- Elevance Health (Atlanta, GA)
- …with fraud and abuse. **How you will make an Impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities ... prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses...document determinations and continue to next step in the claims lifecycle. + Researches new healthcare related questions as… more
- Sedgwick (Atlanta, GA)
- …or university preferred. **Experience** Four (4) years of experience in claims processing or related business experience, or equivalent combination of education ... 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
- MSC Industrial Supply Co. (Mableton, GA)
- …safety team mentoring, MVP Team, ES&H training, Workers Compensation support for claims and issues and return to work, Incident investigation and corrective action ... Follow-up Incident Investigations and Supports Workers Compensation Cases** + Coordinates claims loss analysis evaluations for CFC associates in conjunction with… more
- Aveanna Healthcare (Atlanta, GA)
- …any and all guarantors for services provided. This is inclusive of claims to commercial, Medicare, Medicaid and private pay accounts. Essential Job Functions ... Requests Bridge Tickets to correct and update EMR. Works with Collector to ensure claims are refiled and/or billed to the second insurance in a timely manner.… more
- Elevance Health (Atlanta, GA)
- …decisions. **How You Will Make An Impact:** + Analyze and monitor weekly incurred claims , paid claims , pharmacy, lab results, and authorizations to identify cost ... and actuarial software tools. + Experience working with large administrative claims datasets and healthcare cost/utilization metrics. + Ability to apply actuarial… more
- Executive Office for US Attorneys and the Office of the US… (Atlanta, GA)
- …its employees. Cases include employment discrimination; personal injury/tort; medical malpractice claims arising out of Veterans' hospitals or other federally funded ... facilities; Bivens actions; Freedom of Information Act challenges; and claims related to decisions by immigration authorities as to...often brought for the United States under the False Claims Act and involve allegations of health care fraud,… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive ... legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,...will not be held liable or responsible for any claims , losses, damages or expenses resulting from job recruiting… more
- Norstella (Atlanta, GA)
- …offerings leveraging Norstella's unified Real World Data asset, NorstellaLinQ, a combination of claims , lab, SDOH and EMR data. You will be joining an organization ... accuracy and quality. *Perform in-depth analyses on healthcare data sources, including claims , lab, EMR/EHR, and SDOH data, to uncover actionable insights and drive… more
- Norstella (Atlanta, GA)
- …service offerings leveraging Norstella's unified Real World Data asset, a combination of claims , lab, SDOH and EMR data. You will be joining an organization hard ... by querying and analyzing a wide range of healthcare data sources, including claims , lab results, electronic medical records (EMR), and other real-world data *Your… more
- Travelers Insurance Company (Atlanta, GA)
- …key decisions. You will be working with the Pricing, Product, Underwriting, and Claims teams to both learn the business and communicate your findings and ... customer segments in the Financial Institutions business unit. + Work with the Claims department to ensure best estimates are appropriately reserved for key … more