- Cardinal Health (Atlanta, GA)
- …reviewing, and transmitting claims using billing software including electronic and paper claim processing + Following up on unpaid claims within standard ... for verifying patient insurance and benefits, preparing and submitting claims to payers, correcting rejected claims , following...and submitting claims to payers, correcting rejected claims , following up on unpaid and denied claims… more
- Waystar (Atlanta, GA)
- …We process billions of transactions annually, leveraging a massive dataset of claims , remittances, and patient data to drive outcomes. With Waystar AltitudeAI (TM) ... using LLMs for policy document interpretation, predictive modeling for claim denial rates, intelligent task prioritization) to create differentiated, proprietary… more
- CVS Health (Atlanta, GA)
- …review a clinical determination and understand rationale for decision. + Able to research claim processing logic and various systems to verify accuracy of ... benefit language in SPDs or COCs. + Experience in research and analysis of claim processing a plus. + Demonstrated ability to handle multiple assignments… more
- CVS Health (Atlanta, GA)
- …with key payers to discuss reimbursement issues and payer publication notices affecting claims processing changes + Ensure daily reconciliation of electronic ... are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and...variances, and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the… more
- Molina Healthcare (Atlanta, GA)
- …concisely and accurately in accordance with regulatory requirements. * Researches claims processing guidelines, provider contracts, fee schedules and systems ... or equivalent combination of relevant education and experience. * Health claims processing experience, including coordination of benefits (COB), subrogation… more
- Molina Healthcare (Macon, GA)
- …managed care or payer environment. + In-depth knowledge of medical and hospital claims processing , including CPT/HCPCS, ICD, and modifier usage. + Strong ... requirements related to but not limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance. This role… 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
- Intermountain Health (Atlanta, GA)
- …**Essential Functions** + Oversees the day-to-day revenue cycle functions including claims processing , denials, payments, customer service, and follow up ... + Insurance Processing and Issues + Medical Terminology + Claims Processing + Collaboration + Time Management + Team Building **Qualifications** + High… more
- VetsEZ (GA)
- …citizenship required). Preferred Experience: + Prior experience in care coordination, claims processing , or patient engagement systems. + Practical experience ... develop, test, and operationalize AI-driven product ideas-such as automated claims triage, intelligent document processing , and conversational assistants-into… more
- Molina Healthcare (Savannah, GA)
- … claims , COB and DRG/RCC pricing). * Experience with Medicaid and Medicare claims denials and appeals processing , and knowledge of regulatory guidelines for ... JOB DESCRIPTION Job Summary Leads and manages team responsible for claims activities including reviewing and resolving member and provider complaints, and… more
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