Supervisor Coding - PHYS Piedmont Healthcare Inc.Supervisor Coding - PHYSAtlanta, GeorgiaFull timeWorks with managers to assist with departmental needs and planning, including developing policies and procedures to facilitate timely and accurate reimbursement. Overview: At Piedmont Healthcare, you’ll love a shared purpose, be motivated to be your best, and be recognized for your contributions.
NewCoding Quality Auditor Houston Methodist HospitalCoding Quality AuditorGAHouston Methodist also includes a research institute; a comprehensive residency program; international patient services; freestanding comprehensive care clinics, emergency care and imaging centers; and outpatient facilities. The health system consists of eight hospitals: Houston Methodist Hospital, its flagship academic hospital in the Texas Medical Center, seven community hospitals and one long-term acute care hospital throughout the Greater Houston metropolitan area.
Practice Coding Specialists - Georgia Colon & Rectal Surgery Associates DeKalb Northside Hospital Inc.Practice Coding Specialists - Georgia Colon & Rectal Surgery Associates DeKalbDecatur, GeorgiaFull timeCoordinate with Practice Coordinator and Revenue Integrity to assure all necessary documentation is present to support selected procedure codes or to code cases as needed. Must have minimum of 2 years hospital and/or physician practice coding experience or successful completion of the one-year Revenue Integrity Internship Program.
NewCoding Data Quality Auditor CVS Health CorpCoding Data Quality AuditorGA$18.50–$38.82 / hourResponsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures. Proficient in abstraction and assignment of accurate medical codes for diagnoses as documented by physicians and other qualified healthcare providers in the office and/or facility setting.
Coding Educator - Physician Piedmont Healthcare Inc.Coding Educator - PhysicianAtlanta, GeorgiaFull timeResponsibilities: Assess the educational needs of physicians regarding coding and documentation and direct development of effective regularly scheduled educational programs that meet physician needs and serve as the primary resource to physicians for documentation and coding issues. Responsible for conducting coding and billing training programs for billing and coding specialists and physicians.
NewCoding Educator- Jacksonville/ NE Florida Millennium Physician GroupCoding Educator- Jacksonville/ NE FloridaGACoordinates and facilitates current coding and billing education and training using a wide variety of methods and media to deliver content, including onsite observation and training, printed materials and technical reports, power point presentations, teleconference and videoconference platforms. S/he will have responsibility for building relationships with the clinical and clerical teams to ensure open communication for questions concerning the appropriate elements of a medical records structure and content as well as the assignment of the appropriate codes as supported.
Medical Billing & Coding Specialist CrewBloomMedical Billing & Coding SpecialistAtlanta, GARemoteYou will work closely with healthcare practitioners in private practices and medical clinics to accurately review, assign, and manage medical codes, ensuring compliant billing, timely reimbursements, and efficient revenue cycle operations. While industry certifications are a plus, what matters most is hands-on experience with medical billing and coding, particularly a strong understanding of Eye Care Practice (ECP) coding guidelines and regulations.
NewCoding Business Analyst II - Policy Review Centene Corporation GroupCoding Business Analyst II - Policy ReviewGA$56,200–$101,000 / yearMonitor, report on, and track regulatory, coding, and policy updates, ensuring timely implementation and communication of changes across impacted stakeholders. 2+ years of business process analysis, preferably healthcare (i.e. documenting business process, gathering requirements) or claims payment/analysis experience.
NewCoding Technical Analyst (10K Sign-On Bonus Available) WellStar Health System IncCoding Technical Analyst (10K Sign-On Bonus Available)GAJob Summary: The Coding Department Edit Resolution Analyst serves as a revenue cycle, technology and coding expert to the Coding team and leadership to answer questions, investigate accounts, identify system issues and test new functionality and updates, resolve billing/account edits and denials, and participate in improvement opportunities. Works on misc work queues such as missing, missing phys, ready to code Serves as a technology training resource for new contract and WellStar coders, mentoring them on processes and applications, and other questions as needed.
