- 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
- Elevance Health (Atlanta, GA)
- **Clinical Compliance Medical Director** _Please note that per our policy t_ _his role enables associates to work virtually full-time, with the exception of required ... an accommodation is granted as required by law._ The **Clinical Compliance Medical Director** is responsible for providing clinical guidance related to the company's… 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, HCPCS and ICD-10 code. +… 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
- Guidehouse (Atlanta, GA)
- …cases by analyzing documentation and discussing correct code assignment. + Reviews medical records flagged through the SMART (Inpatient and Outpatient tools) ... software for patterns of coding errors and opportunities for coder and /or clinical education. + Serves as a...any other EHR + Knowledge of Anatomy, Physiology and Medical Terminology The annual salary range for this position… more
- Elevance Health (Atlanta, GA)
- …background. **Preferred Skills, Capabilities and Experience:** + Certified Professional Coder -AAPC Please be advised that Elevance Health only accepts resumes ... and incentive bonus programs (unless covered by a collective bargaining agreement), medical , dental, vision, short and long term disability benefits, 401(k) +match,… more
- Cardinal Health (Atlanta, GA)
- …to work in a team environment and perform multi-job functions. + Knowledge of medical terminology and electronic medical records . + Professional and/or ... requirements. + Facilitates assigning of ICD-9 and ICD-10 codes by analyzing patient medical records . + Availability to assist with research of denied claims.… more
- Elevance Health (Atlanta, GA)
- …Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG)** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and ... 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
- CenterWell (Stone Mountain, 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