- IQVIA (Atlanta, GA)
- **Patient Support Medical Claims Processing Representative** _Contract Remote Role - Location (Open to Remote US)_ As the only global provider of commercial ... 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative** to join our team....+ High School Diploma or equivalent + Experience in claim processing required + Medical Billing Certification… more
- AIG (Atlanta, GA)
- …party contractors or by internal claim handling teams associated with the processing of commercial or personal line claims . + Generate monthly reports that ... need to succeed + Proven claim adjudication or claim operations experience for multi-line commercial claims . Claim Audit or file review experience is… more
- Sedgwick (Atlanta, GA)
- …expertise preferred. **Skills & Knowledge** + Subject matter expertise in worker's compensation claims and/or liability claims processing + Ability to obtain ... FUNCTIONS and RESPONSIBILITIES** + Proactively and strategically manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional… more
- CVS Health (Atlanta, GA)
- …competently, accurately and efficiently. **Preferred Qualifications** - 18+ months of medical claim processing experience - Self-Funding experience - DG system ... every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a… more
- Axis (Alpharetta, GA)
- …determine coverage, liability, and settlement value. + Leading initiatives to enhance claims processing efficiency and accuracy within the team. + Collaborating ... Claims Specialist - Cyber, Media, and Crime Claims for its North America Claim Team....and directing the development of training materials relevant to claims processing . + Show a commitment to… more
- Sedgwick (Atlanta, GA)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... and provides report of investigation pertaining to new events, claims and legal actions. + Negotiates claim ...depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client;… more
- Axis (Alpharetta, GA)
- …analyze the claim exposure, determine the proper course of action, and pursue claims to conclusion Set accurate and timely claim reserves and make referrals ... payments, ensuring these are processed accurately and promptly, including monitoring and processing of claims bordereaux and ISO searches and reporting Ensure… more
- Sedgwick (Atlanta, GA)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
- Sedgwick (Atlanta, GA)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
- CVS Health (Atlanta, GA)
- …and/or RX claims . They will adjudicate complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. This person ... on customer service platforms, specifically by using technical and claims processing expertise. + Apply medical necessity...**Required Qualifications** + 2+ years of experience with medical claim processing . + 2+ years of experience… more