- Elevance Health (Atlanta, GA)
- ** Clinical Quality Auditor Lead ** Must Have An Active Clinical License.** Location: **Virtual** - This role enables associates to work virtually ... Hours: **Monday - Friday, 8 am to 4:30 pm Or 9 am to 5:30 pm** The ** Clinical Quality Auditor Lead ** is responsible for participating in clinical … more
- Elevance Health (Atlanta, GA)
- **Title:** Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG and APR-DRG) **Virtual:** This role enables associates to work virtually ... granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor -RN** is responsible for auditing...minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and… more
- Elevance Health (Atlanta, GA)
- … Auditor II** - all the above, plus: Independently interprets Medical Policy and Clinical Guidelines. + **Claims Auditor Senior** - all the above, plus : ... **Claims Auditor I, II and Senior** **Location :** This...trending analysis. + Provides feedback on processing errors; identifies quality improvement opportunities and initiates basic requests related to… more
- Elevance Health (Atlanta, GA)
- …DRG Coding / Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad, deep and niche knowledge of medical claims ... **DRG Coding Auditor Principal** **_Virtual: _** _ _ This role...Clinics, and the ICD-10 Alphabetic and Tabular Indices), complex clinical guidelines and maintaining objectivity in the performance of… more
- Elevance Health (Atlanta, GA)
- …(DRG) Coding/ Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment ... **Build the Possibilities. Make an Extraordinary Impact.** **Title** : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) **Virtual: ** _ _ This role enables… more
- Molina Healthcare (GA)
- …and Visio (flow chart equivalent) **PREFERRED QUALIFICATIONS:** + Degree in Preferred field: Clinical Quality , Public Health, or Healthcare + 5 years of ... program requirements and reporting and monitoring for key quality program activities. Acts as a lead ...for specific roles) + Active, unrestricted Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you… more