2 senior clinical compliance auditor jobs found in Atlanta

Senior Medical Coder At Clover Health, we are committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America's seniors. We prioritize preventive care while leveraging data and technology through the Clover Assistant, a powerful tool that helps physicians make informed health recommendations. By giving doctors a holistic view of each member's complete health history, we ensure better care at a lower costdelivering the highest value to those who need it most. We're building a modern operating model for medical codingone that connects Risk Adjustment, Payment Integrity, and Quality (STARS/HEDIS) into a single, data-driven system. This is a rare opportunity to work at the center of that transformation: ensuring compliant, high-quality coding today while helping design the workflows that will define how a plan of the future operates. As part of the Office of the CEO's AI Ops initiative, you'll combine deep subject matter expertise with an...

Overview Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady! Location: Atlanta, GA Job Type: FTE Shift/Schedule: Days This is a remote role, but the ideal candidate will be required to come into the office occasionally to meet with the providers. Summary The Physician Compliance Auditor is responsible for conducting compliance audits, reporting results, researching/investigating issues, and establishing compliance monitoring processes. The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters, and other compliance issues as directed by the Physician Coding Director, Compliance Director. This position requires effective communication with internal stakeholders...