- Elevance Health (Atlanta, GA)
- …and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately ... related questions as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations. +… more
- Molina Healthcare (Savannah, GA)
- …to reduce the likelihood of a formal appeal being submitted. * Reevaluates medical claims and associated records independently by applying advanced clinical ... - 5:00pm Central time Remote position **Essential Job Duties** * Performs clinical/ medical reviews of previously denied cases in which a formal appeals request… more
- Pearle Vision (Gainesville, GA)
- … office administrator, medical billing and collections, appointment scheduler or medical records clerk and direct patient care. ESSENTIAL DUTIES AND ... patients * Answering telephones * Updating and maintaining Electronic Medical Records * Obtaining insurance verification and...claim forms * Patient and insurance billing * Optometric medical billing and coding * Vision insurance… more
- WTW (Atlanta, GA)
- …retirement business and technology. The ideal candidate will have hands-on experience coding systems and a deep understanding of market technology. This role is ... + Strong background in product and technology development, with hands-on experience coding systems. + Deep understanding of market technology and the ability to… more
- Datavant (Atlanta, GA)
- …for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized system, ... Review, analyze, and code diagnostic information in a patient's medical record based on client specific guidelines for the...guidelines. + Coders must meet and maintain a 95% coding accuracy rate. + Any other task requested by… more
- PwC IT Services Co. (Atlanta, GA)
- …contribute to root cause analysis. Participate in architecture decisions, enforce coding standards, and promote development best practices. Required Skills & ... Analysis, C#.NET, C++ Programming Language, Client Management, Code Review, Coding Standards, Communication, Computer Engineering, Computer Science, Continuous Integration/Continuous… more
- Prime Therapeutics (Atlanta, GA)
- …of pharmacy benefit structures, drug pricing and claims processing + Familiarity with drug coding systems (NDC) and medical coding (ICD, CPT, HCPCS) ... and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance… more
- CVS Health (Atlanta, GA)
- …is a full time role and is ideal for a data professional with strong coding skills in SQL and Python who can transform complex healthcare data into actionable ... findings to non-technical audiences. + 2+ years experience interpreting medical claim data + Advanced experience in SQL &...claim data + Advanced experience in SQL & Python coding sourcing from a data warehouse + 3+ years… more
- CVS Health (Atlanta, GA)
- …in business/health administration preferred. + 2-3 project management background. + Medical billing and coding certification. **Education** + College degree ... The analyst will also support financial operations through invoice tracking and coding validation, contributing to accurate and timely billing processes. This role… more
- CVS Health (Atlanta, GA)
- …waste, and abuse investigatory and audits required. * Knowledge of CPT/HCPCS/ICD coding *Proficiency in Word, Excel, MS Outlook products, Database search tools, and ... years Medicaid Fraud, Waste and Abuse investigatory experience. * Billing and Coding certifications such as CPC (AAPC)and/or CCS (AHIMA) * Knowledge of Behavioral… more