- 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, deep and niche knowledge of ... all lines of business, and its clients. Specializes in review of DRG coding via medical record...or appeals may only be reviewed by other DRG Coding Audit Principals (or Executives). **How you… 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
- Banner Health (GA)
- …teams with different focuses (Facility vs Profee)._ In this **Inpatient Facility-based HIMS Coding Quality Associate** position, you bring your **5 years of ... team that values growth and development! This is a Quality position, not a day-to-day coding production...audit of clinical documentation to ensure that clinical coding is accurate for proper reimbursement and that … more
- Molina Healthcare (Atlanta, GA)
- …coding principles, clinical guidelines, and objectivity in performance of medical audit activities. Draws on advanced ICD-10 coding expertise, clinical ... **Job Description** **Job Summary** The Manager, Clinical DRG Coding & Validation must have an extensive background in either facility-based nursing and/or inpatient… 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 ... Management to implement benchmarks, establish acceptable thresholds, and effective quality assurance programs. You will: + Maintain a ...assurance program + Play a key role in ensuring coding compliance and accuracy + Monitor the performance of… more
- Datavant (Atlanta, GA)
- …+ Provide monthly performance data to clients (eg, volume metrics, six-month trends, quality audit scores, and productivity levels). + Include action plans for ... educational and life experiences to realize our bold vision for healthcare. The ** Coding Operations Manager** is essential to the Provider HIM Coding division.… 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
- 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)
- …participant materials + Provide support to client relations for trainings needed for client audit findings + Research and analysis of coding error trends What ... Adjustment Trainer to help us uplevel our Risk Adjustment Coding Department through improving overall coding accuracy...learning to the work environment through various methods + Review client level audits and advise training content to… more
- Intermountain Health (Atlanta, GA)
- …and payor guidelines, and ensures consistent and compliant application with charge/ coding capture, charge editing, and audit and reimbursement practices. ... Intermountain's policies and procedures. **Essential Functions** 1.Analyze data, develop reports, review trends, and recommend enhancements as defined by the RI… more
- Datavant (Atlanta, GA)
- …KPIs such as suspecting accuracy, chart throughput, RAF impact, data latency, coding quality metrics, and client engagement. **Cross-Functional Collaboration** + ... the development of robust, scalable, and actionable analytics that improve coding outcomes, measure product impact, and support value-based client delivery across… 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
- Sumitomo Pharma (Atlanta, GA)
- …Characteristics (SmPC), and Canadian Product Monograph (PM) + Ensures timely and quality review and assessment of ICSRs, including seriousness, expectedness, ... safety narratives, adverse event coding , concomitant medication coding , and causality statements....study team meetings and governance committees. + Performs aggregate review of post-marketing safety data in support of safety… more
- PruittHealth (Blue Ridge, GA)
- …physicians to obtain accurate and complete documentation to support ICD-10-CM diagnosis coding and surgical procedures. 27. Audit and improve staff ... care plan prior to administering care. 11. Coordinates the review of each assessment/care plan for accuracy (including timeliness...payment models. 25. Serve as a member of the quality assessment and assurance (QAA) and/or the quality… more
- AIG (Atlanta, GA)
- …rating, policies, endorsements, etc.). + Performs quality control of premium audit statements prior to underwriting review ; documents discrepancies and work ... coverages and program structures, as well as internal policy coding systems to ensure account completeness. + Designated as...with the premium auditor for resolution. + Performs quality control of adjustments prior to underwriting review… more
- NTT America, Inc. (Atlanta, GA)
- …and enhancing system and process controls, and assistance with outside audit preparation. **What you'll be doing** **ESSENTIAL DUTIES & RESPONSIBILITIES** + ... proper company code, GL account, department, location, and project cost coding with appropriate supporting documentation + Continuously reviews documents and… more
- Prime Therapeutics (Atlanta, GA)
- …in accordance with procedures or to present to management to recommend for audit or investigation. Serves as a corporate resource on fraud, waste and abuse ... data to find suspicious patterns and outliers using knowledge of healthcare coding conventions, fraud schemes, and general areas of vulnerability. + Contact… more
- Cardinal Health (Atlanta, GA)
- …patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to ... interaction using the appropriate database for the inquiry + Self- audit intake activities to ensure accuracy and efficiency for...1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience + 1-2 years experience with Prior… more