- Molina Healthcare (Columbus, GA)
- …documentation for denial and modification of payment decisions + Independently re-evaluates medical claims and associated records by applying advanced clinical ... and coding experience. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Certified Clinical Coder , Certified Medical Audit Specialists, Certified Case Manager… more
- CenterWell (Atlanta, GA)
- …professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist, Quality based Coder , Referral Coordinator and more. Our approach allows us to provide an ... 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
- CVS Health (Atlanta, GA)
- …the team in determining correct coding and appropriate documentation during the review of medical records . This role requires a strong focus on meeting state, ... Coder (CPC) Manager will oversee a team of medical coders within the Special Investigations Unit (SIU) to...that may warrant a prepayment review. + Maintain appropriate records , files, and documentation for the team. + Utilize… more
- Elevance Health (Atlanta, GA)
- …-expense spending. The **DRG CODING AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the ... its clients. Also responsible for performing clinical reviews of medical records and other documentation to evaluate...Certified Coding Specialist and/or CIC as a Certified Inpatient Coder . + Requires 5 years of experience working with… more
- CVS Health (Atlanta, GA)
- …every day. **Position Summary** + Responsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes ... all State and Federal regulations and internal policies and procedures. + Utilize medical records to ensure support is documented for etiology and manifestations… more
- Elevance Health (Atlanta, GA)
- …Related Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions ... you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of … more
- Emory Healthcare/Emory University (Atlanta, GA)
- …ensuring the accuracy of DRGs. This individual will: + Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits ... between the Clinical Documentation Specialist (CDS) DRG and the Coder DRG. + Reviews non-CC/MCC records to determine if record was miscoded or if additional… more
- Molina Healthcare (GA)
- …the likelihood of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, ... more of the following: + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional… more
- CenterWell (Atlanta, 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 (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