• 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 ... 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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  • Inpatient DRG Coding Auditor

    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
    Emory Healthcare/Emory University (06/06/25)
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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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  • Clinical Fraud Investigator II

    Elevance Health (Atlanta, GA)
    …and 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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  • 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)
    …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 (06/18/25)
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