Instructor Part-Time, Professional Certificate Programs, Medical Coding Specialist Kennesaw State UniversityInstructor Part-Time, Professional Certificate Programs, Medical Coding SpecialistKennesaw, GAAdditionally, USG supports Freedom of Expression as stated in Board Policy 6.5 Freedom of Expression and Academic Freedom found on-line at https://www.usg.edu/policymanual/section6/C2653 . Interprets inpatient diagnosis and procedure coding and reporting guidelines and explain differences among acute care inpatient settings, outpatient, and physician office health care settings.
Coding & Documentation Coordinator Emory HealthcareCoding & Documentation CoordinatorAtlanta, GeorgiaFull timeThose tasks and activities include but are not limited to the following: distribution of uncoded patient encounters to employed and contract coding resources for final coding; ongoing training of coders and vendor support staff on the accurate coding of patient encounters according to patient type and/or facility specific coding guidelines. Works with physicians, mid-level staff and clinical departments re: complete patient documentation for coding of patient encounters; performs intermittent quality reviews for coding accuracy and reports findings to appropriate internal and vendor resources.
Hospital Coding Compliance Auditor Emory Healthcare/Emory UniversityHospital Coding Compliance AuditorAtlanta, GAEnvironmental exposures include, but are not limited to, blood-borne pathogen exposure, bio-hazardous waste, chemicals, gases, fumes, vapors, communicable diseases, electrical shock, floor surfaces, hot/cold temperatures, indoor/outdoor conditions, latex, lighting, patient care/handling injuries, radiation, shift work, and travel. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoingmentorshipand leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be.
Coding Specialist Ortho Sport and Spine PhysiciansCoding SpecialistAtlanta, GAAs our Biller and Coder, your daily duties will include entering and coding patient services and charges into our EMR system and generating invoices to mail out to patients. The ideal candidate must also be able to demonstrate excellent written and verbal communication skills, as communicating with clients and various insurance agents or patients will form a large part of the job.
Coding Analyst Northside Hospital IncCoding AnalystSandy Springs, GACoordinates with Department Managers, Practice Managers and/or providers on new procedures being performed to assure the charges are set up appropriately and timely and the staff responsible for entering charges is educated. Coordinate with Department Managers and/or Practice Mangers to assure all necessary documentation is present to support selected procedure codes or to code cases as needed.
Medical Billing and Insurance Coding Instructor (61697) International Education CorporationMedical Billing and Insurance Coding Instructor (61697)GATo Do What: In this position, you will be responsible for the delivery of quality educational instruction by helping develop the technical and soft skills needed for our students to secure a job in their new career. Were Looking For: Someone with tenacity, passion, discipline and grit to join our team as a Medical Billing and Insurance Coding Instructor at our Stone Mountain Campus.
NewManager of DRG Coding & Clinical Validation Audit Elevance Health IncManager of DRG Coding & Clinical Validation AuditAtlanta, GA$115,020–$207,216 / yearPreferred Skills, Capabilities and Experiences: Preferred experience includes a minimum of 5-7 years of inpatient coding or DRG auditing experience, including 2-3 years in a leadership or supervisory capacity. The Managers of DRG Coding & Clinical Validation leads a high-performing team responsible for auditing inpatient medical records to ensure the accuracy and compliance of Diagnosis-Related Group (DRG) assignments.
Coding Coordinator (REMOTE) BayCare Health SystemCoding Coordinator (REMOTE)Atlanta, GARemoteResponsibilities: The Medical Records Coding Coordinator performs reviews of medical records to assign or confirm appropriate diagnosis assignment of ICD-10-CM, ICD-10-PCS, CPT4, HCPCS and Modifiers. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians.
HIM Coding Manager Shepherd CenterHIM Coding ManagerGAWith five decades of experience, Shepherd Center provides world-class clinical care, research, and family support for people experiencing the most complex conditions, including spinal cord and brain injuries, multi-trauma, traumatic amputations, stroke, multiple sclerosis, and pain. Minimum of 3 years of recent acute care and/or physician practice coding experience with a minimum of 3 years of progressive supervisory and/or management experience in Coding and/or HIM preferred; preferably over a large group or at a system level.
