- Careerbuilder-US (Atlanta, GA)
- …Job Description: . This position works under the supervision of the Medical Claims Review Nurse and is cross trained to work in a variety of areas and functions, ... including appeals , claims analytics, DRG Validation claims repricing, and outpatient payment integrity audit concepts. . Knowledge of all back-office functions of a… more
- Elevance Health (Atlanta, GA)
- ** Nurse Medical Management I** At **Federal Health Products and Services - FHPS** , a proud member of the Elevance Health, Inc. family of companies, it's a powerful ... 7 pm (EST) shift rotation twice a month.** The ** Nurse Medical Management I** is responsible for collaborating with...of care and accurate claims payment. May also manage appeals for services denied. **How You Will Make an… more
- PruittHealth (Norcross, GA)
- …knowledge and ability to manage the Medicare and Medicaid denials and appeals process. + 6. Demonstrates ability to perform and document audits, including ... with other partners. **LICENSURE, CERTIFICATION AND EDUCATION REQUIREMENTS:** + Must be a Registered Nurse in good standing in at least one of the states in which… more
- Elevance Health (Atlanta, GA)
- …for system edits. + Coordinates research and responds to system inquiries and appeals . Conducts research of claims systems and system edits to identify adjudication ... an equivalent background. **Preferred Qualifications, Skills, and Experiences:** + Registered Nurse with active licenses strongly preferred + Proficient in Excel and… more
