (Atlanta, GA)
- …coding or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement ... 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 (Atlanta, GA)
- …assurance environment preferred. + Broad, deep and niche knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement ... considered._ The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG)… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …degree required. + Current Certified Coding Specialist (CCS) or Certified Professional Coder certification required. + Minimum of five to seven (5-7) years of ... + Proficient in MDAudit Enterprise software and Epic electronic health record systems . + Thorough knowledge of coding documentation improvement practices. + Thorough… more
- Elevance Health (Atlanta, GA)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems , provider billing ... Related Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs… more
- Molina Healthcare (Atlanta, GA)
- …for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position uses information from a tip, member benefits, and ... medical records to document relevant findings of a post...registered nurse (RN), Licensed practical nurse (LPN) and/or Certified Coder (CPC, CCS, and/or CPMA) **Preferred Education** Bachelor's degree… more
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