- US Tech Solutions (Atlanta, GA)
- …to such areas as project correspondence, documentation, timely notice of claims , subcontract negotiation and subcontract administration. **Skills:** + This role will ... manage new projects for buildout of facilities for healthcare and life sciences clients. + The PM must have a background in these two fields. Additionally, the PM must have an engineering and IT background along with HVAC management. **Education:** +… more
- Insight Global (Temple, GA)
- …Hygiene surveys to ensure facility environment safety. Co-manage Workers Compensation claims with designated HR team members. Work with designated legal ... representatives as required. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone… more
- GAP Solutions Inc (Atlanta, GA)
- …Assisting with drafting SOP's. + Processing personal liability insurance reimbursement claims . + Initiating tentative selection notifications, notice of results or ... disposition letter. + Researching and compiling information on the full range of federal HR topics. + Responding to and providing general HR guidance to applicants and staff, maintain employee files. + Provide wide ranging administrative support to managers… more
- Walgreens (Monroe, GA)
- …Quality Improvement Program. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with ... insurance companies as well as medical providers and conducts or participates in 3rd party audit. + Assists and supports Store Manager and Pharmacy Manager in analyzing and seeking to improve pharmacy financials, operational quality and customer service. +… more
- Cardinal Health (Atlanta, GA)
- …knowledge of healthcare data, including clinical data, patient demographics, and claims data. Understanding of HIPAA and other relevant regulations, preferred. + ... Experience working with cloud platforms like Google Cloud Platform (GCP) for data processing, model training, evaluation, monitoring, deployment and support preferred. + Proven ability to lead data science projects, mentor colleagues, and effectively… more
- The Hartford (Alpharetta, GA)
- …Use quality management to develop talent and ensure compliance. + Leverage claims , risk engineering, and service operations partnerships. + Champion enterprise tools ... and reporting systems. Qualifications + 8+ years of Commercial Carrier Underwriting experience; management experience preferred. + Strong financial and business acumen. + Proven leadership capabilities. + Proficiency with Microsoft Office and internal systems.… more
- Public Consulting Group (Atlanta, GA)
- …Third Party Administrator Services + Enhance Health and Public Safety Services + Claims Processing Services and Solutions + Consulting and Advisory Services + Cost ... Allocation Plans and Time Studies + Cost Settlement and Supplemental Payment Strategies + Healthcare Access and Markets This director will run the office of the CIO with planning and test execution. This director will have a team of delivery managers (scrum… more
- Evolent (Atlanta, GA)
- …requesting or submitting prior authorization requests and/or relevant health care experience in claims or appeal & grievances is required. + Ability to read, write ... and speak the English language fluently with patients and providers. + Ability to adapt to fluctuating situations and perform work of a detailed nature, while avoiding errors. + Proficient using computer and Windows PC applications, which includes strong… more
- Humana (Atlanta, GA)
- …The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of ... diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with review policies,… more
- Walgreens (Warner Robins, GA)
- …technology. Finds opportunities to improve productivity + Ensures insurance claims are processed accurately to prevent payment rejections. Resolves patient ... issues by working with insurance companies and medical providers and conducting or participating in third party audits. + Follows-up with medical providers to clarify prescribed medications, dosages, refills, interactions, and allergies to suggest alternative… more