- Highmark Health (Atlanta, GA)
- …of a grievance/appeal; documents, investigates, refers and coordinates grievances and appeals ; initiates a case file for each grievance and appeal; ensures ... all involved parties. + Participate in workgroup meetings to address trends in appeals and grievances and to work on process improvement initiatives with cross… more
- Intermountain Health (Atlanta, GA)
- …the patient's account within Intermountain's policies and procedures. **Revenue Integrity Analyst II** 1.Analyze data, develop reports, review trends, and recommend ... updates to charging/coding/NCCI regulations and/or errors, and regarding audits and appeals , to facilitate corrective action planning for improved processes. 7.… more
- Evolent (Atlanta, GA)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Analyst , Client Analytics** Integrate and analyze claims and enrollment data from multiple ... Evolent's clinical services (ie, specialty care, utilization management, care management, appeals & grievances) + Using analytical tools to integrate various data… more
- Intermountain Health (Atlanta, GA)
- …updates to charging/coding/NCCI regulations and/or errors, and regarding audits and appeals , to facilitate corrective action planning for improved processes. + ... Complies with all CMS, Federal and State regulations, and payor guidelines, and ensures consistent and compliant application with charge/coding capture, charge editing, and audit and reimbursement practices. Researches and collaborates on regulation updates to… more
- State of Georgia (Fulton County, GA)
- …investigation. SUPERVISION : + Legal services division staff including paralegal and analyst . MINIMUM QUALIFICATIONS : + Three years of directly related experience. ... Hearings, and before an Administrative Law Judge, the Georgia Court of Appeals , and the Georgia Supreme Court. + Experience interacting directly with the… more