NewMedical Coding Educator Humana IncMedical Coding EducatorGARemote$59,300–$80,900 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
Coding Provider Liaison Four Winds HealthCoding Provider LiaisonAtlanta, GAPart timeThe Coding Provider Liaison (Professional Coding Auditor & Educator) works collaboratively with physicians, other healthcare professionals and coding staff to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to all patients, as well as ensuring compliant reimbursement of patient care services. Works as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges.
Professional Coding Auditor & Educator Four Winds HealthProfessional Coding Auditor & EducatorAtlanta, GAPart timeThe Professional Coding Auditor & Educator works collaboratively with physicians, other healthcare professionals and coding staff to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to all patients, as well as ensuring compliant reimbursement of patient care services. Works as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges.
Coding Provider Liaison Well Street Urgent CareCoding Provider LiaisonAtlanta, GAThe Coding Provider Liaison (Professional Coding Auditor & Educator) works collaboratively with physicians, other healthcare professionals and coding staff to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to all patients, as well as ensuring compliant reimbursement of patient care services. Works as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges.
Professional Coding Auditor & Educator Well Street Urgent CareProfessional Coding Auditor & EducatorAtlanta, GAThe Professional Coding Auditor & Educator works collaboratively with physicians, other healthcare professionals and coding staff to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to all patients, as well as ensuring compliant reimbursement of patient care services. Works as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges.
IT Consultant IV, Solutions - SNOMED CT, Clinical Coding, Epic, EHR, Informatics Kaiser PermanenteIT Consultant IV, Solutions - SNOMED CT, Clinical Coding, Epic, EHR, InformaticsAtlanta, GAEssential Responsibilities: Completes work assignments and supports business-specific projects by applying expertise in subject area; supporting the development of work plans to meet business priorities and deadlines; ensuring team follows all procedures and policies; coordinating and assigning resources to accomplish priorities and deadlines; collaborating cross-functionally to make effective business decisions; solving complex problems; escalating high priority issues or risks, as appropriate; and recognizing and capitalizing on improvement opportunities. Ability and/or having the capacity to learn -knowledge representation- logic to create, maintain subsets of clinical records to support reporting, business intelligence in the areas of best practice alerts, population and healthcare management, quality measurements, and health information exchanges.
NewRemote Inpatient Coding Specialist - Flexible Hours PiedmontRemote Inpatient Coding Specialist - Flexible HoursAtlanta, GARemoteThe role involves reviewing and coding documentation for inpatient medical records, ensuring coding accuracy, and collaboration with care teams. A healthcare organization is looking for an Inpatient Coder for a remote work opportunity.
NewCoding Denials Supervisor Four Winds HealthCoding Denials SupervisorAtlanta, GAPart timeWellStreet Urgent Care is seeking an experienced Coding Denials Supervisor to lead a team responsible for resolving coding-related claim denials across our multi-state urgent care organization. As one of the nation's fastest-growing urgent care organizations, we're looking for talented professionals who are passionate about making an impact while helping build the future of healthcare.
Epic Resolute Application Developer (Charge Router and Coding Skills) - 6260321 Accenture PlcEpic Resolute Application Developer (Charge Router and Coding Skills) - 6260321Atlanta, GAIn addition to delivering innovative solutions for Accenture's clients, you will work with a highly skilled, diverse network of people across Accenture businesses who are using the latest emerging technologies to address today's biggest business challenges. Dropping orders using chart review-> creating new patient encounter -> dropping an order and signing the order/Unite charge entry ->creating new encounter.
Practice Coding Specialist Northside Hospital Inc.Practice Coding SpecialistAtlanta, GeorgiaFull timeCoordinate with Practice Coordinator and Revenue Integrity to assure all necessary documentation is present to support selected procedure codes or to code cases as needed. Must have minimum of 2 years hospital and/or physician practice coding experience or successful completion of the one-year Revenue Integrity Internship Program.
