- Elevance Health (Norfolk, VA)
- ** Clinical Provider Auditor II ** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and ... an accommodation is granted as required by law. The ** Clinical Provider Auditor II...or any combination of education and experience, which would provide an equivalent background. + Requires coding certification (CPC,… more
- Elevance Health (Norfolk, VA)
- ** Clinical Provider Auditor II ** **Supports the Payment Integrity line of business** **Hybrid 1** : This role requires associates to be in-office **1-2** ... Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Provider Auditor II ** is responsible for… more
- Elevance Health (Norfolk, VA)
- **Claims Auditor II ** **Location :** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... accommodation is granted as required by law._ The **Claims Auditor II ** is responsible for audits of...to Recovery Team. + Independently interprets Medical Policy and Clinical Guidelines. **Minimum Requirements :** + Requires a HS… more
- Highmark Health (Richmond, VA)
- …coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure ... meetings and interacts with management to resolve issues and provide advice on new programs. Provides guidance to system...+ Validates the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems, missed secondary diagnoses and… more
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