- Elevance Health (Columbus, GA)
- …+ Requires a HS diploma or equivalent and a minimum of 4 years of claims processing and/or customer service experience; or any combination of education and ... SPECIALIST III** is responsible for the discovery, validation, recovery, and adjustments of claims overpayments. May do all or some of the following in relation to… more
- Molina Healthcare (GA)
- …and tests assumptions through data, but leads with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to...SAI targets are met. + Leads efforts to improve claim payment accuracy and financial performance without needing extensive… more
- CVS Health (Atlanta, GA)
- …analytical, critical-thinking, and problem-solving skills. **Preferred Qualifications** + Claims processing experience. + Customer service experience. ... related to Network contracts and agreements. + Research identified issues; submit claim adjustment requests and determine the root cause of disputes. + Serve… more
- Elevance Health (Atlanta, GA)
- …+ Requires a HS diploma or equivalent and a minimum of 2 years of claims processing and/or customer service experience; or any combination of education and ... SPECIALIST II** is responsible for the discovery, validation, recovery, and adjustments of claims overpayments. May do all or some of the following in relation to… more
- Lowe's (Suwanee, GA)
- …+ Escalated customer concern resolution + Working alerts and queues + Inputting customer claims into the claim portal system + Responsible to support delivery ... Delivery processes to solve inquiries/issues and maintain customer satisfaction. Processing orders and fulfilling customer needs to ensure customer satisfaction.… more
- Banner Health (GA)
- …data base and indices, and must be familiar with coding and abstracting software, claims processing tools, as well as common office software and electronic ... to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim... claims software to address coding edits and claim denials utilizing multiple platforms and internal tracking tools.… more
- Fresenius Medical Center (Kennesaw, GA)
- …of outstanding payments from past due accounts. + Ensure timely receipt of claim payments; processing payments accordingly and reconciling all necessary data. + ... the Patient Account Representative - Collections ensures the timely receipt of claim payments and minimizes bad debt accrual. In this capacity, the Patient… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …(where necessary), and ensure quality of care. CLAIMS MANAGEMENT: + Oversee TPA claim processing , ensure accurate and timely payment of claims , and ... + Understand and mitigate financial risks associated with self-funding such as large claims and fluctuations in healthcare costs. ADVISORY AND GUIDANCE: + Work with… more
- Sedgwick (Atlanta, GA)
- …college or university preferred. **Experience** Four (4) years of experience in claims processing or related business experience, or equivalent combination of ... **Skills & Knowledge** + Working knowledge of billing and reconciliation systems, claim systems, financial services, and insurance products + Excellent oral and… more
- Peachtree Orthopedics (Atlanta, GA)
- …+ Responsible for a variety of medical office /clerical tasks relating to claims processing ; contact patients and responsible parties to resolve past-due ... with minimal or no assistance necessary. + Independently assess claims edits and other billing messages to resolve any...use of modifiers preferred. + Familiar with CMS 1500/UB04 claim form completion, knowledge of Medicare, Managed care and… more