Clinical Auditor
6 days ago
Zelis is seeking a skilled Clinical Auditor to join our team. As a Clinical Auditor, you will be responsible for conducting thorough reviews of healthcare claims to ensure compliance with medical guidelines and regulations.
Key Responsibilities:- Conduct in-depth reviews of healthcare claims to identify potential errors or discrepancies
- Apply knowledge of medical guidelines and regulations to ensure compliance
- Collaborate with cross-functional teams to resolve issues and improve processes
- Develop and maintain expertise in healthcare regulations and guidelines
- 3-5 years of experience in healthcare auditing or claims review
- Strong understanding of medical guidelines and regulations
- Excellent analytical and communication skills
- Ability to work independently and as part of a team
- A dynamic and supportive work environment
- Opportunities for professional growth and development
- A competitive salary and benefits package
Zelis is a leading healthcare technology company that is committed to modernizing the healthcare financial experience. We are proud to offer a hybrid and remote-friendly culture that values diversity, equity, and inclusion.
At Zelis, we are dedicated to creating a workplace that is inclusive and respectful of all individuals. We welcome applications from diverse candidates and are committed to ensuring that our application process is accessible to all.
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Clinical Auditor
3 weeks ago
Atlanta, Georgia, United States Zelis Full timeJob Title: Clinical AuditorAt Zelis, we are seeking a highly skilled Clinical Auditor to join our team. As a Clinical Auditor, you will be responsible for conducting in-depth reviews of medical claims to ensure compliance with accepted medical guidelines and clinical criteria.Key Responsibilities:Conduct thorough reviews of medical claims to identify...
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Clinical Auditor
6 days ago
Atlanta, Georgia, United States Zelis Full timeJob Title: Clinical AuditorZelis is seeking a skilled Clinical Auditor to join our team. As a Clinical Auditor, you will be responsible for conducting thorough reviews of healthcare claims to ensure compliance with medical guidelines and regulations.Key Responsibilities:Conduct in-depth reviews of healthcare claims to identify potential errors or...
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Clinical Auditor
3 weeks ago
Atlanta, Georgia, United States Zelis Full timeJob SummaryZelis is seeking a skilled Clinical Auditor to join our team. As a Clinical Auditor, you will be responsible for conducting in-depth claim reviews to ensure compliance with medical guidelines and billing rules.Key ResponsibilitiesConduct post-service, pre or post payment claim reviews based on accepted medical guidelines and clinical...
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Clinical Trials Auditor
1 day ago
Atlanta, Georgia, United States Emory HealthcareEmory University Full timeJob SummaryEmory University is seeking a highly skilled Clinical Trials Auditor to join our team. As a Clinical Trials Auditor, you will be responsible for ensuring compliance with federal and state laws and regulations, as well as the University's policies and procedures related to clinical trials.Key ResponsibilitiesConduct audits to ensure compliance with...
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Clinical Auditor
3 weeks ago
Atlanta, Georgia, United States Zelis Full timeJob SummaryZelis is seeking a skilled Clinical Auditor to join our team. As a key member of our team, you will be responsible for conducting in-depth claim reviews to identify revenue opportunities and optimize payment integrity.Key ResponsibilitiesConduct post-service, pre or post payment claim reviews based on accepted medical guidelines and clinical...
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Clinical Auditor
3 weeks ago
Atlanta, Georgia, United States Zelis Full timeJob SummaryZelis is seeking a highly skilled Clinical Auditor to join our team. As a key member of our organization, you will be responsible for conducting thorough reviews of healthcare claims to ensure compliance with medical guidelines and billing rules.Key ResponsibilitiesConduct in-depth reviews of facility and outpatient bills to ensure accuracy and...
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Clinical Auditor
3 weeks ago
Atlanta, Georgia, United States Zelis Full timeJob SummaryZelis is seeking a highly skilled Clinical Auditor to join our team. As a key member of our team, you will be responsible for conducting in-depth claim reviews to identify revenue opportunities and ensure compliance with medical guidelines and billing rules.Key ResponsibilitiesConduct post-service, pre or post payment claim reviews to identify...
