- HUB International (Atlanta, GA)
- …including, but not limited to, pre-sale, post-sale/implementation, and premium and claims administrative processes + Diligent attention to detail and accuracy ... **Preferred Qualifications** + College Degree or equivalent job experience + 2 years of experience working with Employee Benefits Programs in a brokerage firm or equivalent setting within the Insurance industry + Proficient understanding of Employee Benefits… more
- Centene Corporation (Augusta, GA)
- …care or medical group experience, provider relations, quality improvement, claims , contracting utilization management, or clinical operations. Project management ... experience at a medical group, IPA, or health plan setting. Proficient in HEDIS/Quality measures, cost and utilization.Pay Range: $55,100.00 - $99,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance,… more
- Mass Markets (GA)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service, ... Digital Experience Provider (DXP), Account Receivables Management (ARM), Application Software Development, Managed Services, and Technology Services, to mid-market, Federal & enterprise partners. MCI now employs 10,000+ talented individuals with 150+ diverse… more
- CVS Health (Atlanta, GA)
- …routine nature. + Handle incoming calls from members and providers regarding claims status, benefits and eligibility, PPO participation, etc + Maintain department ... established performance metrics at a meets or exceeds expectations level + Work together as a team and apply the Aetna Core Values in day-to-day operations + Creating a Differentiated Service Experience + Demonstrating Service Discipline + Handling Service… more
- Molina Healthcare (Augusta, GA)
- …pharmacy prior authorization requests and/or appeals. + Explains Point of Sale claims adjudication, state, NCQA, and CMS policy/guidelines, and any other necessary ... information to providers, members, and pharmacies. + Assists with clerical services/tasks and other day-to-day operations as delegated. + Effectively communicates plan benefit information, including but not limited to, formulary information, copay amounts,… more
- Molina Healthcare (Atlanta, GA)
- …credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. * ... Completes follow-up for provider files on 'watch' status, as necessary, following department guidelines and production goals. * Reviews and processes daily alerts for federal/state and license sanctions and exclusions reports to determine if providers have… more
- Mass Markets (Hinesville, GA)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service, ... Digital Experience Provider (DXP), Account Receivables Management (ARM), Application Software Development, Managed Services, and Technology Services, to mid-market, Federal & enterprise partners. MCI now employs 10,000+ talented individuals with 150+ diverse… more
- Mass Markets (Midway, GA)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service, ... Digital Experience Provider (DXP), Account Receivables Management (ARM), Application Software Development, Managed Services, and Technology Services, to mid-market, Federal & enterprise partners. MCI now employs 10,000+ talented individuals with 150+ diverse… more
- Peachtree Orthopedics (Sandy Springs, GA)
- …a daily collection sheet, and reconcile daily receivables. Create insurance claims and patient statements. + Patient Advocacy: Assist patients in understanding ... their billing, establish payment plans, and follow up on outstanding balances. + Insurance Expertise: Obtain insurance verifications and prior authorizations, communicate with adjusters, and stay up-to-date with third-party billing and reimbursement. + Team… more
- AECOM (Atlanta, GA)
- …mitigate and eliminate such * Directs staff to operate and minimize exposure to claims * Supervises and directs Project Managers with multiple projects or program of ... projects **Qualifications** **Minimum Qualifications** + BA/BS + 8 years or more of relevant experience or demonstrated equivalency of experience and/or education + Due to the nature of the work, US Citizenship is required **Preferred Qualifications** +… more