- Centene Corporation (Atlanta, GA)
- …and requires an clinical license. 3+ years of nursing or quality improvement experience. **Licenses/Certifications:** Current state's clinical license ... processes to measure member outcomes. Assess provider performance and quality of care through clinical case reviews....and delivered timely + Perform other performance and process improvement activities + Performs other duties as assigned +… more
- Elevance Health (Atlanta, GA)
- …state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement , and a minimum of ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS-DRG, AP-DRG...and Hospital-Acquired Conditions (HACs). + Suggests and develops high quality , high value, concept and or process improvement… more
- Humana (Atlanta, GA)
- …entry regarding claim/encounter information + Support and participate in process and quality improvement initiatives **What Humana Offers** We are fortunate to ... our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct… more
- Elevance Health (Atlanta, GA)
- …Preventable Adverse Events (PAEs) or Never Events. + Suggests and develops high quality , high value concept and or process improvement and efficiency ... **DRG Coding Auditor Principal** **_Virtual: _** _ _ This role...Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad, deep and niche… more
- Elevance Health (Atlanta, GA)
- …as re-admissions, Inpatient to Outpatient, and HACs. + Suggests and develops high quality , high value concept and or process improvement and efficiency ... (DRG) Coding/ Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment… more
- Datavant (Atlanta, GA)
- …in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding education, interim coding ... you to help shape the future of healthcare from your own workspace! Inpatient auditor with 3-5 years of experience at a Trauma Level 1 facility. SMART software… more