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GCP Auditor
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Healthcare Revenue Integrity Specialist
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Nurse Auditor
24 hours ago
Atlanta, Georgia, United States Zelis Full timeJob Title: Nurse ReviewerJob Summary:Zelis is seeking a highly skilled Nurse Reviewer to join our team. As a Nurse Reviewer, you will be responsible for conducting post-service, pre or post payment in-depth claim reviews based on accepted medical guidelines and clinical criteria, billing and coding rules, plan policy exclusions, and payment...
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Nurse Auditor
2 weeks ago
Atlanta, Georgia, United States Zelis Full timeJob SummaryThe Nurse Reviewer will be responsible for conducting in-depth claim reviews based on accepted medical guidelines and clinical criteria, billing and coding rules, plan policy exclusions, and payment errors/overpayments. This role requires a strong understanding of audit techniques, identification of revenue opportunities, and financial negotiation...
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Healthcare Auditor
3 weeks ago
Atlanta, Georgia, United States Zelis Full timeJob SummaryThe Nurse Reviewer will be responsible for conducting thorough reviews of medical claims to ensure compliance with regulatory guidelines and company policies. This role requires a strong understanding of healthcare regulations, medical coding, and billing practices. The ideal candidate will have experience in auditing and claims review, with a...
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Government Reimbursement Specialist
1 week ago
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Clinical Provider Auditor II
3 weeks ago
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Nurse Auditor
1 week ago
Atlanta, United States Pivotal Placement Services, Inc Full timeHospital Bill AuditorThis is a full-time permanent opportunity for a managed care company, which allows a nurse leader for more growth opportunities. We are looking for highly skilled, self-motivated, registered nurses (RN) who can provide support to the revenue integrity team. This nurse will complete audits following department guidelines and the...
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Nurse Auditor
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Atlanta, United States Pivotal Placement Services Full timeHospital Bill Auditor This is a full-time permanent opportunity for a managed care company, which allows a nurse leader for more growth opportunities. We are looking for highly skilled, self-motivated, registered nurses (RN) who can provide support to the revenue integrity team. This nurse will complete audits following department guidelines and the partners...
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Nurse Auditor
1 week ago
atlanta, United States Pivotal Placement Services, Inc Full timeHospital Bill AuditorThis is a full-time permanent opportunity for a managed care company, which allows a nurse leader for more growth opportunities. We are looking for highly skilled, self-motivated, registered nurses (RN) who can provide support to the revenue integrity team. This nurse will complete audits following department guidelines and the...
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Accounting Manager
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Atlanta, United States Experity Defunct Full timeExperity is the leading software and services company for on-demand healthcare in the U.S. We provide software solutions that remove complexities and simplify operations for 5700+ urgent care clinics across the country. We create, maintain, and support products to facilitate the complete on-demand healthcare experience: from patients finding clinics and...
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Accounting Manager
2 weeks ago
Atlanta, United States Experity Defunct Full timeExperity is the leading software and services company for on-demand healthcare in the U.S. We provide software solutions that remove complexities and simplify operations for 5700+ urgent care clinics across the country. We create, maintain, and support products to facilitate the complete on-demand healthcare experience: from patients finding clinics and...
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Quality Manager
4 months ago
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Quality Manager
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Research QA/QI Analyst
2 weeks ago
Atlanta, United States Children's Healthcare of Atlanta Full timeNote: If you are CURRENTLY employed at Children's and/or have an active badge or network access, STOP here. Submit your application via Workday using the Career App (Find Jobs). Work Shift Day Work Day(s) Friday, Monday, Thursday, Tuesday, Wednesday Shift Start Time 9:00 AM Shift End Time 5:00 PM Worker Sub-Type Regular Children's is one of the nation's...
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Atlanta, Georgia, United States Emory Healthcare Full timeJob SummaryEmory Healthcare is seeking a highly skilled Senior Financial Analyst to join our team in the Net Patient Service Revenue (NPSR) department. As a key member of our finance team, you will be responsible for overseeing the financial reporting related to patient service revenue, ensuring accurate and timely revenue recognition, and calculating the...
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RN Hospital Bill Audit/Appeal Lead
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Atlanta, United States Elevance Health Full timeSupports the Carelon Payment Integrity line of businessLocation: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles from our Elevance Health Pulse Point locations.Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is...
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Nurse Audit Lead – Carelon Payment Integrity
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Government Reimbursement
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Atlanta, United States Emory HealthcareEmory University Full timeOverview Be inspired . Be rewarded. Belong. At Emory Healthcare. 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. We...