- Humana (Atlanta, GA)
- …internal and external stakeholders. + Provider outreach to close care gaps, audit records to identify improvement opportunities, and abstract data from records to ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Humana (Atlanta, GA)
- …operational goals, including regulatory compliance requirements + Promotes and builds an " Audit Ready Every Day" culture + Further simplifies and improves processes ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Fresenius Medical Center (Brunswick, GA)
- …as directed. + Participates in medical records, infection control, and other audit processes as directed. + Actively collaborates with others during staff huddles ... diploma or GED required. + Must meet Centers for Medicaid and Medicare Services (CMS)-approved state and/or national certification requirements within the required… more
- Humana (Atlanta, GA)
- …+ Building working relationships with internal stakeholders and supporting external audit preparation efforts. + Demonstrating an understanding of departmental and ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Cardinal Health (Atlanta, GA)
- …for reporting any payer issues to the appropriate team + Must self- audit activities to ensure accuracy and efficiency for the program **_Qualifications_** + ... benefit investigations, prior authorizations, and appeals, preferred + Knowledge of Medicare , Medicaid and Commercially insured payer common practices and policies,… more
- Molina Healthcare (Columbus, GA)
- …MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the ... + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management… more
- Waystar (Atlanta, GA)
- …ensure proper interpretation and implementation of compensation plans. + Validate and audit data inputs from CRM systems (eg, Salesforce), ERP, and payroll systems ... hospitals and health systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out our organizational values:… more
- BrightSpring Health Services (Valdosta, GA)
- …+ Achieves 95% or greater accuracy rate on transactions keyed based on quarterly audit + Ensures each completed batch cover sheet total balances to the postings in ... of exact job experience + At least two years' experience in a Medicare certified Home Health/Hospice environment that routinely bills insurance + Strong ability to… more