- Molina Healthcare (Atlanta, GA)
- **JOB DESCRIPTION** **Job Summary** The SIU Coding Investigator is responsible for investigating and resolving instances of healthcare fraud and abuse by medical ... position uses information from a tip, member benefits, and medical records to document relevant findings of a post...GED (or higher) **Required Experience** + 3+ years CPT coding experience (surgical, hospital, clinic settings) or 5+ years… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …risk areas. + Implements policies, strategies, and workflows to ensure accurate medical record documentation, professional billing and coding compliance. + ... with government and payor guidelines. + Analyzes and reviews medical record documentation and billing data for all pertinent...background preferred (ie, LPN, RN, etc.). + Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …compliance. **MINIMUM REQUIREMENTS:** + Bachelors degree required. + Current Certified Coding Specialist (CCS) or Certified Professional Coder certification ... coding , and documentation requirements, Federal and State regulations, medical necessity, clinical best practices, and facility/professional billing issues.… 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 ... of medical audit activities. + Draws on advanced ICD-10 coding expertise, mastery of clinical guidelines, and industry knowledge to substantiate conclusions. +… more
- CenterWell (Augusta, GA)
- … medical record documentation in a timely manner working with a quality- based coder to optimize coding specificity. . Follows policy and protocol defined by ... Care Coach Nurse, MA, Behavioral health specialist, Quality based Coder , Referral Coordinator and more. Our approach allows us...accordance with standards of care. . Follows level of medical care and quality for patients and monitors care… more
- CenterWell (Woodstock, GA)
- … medical record documentation in a timely manner working with a quality- based coder to optimize coding specificity. . Follows policy and protocol defined by ... Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators… more
- CenterWell (Savannah, GA)
- … medical record documentation in a timely manner working with a quality- based coder to optimize coding specificity. + Follows policy and protocol defined by ... Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators… more
- CenterWell (Decatur, GA)
- …allmedical record documentation in a timely manner working with a quality- based coder to optimize coding specificity. + Follows policy and protocol defined ... accordance with standards of care. + Follows level of medical care and quality for patients and monitors care...limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care. + Acts as… more
- 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)
- …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