- Humana (Atlanta, GA)
- …first** The Encounter Data Management Professional ensures data integrity for claims errors. The Encounter Data Management Professional work assignments are varied ... make an impact** **Required Qualifications** + 1 - 5 years or more of claims processing experience + Minimum of 1 year experience in conducting thorough root cause… more
- Humana (Atlanta, GA)
- …problems within the encounter process between Humana and CMS using data analysis, claims research, and other resources to provide insight and ensure data integrity ... for Medicare/Medicaid claims errors. **Key Role Functions** + Develop business processes to ensure successful submission and reconciliation of encounter submissions… more
- V2X (Columbus, GA)
- …from base to battlefield. We bring 120 years of successful mission support to improve security, streamline logistics, and enhance readiness. Aligned around a ... required for service members and DFAS to settle all claims . + Process Claims for Reimbursement, determine entitlements and prepare documents for submission… more
- Elevance Health (Atlanta, GA)
- …week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office ... + Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to… more
- Molina Healthcare (Savannah, GA)
- …in the specific programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support , or other specific program ... of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of… more
- Utilities Service, LLC (Bainbridge, GA)
- …the crew. + May be delegated the authority to investigate incident reports, damage claims , etc., and to settle minor damage claims . + Maintains accurate records, ... employees. " **Benefits** We offer a competitive range of benefits to support our employees' health, well-being, and financial security. Medical, dental, and vision… more
- Legacy Parking Company (Atlanta, GA)
- …expectations of our various clients + Identifying high potential employees to support the organization's continued growth + Implement all policies and procedures to ... and Team Leaders + Monitor and review all damage claims . Recommend and implement plans or programs to improve...operations to prevent the occurrence or reoccurrence of similar claims + Monitor facility maintenance for cleanliness standards and… more
- Prime Therapeutics (Atlanta, GA)
- …Evaluates the utilization and financial experience of customers and prospects + Performs claims re-pricing analyses of moderately complex external claims data + ... + Participates in development of methodologies, models, reports and strategies to support objectives of the position + Other duties as assigned **Minimum… more
- Evolent (Atlanta, GA)
- …leveraging advanced analytics to solve complex healthcare challenges and support impactful decision-making that enhances organizational performance and patient ... + Lead in-depth analyses of healthcare data - including authorizations, claims , membership, and clinical outcomes to identify cost drivers, utilization patterns,… more
- Evolent (Atlanta, GA)
- …and develops analytic tools to solve complex business challenges as well as support decision making that can have a considerable impact on organizational performance ... public health, biology) + At least 5 years of professional experience in claims -based healthcare analytics with a payer, provider, vendor, managed care, or related… more