- Northeast Georgia Health System, Inc (Oakwood, GA)
- …coding knowledge ie American Academy of Professional Coders, Professional Medical Coding Curriculum, NGPG Compliance Proficiency training, specialty ... the medical necessity of services, compliance with other documentation, coding and billing standards. CEQAs apply standardized audit scoring methodology to… more
- MultiPlan (Atlanta, GA)
- …mining and coordination of benefits techniques to client paid claims data.3. Evaluate medical claims for coding and pricing errors using accurate HCPCS, ICD-10, ... people come to shine! JOB SUMMARY: This role reviews medical paid claims against provider contracts and policies to...of benefit techniques to analyze and audit hospital and physician claims to identify errant claim payments. JOB ROLES… more
- Emory Healthcare/Emory University (Atlanta, GA)
- **Overview** + Ability to analyze medical record notes to ensure correct coding , billing compliance and complete charge capture. + Ability to research regulatory ... ICD-10 CM coding . + Certified as a coding specialist (CCS), coding specialist physician...billed codes by applying appropriate CPT and ICD-10 CM coding and governmental guidelines. + Formulates recommendations based… more
- Highmark Health (Atlanta, GA)
- …using skills including but not limited to Hierarchical Condition Category (HCC) Coding , medical coding , clinical terminology and anatomy/physiology, Centers ... with different MA, ESRD, and ACA HCC Models; works independently in various coding applications and electronic medical record systems to support departmental… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …programs and more! **Description** We are seeking an experienced **Inpatient DRG Coding Auditor** to extract data from patient encounters ensuring the accuracy of ... DRGs. This individual will: + Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits the accuracy and completeness of… more
- CenterWell (Marietta, GA)
- …health first** The Primary Care Physician (PCP) works as a lead in our team- based care environment. We are a value based care provider focused on quality of ... accordance with standards of care. + Follows level of medical care and quality for patients and monitors care...documentation in a timely manner working with a quality- based coder to optimize coding specificity. +… more
- Morehouse School Of Medicine (Atlanta, GA)
- Medical Coder Bookmark this Posting | Print Preview...B. Certified Coding Specialist (CCS) C. Certified Coding Specialist- Physician Based (CCS-P) + ... place of distinction, serving as the nation's leading academic medical center for vulnerable populations. It's also a place...experience or a minimum of five (5) years of coding experience in a physician billing Revenue… more
- Intermountain Health (Atlanta, GA)
- …reimbursement. Scope 1.Assigns ICD, CPT and HCPCS coding classifications based on clinical documentationand/or physician orders. Utilizes appropriate tools, ... from physicians, clinical departments and others on documentation questions, as needed. Performs coding at an at an intermediate level coding complexity. 2.… more
- Intermountain Health (Atlanta, GA)
- …Common Procedural Coding System (HCPCS) coding classifications based on clinical documentation and/or physician orders. Utilizes appropriate tools, ... from physicians, clinical departments, and others on documentation questions as needed. Performs coding at an intermediate level of coding complexity to ensure… more
- Humana (Atlanta, GA)
- … Director relies on medical background and reviews health claims. The Medical Director (Staff Geriatrician or Physician with Ten (10) Years of Clinical ... and will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer based review of moderately complex to… more
- Universal Health Services (Lawrenceville, GA)
- …Qualifications + High School diploma or equivalent required. + Associates in Medical Coding preferred. + Successful completion or current enrollment in ... + Assigns appropriate ICD-10-CM diagnosis and ICD-10-PCS procedure codes based on documentation, identifies the principal diagnosis and secondary...an AHIMA or AAPC approved medical coding certifications(s) in good standing. +… more
- Emory Healthcare/Emory University (Decatur, GA)
- … encounters to ensure the highest level of code accuracy based on physician documentation. + Uses clinical coding expertise based on the Official ... or CPC, CPC-H, CCA, RHIA, RHIT, CCS, CCS-P certified. + Must complete coding proficiency evaluation. + Anatomy and physiology, medical terminology, clinical… more
- Humana (Atlanta, GA)
- …and will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer based review of moderately complex to ... The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities,… more
- Humana (Atlanta, GA)
- …will understand how to operationalize this knowledge in their daily work The Medical Director's work includes computer- based review of moderately complex to ... The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities,… more
- CVS Health (Atlanta, GA)
- …Level Appeals / Special Projects and Committee participation when needed. + The Medical Director will provide clinical, coding , and reimbursement expertise as ... Health Plan / Payor. Previous UM experience as a Physician Advisor in a Health / Hospital system. Board...law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief,… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …Education and relevant stakeholders. + Work closely with multidisciplinary teams including Coding DRG Auditors and second level physician reviewers to justify ... illness, risk of mortality and risk adjustment factors during inpatient medical record review. Audits will be conducted retrospective (post-discharge, pre-bill) once… more
- Fresenius Medical Center (Decatur, GA)
- …developing educational or promotional materials, providing education to the physician practice clients. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Responsible for ... to ensure patient safety, conduct peer review, and evaluate outcomes based payment methodologies. + Proactively communicates to Regional Practice Administrator and… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …closely with revenue cycle and supply chain management teams to optimize coding , documentation, and cost-saving initiatives. + Overall, this role requires a ... department. + The position collaborates closely with the senior and executive physician and administrative leaders across the system. + In addition, the position… more
- Emory Healthcare/Emory University (Atlanta, GA)
- **Overview** Our Nurse Practitioners and Physician Assistants are an integral part of the Emory Healthcare integrated academic health care system. Some highlights of ... of CT Surgery is seeking an experienced Acute Care Nurse Practitioner or Physician Assistant for the Cardiac Surgery Inpatient Lead position. The responsibilities of… more
- Intermountain Health (Atlanta, GA)
- …severity of illness of patients through improved clinical documentation and diagnostic coding practices. Job Essentials Reviews medical records documentation for ... maintains accurate records to document costs and benefits. Facilitates and enhances the coding and diagnosis-related group between physician and coding … more
