- 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 ... accommodation is granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor -RN** is responsible for auditing inpatient medical records… more
- Elevance Health (Atlanta, GA)
- ** Clinical Provider Auditor I** **Location** : We prefer any of the following cities/States: Woodland Hills, CA; Denver, CO; Miami, FL; Tampa, FL; Atlanta, ... an accommodation is granted as required by law. The ** Clinical Provider Auditor I** is...or any combination of education and experience, which would provide an equivalent background. Must achieve coding certification (CPC,… more
- CGI Technologies and Solutions, Inc. (Atlanta, GA)
- **Remote Senior Inpatient Auditor - MS-DRG & Clinical Validation** **Category:** Analytics and Emerging Digital Technologies **Main location:** United States, ... **Employment Type:** Full Time **Position Description:** CGI is seeking a high-caliber MS-DRG Auditor to join our Healthcare Compliance Team. In this role, you will… more
- Centene Corporation (Atlanta, GA)
- … documentation, and modify business processes to measure member outcomes. Assess provider performance and quality of care through clinical case reviews. ... + Lead clinical audits for provider medical records both remotely via electronic medical records...quality services + Lead case reviews to assess the clinical performance provided in the provider network,… more
- Humana (Atlanta, GA)
- …our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and ... codes (eg, ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis… more
- Elevance Health (Atlanta, GA)
- **Nurse Auditor Senior - Payment Integrity Complex and Clinical Audit** **Location:** This role enables associates to work virtually full-time, with the ... providers through prepayment claims review, post payment auditing, and provider record review. **How you will make an impact:**...AS in nursing and minimum of 4 years of clinical nursing experience; or any combination of education and… more
- Humana (Atlanta, GA)
- …our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct ... are met (eg, ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor 's work assignments are varied and frequently require interpretation...to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …more **Work Location:** Atlanta, GA **Description** + The Corporate Director Compliance Auditor - Healthcare Provider provides expert leadership in evaluating ... career and be what you want to be. We provide : + Comprehensive health benefits that start day 1...and strengthening the organization's compliance program across clinical , billing, privacy, and operational domains. + This role… more
- Elevance Health (Atlanta, GA)
- **DRG Coding Auditor Principal** **_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 Principal** is responsible for auditing inpatient medical records on… more
- Elevance Health (Atlanta, GA)
- …**Build the Possibilities. Make an Extraordinary Impact.** **Title** : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) **Virtual: ** _ _ This role enables ... reside within a commuting distance from an office.** The **DRG Coding Auditor ** is responsible for auditing inpatient medical records and generating high quality… more