- Emory Healthcare/Emory University (Decatur, GA)
- …mentorship, _development,_ and leadership programs + And more **Description** We're seeking a ** Utilization Review (UR) Specialist (Registered Nurse / RN)** ... documentation and/or clinical data. + When appropriate, the UR Specialist will utilize the UR Department's Severity of Illness/Intensity...experience or a minimum of two years of previous utilization review experience. + Must have a… more
- State of Georgia (Fulton County, GA)
- Compliance Specialist 2 Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/73083/other-jobs-matching/location-only) New Hot Regulatory Accounting ... paid accurately and timely. Under supervision, the Vendor Management Compliance Specialist II is responsible for monitoring incoming supplier change requests,… more
- ADP (Alpharetta, GA)
- …Person Counts, Results-Driven, - Social Responsibility.** **POSITION SUMMARY:** The Implementation Specialist Job Family acts as a consultant and project manager to ... track order progress. After account is setup, a quality review is conducted to ensure accuracy. Collaborates with FLT...a welcome call to ensure optimum product awareness and utilization , and sets overall expectations. As client status updates… more
- Datavant (Atlanta, GA)
- …tools. The specialist serves as a key liaison between coding, billing, utilization review , case management, and payer relations to reduce denials and improve ... and life experiences to realize our bold vision for healthcare. The Specialist is responsible for identifying, analyzing, and resolving claim denials across the… more
- State of Georgia (Fulton County, GA)
- …and federal rules and regulations. Develop, implement and evaluate the surveillance of utilization review process to ensure quality services. Monitor, track, and ... Compliance Specialist I Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/71059/other-jobs-matching/location-only) Regulatory… more
- Kuehne+Nagel (East Point, GA)
- …counts in more ways than we imagine. **** The Aerospace Operational Care Specialist is responsible for managing the coordination of shipments accurately and timely, ... meeting customer transit time requirements. The Operational Care Specialist is part of a team (Operational Care Centers)...systems, including financial data, such as costs + To review and clarify CCL instructions if there are conflicts… more
- CBRE (Atlanta, GA)
- QA/QC Specialist -Data Center Job ID 235362 Posted 03-Sep-2025 Service line GWS Segment Role type Full-time Areas of Interest Construction, Data Centers Location(s) ... This position supports change, event & root cause analysis processes through review and/or approval actions. This role ensures all CBRE employees are qualified… more
- Cognizant (Atlanta, GA)
- …and retro-authorization as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral, preauthorization, medical ... necessity determinations to the Health Plan/Medical Director based on the review of clinical documentation in accordance with Medicare, Medicaid, and third-party… more
- HD Supply (Atlanta, GA)
- …issues such as payroll discrepancies, vacation accrual discrepancies and benefit utilization . **Major Tasks, Responsibilities, and Key Accountabilities** + Acts as a ... guidance only on unusual, complex problems or issues. Work review typically involves periodic review of output by a supervisor and/or direct customers of… more
- Evolent (Atlanta, GA)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …data POA, Discharge Disposition. + Reviews discrepancies between the Clinical Documentation Specialist (CDS) DRG and the Coder DRG. + Reviews non-CC/MCC records to ... educate physicians, nursing, and other clinical staff to improve documentation. + Review ?s DRG Reassignment letters and assists in formulating Appeal letters… more
- WSP USA (Atlanta, GA)
- …and Profiles, Cross section details + LiDAR and aerial photo data analysis + Utilization of wetlands, vernal pool and sensitive resource data in line and structure ... in leading overall transmission line design for all capital projects + Review /Design transmission line plan and profile drawings using PLSCADD to ensure compliance… more
- Ryder System (Atlanta, GA)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... (Tier 1 Call Center Representatives and Tier 2 Functional Specialist ). Ensure contact center staff have the training and...to get things done regardless of obstacles + Optimized utilization of resources to provide a delightful and consistent… more
- ChenMed (Decatur, GA)
- …and explain nurse practitioner role. + Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... as part of the clinical operations team and is responsible for providing specialist patient care in nursing homes, skilled nursing facilities (SNF) and home… more
- Hargrove Engineers & Constructors (Atlanta, GA)
- …Duties may include performing advanced engineering work serving as a technical specialist for complex engineering assignments. Work at this level requires extensive ... progressive experience in pulp and paper process engineering and involves utilization of project controls for cost, schedule and quality of projects. This work will… more
- ASM Research, An Accenture Federal Services Company (Atlanta, GA)
- …on the project in a senior administrator capacity. Considered a technical specialist in a variety of IT administrator disciplines. + Configure, monitor, and ... as needed (aside from on-call rotation). + Optimize system operations and resource utilization as well as perform system capacity analysis and planning. + Utilize… more