- WTW (Atlanta, GA)
- …teams of consultants across WTW, including brokers, service colleagues, and claims advocates, to deliver efficient and effective support. This role requires ... strong leadership, communication, and project management skills to align resources with client needs. A Client Advocate (CA) will need to have: + Strong negotiation skills + Strong management skills (mentoring and leading ACAs; coordinating with brokers) +… more
- Elevance Health (Atlanta, GA)
- …impact on existing programs. + Conduct comprehensive analysis of healthcare data, claims , and financial reports to identify trends, patterns, and opportunities for ... improvement. + Consolidates and prepares executive summary reports for various business segments in the SBU for top management decision-making. + Analyzes and designs solutions to address varied and highly complex business needs. + May collaborate with… more
- PruittHealth (Norcross, GA)
- …and post payments to patient accounts 5. Investigate or appeal and revise rejected claims for resubmittal. 6. Carry out all duties with a "Commitment to Caring" ... attitude in accordance with the company's mission, vision, and philosophy. 7. Follow all company policies and procedures, state and federal laws and regulations and report violations to the appropriate supervisor. 8. File and organize all appropriate paperwork… more
- Elevance Health (Columbus, GA)
- …of reimbursement, as applicable. + Assists in problem solving with providers, claims or service issues. **Minimum Requirements:** Requires BA/BS in a health related ... field and minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. Current, unrestricted RN license in applicable state(s) required. Multi-state licensure is required if this… more
- Walmart (Mcdonough, GA)
- …in accordance with company policies and procedures by properly handling claims and returns; zoning the area; stocking, arranging and organizing merchandise; ... setting up, cleaning, and organizing product displays; removing damaged goods; signing and pricing merchandise according to company policies and procedures; identifying shrink and damages; and securing fragile and high-shrink merchandise. Monitors food and… more
- Humana (Atlanta, GA)
- …The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of ... diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with review policies,… more
- Mass Markets (Savannah, GA)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service, ... Digital Experience Provider (DXP), Account Receivables Management (ARM), Application Software Development, Managed Services, and Technology Services, to mid-market, Federal & enterprise partners. MCI now employs 10,000+ talented individuals with 150+ diverse… more
- Elevance Health (Atlanta, GA)
- …BI) strongly preferred + Familiarity with healthcare datasets (ie closed claims , EHR/EMR), market access analytics, and commercial strategies in the pharmaceutical ... domain. + Experience in developing and conducting training sessions for internal and external stakeholders. + Familiarity with AWS and Cloud environments. + Proven ability to design modeling studies and experience with data models, addressing data quality… more
- J&J Family of Companies (Atlanta, GA)
- …on product coverage, prior authorizations and appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations (local ... payers, government payers, etc.) for core and launch products. + Collaborate with field support team members such as sales representatives and key account managers and serve as reimbursement expert for the local team. + Act with a sense of urgency to address… more
- Guidehouse (Atlanta, GA)
- …as ICD-10, DRG, and CPT + Experience with commercial health datasets, eg, claims , encounters, risk scoring, HEDIS measures, etc. + Knowledge of recent and ongoing ... public health initiatives in surveillance and informatics + Bachelor's degree and 3 years of prior relevant consulting experience (relevant experience may be substituted for formal education or advanced degree) + 3 years of experience in data analytics and… more