Practice Coding Specialist - Bariatric Innovations of Atlanta Northside Hospital Inc.Practice Coding Specialist - Bariatric Innovations of AtlantaAtlanta, GeorgiaFull timeCoordinate with Practice Coordinator and Revenue Integrity to assure all necessary documentation is present to support selected procedure codes or to code cases as needed. Must have minimum of 2 years hospital and/or physician practice coding experience or successful completion of the one-year Revenue Integrity Internship Program.
Outpatient Hospital-Based Coding Supervisor - RHIT RHIA CCS - Mon - Fri Days - 100% Remote Northeast Georgia Health System IncOutpatient Hospital-Based Coding Supervisor - RHIT RHIA CCS - Mon - Fri Days - 100% RemoteGARemoteLicensure or other certifications: Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) or Certified Inpatient Coder (CIC) or Certified Outpatient Coder (COC) or Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA). The Coding Supervisor supervises the coding workflow; monitors employee performance; addresses complaints and resolves problems; and actively supervises production and quality control efforts.
Managed Services - Revenue Cycle Coding - Senior Manager PricewaterhouseCoopers LLPManaged Services - Revenue Cycle Coding - Senior ManagerGA$124,000–$280,000 / yearPwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy . As a Senior Manager, you will leverage your skills and influence to deliver quality results, motivate and coach teams to solve complex problems, and apply sound judgment to recognize when to take action or escalate issues.
NewSTEM & Coding Teaching Opportunities Concorde EducationSTEM & Coding Teaching OpportunitiesAtlanta, GA$50–$100 / hourPreferred qualifications include: • At least 60 college credits, where required by the applicable assignment or site; • Experience with coding, programming, computer science, or related technology subjects; • Experience teaching, tutoring, coaching, mentoring, or leading activities with school-age students; • Strong communication, organization, and classroom facilitation skills; • Availability to provide services for the accepted assignment schedule and communicate schedule issues as soon as reasonably practicable; and. Payment for completed services is generally made by direct deposit on the fifteenth day of the month following the month in which services were completed, unless otherwise stated in the accepted assignment terms or required by applicable law.
NewRemote Inpatient Coding Auditor - Trauma Level 1 DatavantRemote Inpatient Coding Auditor - Trauma Level 1Atlanta, GARemote$35–$45 / hourA leading health data platform company in Atlanta is seeking an Inpatient Auditing Specialist to conduct coding audits and provide educational support. Candidates should possess strong organizational and communication skills as they collaborate with healthcare professionals to enhance coding quality and compliance.
Life Safety Code Specialist Senior (GA Market) Advocate Aurora Health IncLife Safety Code Specialist Senior (GA Market)Rome, GARemote$44.15–$66.25 / hourStakeholder Collaboration: Partners with enterprise stakeholders-including Accreditation, Facilities leadership, Facility Safety Officer, and local hospital leadership-to align life safety strategies with organizational goals, ensure regulatory compliance, and support continuous improvement in safety and accreditation readiness. Licensure, Registration, and/or Certification Required: Certified Fire Protection Specialist (CFPS), OR, Certified Life Safety Specialist for Health Care Facility Managers (CLSS-HC), OR, Certified Healthcare Facility Manager (CHFM), OR Other related and applicable industry certifications required within 1 year of hire.
Senior Software Engineer - AI Interaction Evaluator (Codex / Claude Code, up to $200/hr) G2i IncSenior Software Engineer - AI Interaction Evaluator (Codex / Claude Code, up to $200/hr)Atlanta, GA$50–$200 / hourWe're looking for highly experienced software engineer (SR+) to help evaluate the quality of interactions with modern coding agents such as OpenAI Codex and Claude Code. We're specifically looking for engineers who can answer questions like: Does this feel like something a strong engineer would actually say?.
Lead AI Engineer - Java with Claude Code EPAM Systems IncLead AI Engineer - Java with Claude CodeGAThis is a hands-on leadership role that requires deep technical expertise, a drive for innovation, and the ability to leverage AI tools like Claude Code to enhance engineering workflows. Provide strategic guidance on serverless workflows, including authoring Lambda functions and Lambda@Edge logic for authentication, CDN-layer functionality, and other edge use cases.
