- Mass Markets (Savannah, GA)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... support inbound customer service, help desk, technical support, and back-office processing representatives for commercial and public sector support positions. In… more
- CVS Health (Atlanta, GA)
- …identifies opportunities for cost containment, fraud detection, and quality improvement in claims processing and reimbursement. + Assesses impacts of new ... and projection analysis to estimate future healthcare costs, revenue, and profitability. + Analyzes claims data to assess patterns, trends, and cost drivers and… more
- UIC Government Services and the Bowhead Family of Companies (Atlanta, GA)
- …required. + Extensive computer/PC knowledge required including; spreadsheet software, word processing software and knowledge of MS Office Suite. + Must be ... and other protected characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual… more
- Cognizant (Atlanta, GA)
- …to the Health Plan/Payer. The comprehensive process includes analyzing, reviewing, and processing medical necessity denials for resolution. You will be a valued ... accounts. . Maintain working knowledge of applicable health insurers' internal claims , appeals, and retro-authorization as well as timely filing deadlines and… more
- Molina Healthcare (Columbus, GA)
- …as the Provider Online Directory, Utilization Management, Customer Experience, Enrollment, and Claims Payment and Processing . + Develop and enforce operating ... and business leaders to enable enterprise wide capabilities. Synchronizes data among multiple claims systems and application of business rules as they apply to each… more
- CVS Health (Atlanta, GA)
- …Quality, CPHQ preferred. + Background in Managed Care. + Familiarity with claims processing workflows. + Experience with quality improvement, PIPs, ANE ... requirements. + Apply clinical criteria and policies to member/provider claims and coordinate clinical resolutions with MD support. **Performance Improvement… more
- Sedgwick (Atlanta, GA)
- …is passionate about shaping strategy through insights rather than simply processing numbers. The ideal candidate is proactive, detail-oriented, forward-thinking, and ... 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… more
- Pilgrim's (Gainesville, GA)
- …safety and medical areas of the site. + Spend time being visible in the processing plant and other site locations. + Conduct periodic safety and health audits and ... program by attending regularly scheduled meetings, providing supporting documentation for claims in litigation, and assist the Occupational Health Nurse/Third Party… more
- Elevance Health (Atlanta, GA)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and ... fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new healthcare-related questions as… more
- Legacy Parking Company (Atlanta, GA)
- …of Assistant Managers and Team Leaders + Monitor and review all damage claims . Recommend and implement plans or programs to improve safety of operations to ... prevent the occurrence or reoccurrence of similar claims + Monitor facility maintenance for cleanliness standards and...to budget and revenue enhancements. + Responsible for payroll processing ; ensuring sign off on hours in timely manner;… more