• Claims Auditor II

    Elevance Health (Atlanta, GA)
    ** Claims Auditor II** **Location :** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... for employment, unless an accommodation is granted as required by law._ The ** Claims Auditor II** is responsible for audits of high dollar claims across… more
    Elevance Health (10/22/25)
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  • Analyst, Configuration Oversight ( Claims

    Molina Healthcare (Columbus, GA)
    …accurate and timely implementation and maintenance of critical information on all claims and provider databases, validate data housed on databases and ensure ... that the contracts are configured correctly in QNXT. The claims are reviewed to ensure that the configured services...to detect any gaps in the correct payment of claims Make recommendations for potential revision and updates *… more
    Molina Healthcare (09/17/25)
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  • Inpatient Medical Coding Auditor

    Humana (Atlanta, GA)
    …Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider ... caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns… more
    Humana (09/24/25)
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  • Independent Adjuster Auditor

    Sedgwick (Atlanta, GA)
    …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Independent Adjuster Auditor As an Independent Adjuster Auditor at Sedgwick, you'll have the ... professional needs. **PRIMARY PURPOSE** **OF THE ROLE** The Independent Adjuster Auditor reviews Independent Adjuster and other Non-Legal Vendor invoices on behalf… more
    Sedgwick (09/16/25)
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  • DRG Coding Auditor

    Elevance Health (Atlanta, GA)
    **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ _​_ This role enables associates to work virtually full-time, with the exception of required in-person training ... recover, eliminate and prevent unnecessary medical-expense spending. The **DRG CODING AUDITOR ** is responsible for auditing inpatient medical records and generating… more
    Elevance Health (10/13/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Atlanta, GA)
    **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually full-time, ... -5PM (local time) The **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG)** is responsible for...Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes… more
    Elevance Health (10/22/25)
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  • Inpatient Coding Auditor

    BayCare Health System (Atlanta, GA)
    …7:00 AM to 3:30 PM + **Days:** Monday - Friday The Inpatient Coding Auditor is a full-time remote position. _Sign on bonuses available!_ Responsibilities + The ... Inpatient Coding Auditor performs inpatient encounter audits and evaluates compliance related...Performs special audits for specific issues within facility Inpatient claims . + Acts as the Liaison for coding issues… more
    BayCare Health System (10/10/25)
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  • Specialist, Config Oversight (healthcare Medical…

    Molina Healthcare (GA)
    …Healthcare claim audits including, but not limited to; vendor, focal, audit the auditor . Confirm that documentation is clear and concise to ensure accuracy in ... auditing of critical information on claims ensuring adherence to business and system requirements of...& ABILIITIES:** + Minimum 2 years as an operational auditor for at least one core operations function +… more
    Molina Healthcare (09/24/25)
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  • VP Internal Audit

    Sedgwick (Atlanta, GA)
    …Major in accounting or technology field strongly preferred. Certified Internal Auditor (CIA), Certified Public Accountant (CPA), Certified Information Systems ... Auditor (CISA), or other professional certification designation is required....other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
    Sedgwick (10/24/25)
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