- HCA Healthcare (Savannah, GA)
- **Description** **Introduction** Do you want to join an organization that invests in you as a Coding Quality Audit Reviewer ? At Parallon, you come first. ... make a difference. We are looking for a dedicated Coding Quality Audit Reviewer...result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to… more
- Elevance Health (Atlanta, GA)
- …based DRG Coding / Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge of medical claims ... medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review...information to make audit determinations and generate audit findings letters. + Maintains accuracy and quality… more
- Intermountain Health (Atlanta, GA)
- …creates appeals for all payer and regulatory denials and downgrades and provides in-depth coding review , audit findings, and appeal strategies. + Develops ... **Job Description:** The HIM Coding Audit Training Analyst Coordinator provides...coding patterns and trends. + Participates in hospital quality improvement initiatives to assure accurate reimbursement + Participates… more
- CVS Health (Atlanta, GA)
- …all with heart, each and every day. **Position Summary** Responsible for performing quality inter-rater review audits of medical records coded by internal team ... Minimum of 2 years recent and related experience in medical record documentation review , diagnosis coding , and/or auditing **Preferred Qualifications** + 5 years… more
- Banner Health (GA)
- …coding background to a team that values growth and development!** **This is a Quality position, not a day-to-day coding production role but does require ... coding proficiency and recent Hospital Facility Coding experience.** This position is task-production-oriented ensuring ...audit of clinical documentation to ensure that clinical coding is accurate for proper reimbursement and that … more
- Datavant (Atlanta, GA)
- …provide superior quality by performing audits pertaining to risk adjustment coding efforts. The individual will be responsible for daily operations pertaining to ... closely with Management to implement benchmarks, establish acceptable thresholds, and effective quality assurance programs. **You will:** + Maintain a quality … more
- Datavant (Atlanta, GA)
- …you will be instrumental in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding ... references for accurate DRG and APC assignment. + Review non-CC/MCC records to assess proper coding ...appropriate manager. + Prepare the final reports for the coding audit and actively participates in the… more
- Coinbase (Atlanta, GA)
- …and fully supported. *_* *Team / Role Paragraph:* Coinbase is looking for an Internal Audit IT Senior to join the Internal Audit team focusing primarily on ... US (Remote) and will be reporting to an Internal Audit IT Senior Manager. The individual will be responsible...to maximize meetings utility, testing efficiencies and internal controls review coverage across the organization. * Serve as a… more
- Grant Thornton (Atlanta, GA)
- …and help you achieve more, confidently. Your day-to-day may include: + Review operational, financial, and administrative processes to assess risk, internal control, ... include but are not limited to co-sourced and outsourced internal audit , internal control assessments, enterprise risk management program assessments, tests of… more
- Molina Healthcare (Columbus, GA)
- …on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding . **Job Summary** Utilizing clinical knowledge and experience, ... decision making pertinent to clinical experience + Documents clinical review summaries, bill audit findings and ...two years of experience in Claims Auditing, Medical Necessity Review and Coding experience + Familiar with… more
- Datavant (Atlanta, GA)
- …and acting on undiagnosed conditions (prospective suspecting) and ensuring risk adjustment coding accuracy in near real-time (concurrent review ). You will manage ... regulations and best practices related to prospective risk capture and concurrent review . **Compliance & Quality :** + Partner with Legal, Compliance, and… more
- Elevance Health (Atlanta, GA)
- …letters. + Maintains accuracy and quality standards as established by audit management. + Identifies potential documentation and coding errors by recognizing ... the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How...clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding… more
- Datavant (Atlanta, GA)
- …preferably within an academic medical facility. + Experience with significant level of coding quality review feedback + Experience in computerized encoding ... codes from patient records, ensuring precision and adherence to documentation + Oversee and audit the work of Level 1 & 2 Coders, where applicable + Champion… more
- CGI Technologies and Solutions, Inc. (Atlanta, GA)
- …on various payment integrity domains, including pre-payment review , post-payment audit , FWA detection and prevention, coding accuracy, clinical integrity, ... on various payment integrity domains, including pre-payment review , post-payment audit , FWA detection and prevention, coding accuracy, clinical integrity,… more
- Grant Thornton (Atlanta, GA)
- …+ Perform engagement management responsibilities, including project scheduling, financial oversight, quality review , and client relationship management. + Lead ... to reach your own professional goals. Your day-to-day may include: + Review operational, financial, and technology processes to provide management with a… more
- STG International (Milledgeville, GA)
- …facility surveys (inspections) made by authorized government agencies as requested. + Audit nursing documentation in the clinical record for appropriate and relevant ... + Attend and contribute in facility "triple check" process for reviewing coding for accuracy. + Perform administrative duties such as completing medical forms,… more
- Coinbase (Atlanta, GA)
- …monitoring or risk treatment. * Maintain source of truth risk register: Quality control of data, tooling support, and implementing automation/process improvements to ... for risks, assessments, and reporting to meet regulatory requirements. * Support audit and regulatory inspections: Support data compilation to respond to US and… more
- Truist (Atlanta, GA)
- …English (Required) **Work Shift:** 1st shift (United States of America) **Please review the following job description:** Key senior leader to the Truist second ... focus on the oversight of Data Assessment regarding data quality and completeness as it impacts critical various of...Lifecycle within a complex financial organization. 15.. Knowledge of coding , data tools and platforms used for managing, storing,… more
- CenterWell (Savannah, GA)
- …inquiries, requests, and complaints from patients + Ongoing chart review / audit of clinical staff to ensure quality care and identifying opportunities for ... / disease + prevalence / appropriate levels of clinical quality care + Providing guidance to individual clinicians about...quality indicators + Good understanding of best practice coding and documentation in value based environment + Leveraging… more
- Molina Healthcare (GA)
- …Utilization Management and Long-Term Services & Supports issues. + Identifies and reports quality of care issues. + Prepares and presents cases in conjunction with ... specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service...pharmacy, etc.). + Experience demonstrating knowledge of ICD-9, CPT coding and HCPC. + Experience demonstrating knowledge of CMS… more