- Humana (Atlanta, GA)
- …an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and ... researching medical claims + Proficient in Microsoft Office (Word, Excel, Access, PowerPoint) + Working knowledge of SQL + Familiarity with EDI X12 formats… more
- Molina Healthcare (Savannah, GA)
- …of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of ... the specific programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support, or other specific program experience as… more
- Sedgwick (Atlanta, GA)
- …for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The ... advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With… more
- Zurich NA (Atlanta, GA)
- …Diploma or Equivalent and 6 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate ... including an Associate Degree and 4 or more years of experience in the Claims or Underwriting Support areaAND + Knowledge of line/s of business and the legal… more
- Humana (Atlanta, GA)
- …closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid ... APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg performing basic… more
- AIG (Atlanta, GA)
- GenAI Product Manager with Claims ExperienceBe part of something groundbreakingAt AIG, we are making long-term investments in a brand-new, innovative Generative AI ... What we are looking for + Master's in business administration preferred + Claims or Insurance background is preferred + Gen AI experience preferred + Minimum… more
- Molina Healthcare (GA)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... not limited to, Configuration, Business Systems, Encounters (inbound and outbound), Claims , Provider Services and Contracting. * Identifies issues, resolves problems… more
- Sedgwick (Atlanta, GA)
- …for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The ... advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With… more
- Sedgwick (Atlanta, GA)
- …for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The ... advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With… more
- Walgreens (Atlanta, GA)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more