Optometric Technician/ Medical Billing Administrator West Point OpticalOptometric Technician/ Medical Billing AdministratorRoswell, GeorgiaThe position will interact with patients/customers by delivering an exceptional patient/customer experience, foster patient/customer retention, and promotes outstanding associate/doctor satisfaction. An Optometric Office Technician role may combine skills of a medical office administrator, medical billing and collections, appointment scheduler or medical records clerk and direct patient care.
Billing Supervisor Fulgent Genetics IncBilling SupervisorAlpharetta, GASupervises and monitors daily billing department practices through all phases of coding, data entry, billing and collection to ensure that services are billed and revenue is collected in keeping with Medicare and Medicaid regulations and insurance company requirements, in support of the department's revenue budget goals. Search firms or agencies without an applicable contract and/or express approval to recruit for the role in question - that choose to submit a resume or client information to our career page or to any employee of Fulgent - will not be eligible for payment of any fee(s), and any associated shared data will become the property of Fulgent.
Medical Biller SydieraMedical BillerAtlanta, GeorgiaThis role supports healthcare providers by helping manage insurance claims, patient billing, coding processes, and revenue cycle operations. Previous medical billing, medical coding, healthcare administration, or customer service experience is a plus but not required.
Senior Manager, Hospital Billing Emory Healthcare IncSenior Manager, Hospital BillingAtlanta, GAMinimum Qualifications: Minimum of 7 years of related experience - Minimum of 3 years of supervisory or management experience - Bachelors Degree in healthcare or a related field - Deep understanding of medical billing codes (ICD-10, CPT) and healthcare billing regulations - Extensive experience in hospital billing operations, including revenue cycle management - Strong leadership and supervisory skills to manage a billing team - Excellent analytical and problem-solving abilities to identify and resolve billing issues - Proficiency in electronic health records (EHR) systems and billing software - Strong communication and interpersonal skills to collaborate with various stakeholders PHYSICAL REQUIREMENTS: Lifting 10 lbs max, carrying of small articles such as dockets, ledgers, files, small tools, occasional standing & walking, frequent sitting, close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks. RESPONSIBILITIES: A Senior Manager of Hospital Billing oversees the entire hospital billing operation, ensuring accurate and timely submission of patient claims, managing a team of billing specialists, resolving complex billing issues, maintaining compliance with healthcare regulations, and implementing strategies to optimize revenue cycle management and maximize revenue collection for the hospital.
Senior Manager, Hospital Billing Emory Healthcare/Emory UniversitySenior Manager, Hospital BillingAtlanta, GAMinimum Qualifications: + Minimum of 7 years of related experience - Minimum of 3 years of supervisory or management experience - Bachelors Degree in healthcare or a related field - Deep understanding of medical billing codes (ICD-10, CPT) and healthcare billing regulations - Extensive experience in hospital billing operations, including revenue cycle management - Strong leadership and supervisory skills to manage a billing team - Excellent analytical and problem-solving abilities to identify and resolve billing issues - Proficiency in electronic health records (EHR) systems and billing software - Strong communication and interpersonal skills to collaborate with various stakeholdersPHYSICAL REQUIREMENTS: Lifting 10 lbs max, carrying of small articles such as dockets, ledgers, files, small tools, occasional standing & walking, frequent sitting, close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks. RESPONSIBILITIES: + A Senior Manager of Hospital Billing oversees the entire hospital billing operation, ensuring accurate and timely submission of patient claims, managing a team of billing specialists, resolving complex billing issues, maintaining compliance with healthcare regulations, and implementing strategies to optimize revenue cycle management and maximize revenue collection for the hospital.
