- Datavant (Atlanta, GA)
- …As an Auditor , HCC Risk Adjustment Coder, you will review medical records to identify and code diagnoses using a standardized system, ensuring accurate ... to the table:** + Minimum 3 years of HCC coding experience + Minimum 2 years of HCC Auditing...Medicare, commercial, and Medicaid sectors. + In-depth knowledge of medical terminology, abbreviations, pharmacology, and disease processes. + Ability… more
- Elevance Health (Atlanta, GA)
- …you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This...medical audit activities. + Draws on advanced ICD-10 coding expertise, mastery of clinical guidelines, and industry knowledge… more
- Elevance Health (Atlanta, GA)
- …related questions as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations + ... Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Provider Auditor I**...Requires a AA/AS and minimum of 1 year related medical coding /auditing experience; or any combination of… more
- Elevance Health (Atlanta, GA)
- …related questions as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations. + ... **Clinical Provider Auditor II** **Location:** _Hybrid1:_ This role requires associates...+ Requires a AA/AS and minimum of 3 years medical coding /auditing experience, including minimum of 1… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …coding , and documentation requirements, Federal and State regulations, medical necessity, clinical best practices, and facility/professional billing issues. ... Reporting to the Director, Compliance Audit and Analysis, the Sr. Compliance Auditor will develop and execute audit, monitoring, and education for both facility… more
- HCA Healthcare (Savannah, GA)
- …of our team. **Job Summary and Qualifications** As a work from home Inpatient Coding Auditor , you will be responsible for performing internal quality assessment ... guidelines and policy + Demonstrates and applies expert level knowledge of medical coding practices and concepts + Participates on special reviews or projects +… more
- Datavant (Atlanta, GA)
- …1 facility. SMART software experience preferred. **You Will:** + Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and appropriate ... will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education,… more
- Molina Healthcare (GA)
- …Healthcare claim audits including, but not limited to; vendor, focal, audit the auditor . Confirm that documentation is clear and concise to ensure accuracy in ... modules within the core processing system (QNXT). * Conducts focal healthcare Medical claim audits on samples of processed transactions impacted by these… more
- Coinbase (Atlanta, GA)
- …importance of controls, an effective control environment, and the role of Internal Auditor . * Promote new ideas / innovative means of executing projects and internal ... Google Suite or MS Excel, Word and PowerPoint. * Basic scripting experience in coding languages such as Python, Ruby, etc. *Nice to haves:* * Professional Internal… more
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