• Claims Auditor Lead

    Elevance Health (Atlanta, GA)
    ** Claims Auditor Lead ** _This position will work a hybrid model (remote and office), 1-2 times per week. The Ideal candidate will live within 50 miles of one ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The Claims Auditor Lead is responsible for leading the high dollar… more
    Elevance Health (01/03/25)
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  • Pharmacy Internal Auditor

    Elevance Health (Atlanta, GA)
    …service written and verbal inquiries. **How you will make an impact:** + Assists higher level auditor / lead on field work as assigned and acts as auditor in ... **Pharmacy Internal Auditor ** **Location:** This position will work a hybrid...in pre and post implementation audits ofpharmacy operational processes, claims processing and payment, member and provider inquiries, enrollment… more
    Elevance Health (12/24/24)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Atlanta, GA)
    **Diagnosis Related Group Clinical Validation Auditor -** **Registered Nurse** **Location:** This position will work a hybrid model (remote and office). Ideal ... one of our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
    Elevance Health (01/01/25)
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  • Clinical Provider Auditor Senior

    Elevance Health (Atlanta, GA)
    **Clinical Provider Auditor Senior** **Supports the Payment Integrity line of business** _Location:_ Alternate locations may be considered. This position will work ... eliminate and prevent unnecessary medical-expense spending. The **Clinical Provider Auditor Senior** is responsible for identifying issues and/or entities that… more
    Elevance Health (12/18/24)
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  • Special Investigation Unit Manager Clinical…

    CVS Health (Atlanta, GA)
    …convenient and affordable. The Special Investigations Unit is seeking a Manager to lead our team of Certified Professional Coders (CPC). The Manager is responsible ... strategies to manage workload, quality of reviews and process improvements. **Responsibilities:** Lead and mentor a team certified coders who support fraud detection… more
    CVS Health (12/25/24)
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