Senior Manager, Hospital Billing Emory HealthcareSenior Manager, Hospital BillingAtlanta, GeorgiaFull timeMinimum of 7 years of related experience - Minimum of 3 years of supervisory or management experience - Bachelors Degree in healthcare or a related field - Deep understanding of medical billing codes (ICD-10, CPT) and healthcare billing regulations - Extensive experience in hospital billing operations, including revenue cycle management - Strong leadership and supervisory skills to manage a billing team - Excellent analytical and problem-solving abilities to identify and resolve billing issues - Proficiency in electronic health records (EHR) systems and billing software - Strong communication and interpersonal skills to collaborate with various stakeholders. A Senior Manager of Hospital Billing oversees the entire hospital billing operation, ensuring accurate and timely submission of patient claims, managing a team of billing specialists, resolving complex billing issues, maintaining compliance with healthcare regulations, and implementing strategies to optimize revenue cycle management and maximize revenue collection for the hospital.
Remote Medical Billing Specialist TRC Talent SolutionsRemote Medical Billing SpecialistAtlanta, GARemote$18–$22 / hourTemporaryIf you thrive in a fast-paced environment, enjoy problem solving, and have experience working insurance denials and unpaid claims, we'd love to hear from you. Our team partners with healthcare providers and hospital organizations to deliver revenue cycle and accounts receivable support services.
Health Care | Life Sciences, Senior Associate - Registered Nurse / Certified Coder Ankura Consulting Group LLCHealth Care | Life Sciences, Senior Associate - Registered Nurse / Certified CoderGARegistered Nurse with active license, unrestricted license • Bachelor of Science in Nursing from an accredited college/university • Substantial clinical experience with demonstrated ability to interpret clinical documentation and medical necessity • Certified Professional Coder (CPC) with coding experience across inpatient, outpatient, and professional services • Familiar with the revenue cycle process and facility and professional claims • Demonstrates excellent communication skills, both written and oral • Experience managing small projects and teams • Familiar with accessing and identifying clinical documentation in electronic medical record systems • Proficient in Excel, Word, and PowerPoint and able to draft reports and presentations and present findings • Ability to problem solve, multi-task, and prioritize assignments • Understands the importance of privileged and confidential communication • Willingness to travel when needed • Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future. Our clients include academic medical centers, health systems, physician practice groups, post- and sub-acute providers, health plans, pharmacies, and pharmacy benefit management companies, as well as pharmaceutical and medical device manufacturers.
Hospital Billing Coordinator Deloitte Touche Tohmatsu LtdHospital Billing CoordinatorGA$50,000–$60,000 / yearOur purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Medical Biller (US-based) CrewBloomMedical Biller (US-based)Atlanta, GAPatient Communication: Communicate with patients regarding billing inquiries, payment plans, and financial assistance options, providing excellent customer service while resolving concerns. Billing: Generate and send invoices to patients for services rendered, following up on outstanding balances and resolving billing discrepancies.
NewSenior Director of Payment Integrity Delta Dental of California Inc.Senior Director of Payment IntegrityAlpharetta, GAThis leader oversees end-to-end payment integrity capabilities, including pre-payment accuracy, post-payment audit and recovery, clinical and coding review, reimbursement and payment policy, fraud, waste and abuse support, provider billing trend analysis, and payment integrity analytics. Provide end-to-end strategic oversight of Payment integrity programs, including pre-payment prevention, post-payment recovery, clinical review, data mining, coding validation, reimbursement policy, provider education, analytics-driven monitoring, and continuous program optimization.
Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG) Elevance Health IncDiagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG)GA$86,560–$155,808 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would provide an equivalent background.
NewInpatient DRG Reviewer Zelis Healthcare, Inc.Inpatient DRG ReviewerAtlanta, GA$79,000–$99,750 / yearWhere the regrouped 'new DRG' differs from what was originally claimed by the provider, write a customer facing 'rationale' or 'findings' statement, highlighting the problems found and justifying the revised choices of new codes and DRG, based on the clinical evidence obtained during the review. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.
Multi-Specialty Profee and/or Facility Medical Coder Sutherland Global Services IncMulti-Specialty Profee and/or Facility Medical CoderAtlanta, GALeveraging our advanced products and platforms, we drive digital transformation, optimize critical business operations, reinvent experiences, and pioneer new solutions, all provided through a seamless "as a service" model. This will include assigning/sequencing billing codes in compliance with third party payor requirements and obtaining clarification when presented with conflicting or non-specific documentation, when necessary.