- Molina Healthcare (Atlanta, GA)
- …member benefits, and medical records to document relevant findings of a post pay clinical review . This position manages documents and prioritizes case load to ... Review of applicable policies, CPT guidelines, and provider contracts. + Devise clinical summary post review . + Communicate and participate in meetings… more
- CenterWell (Marietta, GA)
- …advanced practice professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist , Quality based Coder, Referral Coordinator and more. Our approach allows ... coding specificity. . Follows policy and protocol defined by Clinical Leadership. . Meets with RMD about quality of...Leadership. . Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues.… more
- The Cigna Group (Dalton, GA)
- …make a difference** : Major Duties: Oversees and manage the administrative, clinical and operational nursing duties: CARE COORDINATION: + Support & Coordination of ... development, including but not limited to onsite preventative services, primary care/ specialist referrals for Employees WORKER'S COMPENSATION: + Case Management to… more