- Molina Healthcare (GA)
- **Job Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan ... 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
- Travelers Insurance Company (Atlanta, GA)
- …technology and the application for improving business process and increasing productivity. + Claim Practices & Support : + Provide Medical guidance, support ... you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided...local and national level. + May provide input and support medical vendor strategies including vendor selection, negotiation and… more
- Centene Corporation (Atlanta, GA)
- …up accurately in the provider information system for state reporting, claims payment, and directories. Responsible for multiple state deliverables, network reporting ... and directories as well as claims payment resolution as it relates to provider set...as it relates to provider set up. + Provide support to the external provider representative to resolve provider… more
- Cardinal Health (Atlanta, GA)
- …understanding of service level goals and objectives when providing customer support . + Demonstrates ability to respond to non-standard requests from vendors ... done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as… more
- Molina Healthcare (GA)
- …narratives, graphs, flowcharts, etc. for use in presentations and audits. Researches claims appeals and grievances using support systems to determine appeal ... written response to incoming provider reconsideration requests relating to claims payment and requests for claim adjustments...relating to claims payment and requests for claim adjustments or to requests from outside agencies (Providers)… more
- Molina Healthcare (Augusta, GA)
- …agencies to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and ... response to incoming provider reconsideration request is relating to claims payment and requests for claim adjustments...relating to claims payment and requests for claim adjustments or to requests from outside agencies **JOB… more
- CVS Health (Atlanta, GA)
- …strategic planning. + Collaborates with other departments, such as underwriting, claims , and finance, to support their decision-making processes. **Relocation:** ... geared toward developing the future financial leaders of Aetna, along-side the support actuarial students need to pass exams and become credentialed actuaries. Each… more
- Robert Half Legal (Atlanta, GA)
- …companies and small businesses, typical duties will include investigating claims , developing defense strategies, negotiating settlements, and litigating cases in ... court. + Investigate claims : This may involve reviewing police reports, medical records,...evidence to determine the validity and extent of the claim . + Develop defense strategies: The attorney will analyze… more
- Elevance Health (Atlanta, GA)
- …provider management team by presenting preliminary review results. + Verifies dollar amount on claim is correct in claims system and writes report of the ... week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office… 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 ... in order to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health insurance policies,… more