- Humana (Atlanta, GA)
- …closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid ... APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg performing basic… more
- AIG (Atlanta, GA)
- GenAI Product Manager with Claims ExperienceBe part of something groundbreakingAt AIG, we are making long-term investments in a brand-new, innovative Generative AI ... What we are looking for + Master's in business administration preferred + Claims or Insurance background is preferred + Gen AI experience preferred + Minimum… more
- Molina Healthcare (GA)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... not limited to, Configuration, Business Systems, Encounters (inbound and outbound), Claims , Provider Services and Contracting. * Identifies issues, resolves problems… more
- Sedgwick (Atlanta, GA)
- …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 ... advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With… more
- Sedgwick (Atlanta, GA)
- …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 ... advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With… more
- IQVIA (Atlanta, GA)
- …cards or vouchers. The **Care Navigator** is primarily responsible for receiving medical claims from HCPs or patients and vetting the claim against program specific ... employee. **Job Responsibilities:** + Primary responsibilities involve receiving medical claims from HCPs or patients, ensuring the adequate supporting documentation… more
- BrightSpring Health Services (Valdosta, GA)
- …accounts list, code and comment prior to monthly Critical Account call.* Rebill claims for any outstanding AR that is collectible. Provide detail comment in aging ... billing, private insurance and/or federally funded programs, researching agings and claims .* Experience in reading and understanding remits for denial reasons and… more
- Walgreens (Atlanta, GA)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… 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, witness statements, and other evidence to determine the validity and extent… 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, ... timesheets, and reports related to the performance of the crew operation. + Controls crew costs, including effective use of people-power, work methods, operation of equipment, etc. + Furnishes General Foreperson and utility representative with reports of… more