- 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
- J&J Family of Companies (Macon, 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
- Molina Healthcare (Macon, GA)
- …+ SQL expertise + Excel expertise + Medicare, Medicaid, Marketplace claims expertise **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting ... and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made… more
- Kemper (Athens, GA)
- …Responding promptly to policyholder service requests such as beneficiary changes, claims , loans, etc. + Appropriately keeping records, accounting for money ... collected, and processing paperwork **Our agents are expected to:** + Increase the agency size + Build strong working relationships with customers + Devote whatever time is necessary to fulfill the responsibilities of the position + Commit to ongoing… more
- Upstone Materials (Augusta, GA)
- …initiatives + Manages the investigation and review of all incidents/accidents and claims management in his/her region and is responsible for determining and ... initiating the appropriate corrective action + Develops safety policies, procedures, and strategies for accident/incident prevention + Advises management of potential safety hazards to personnel or company property and resolves such hazards + Conducts routine… more
- CVS Health (Atlanta, GA)
- …abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and ... prepares cases for clinical and legal review. + Documents all appropriate case activity in case tracking system. + Prepare written case summaries and make referrals to State and Federal Agencies within the timeframes required by Law. + Facilitates the recovery… more
- Mass Markets (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
- Dal-Tile Corporation (Macon, GA)
- …customer returns, and notifying management of damaged shipments for freight claims . + Operates forklift equipment. + Maintains clean and organized facility ... by sweeping, trash removal, restroom, general office maintenance, etc. + May wait on customers and prepare sales slips. + Maintains a safe working environment by obeying all safety rules outlined in the Safety Program and reporting all accidents, unsafe… more
- CGI Technologies and Solutions, Inc. (Atlanta, GA)
- …(PC or CC). * Strong understanding of P&C insurance operations (underwriting, billing, claims ). * Experience with Agile and hybrid delivery models. * Proficiency in ... tools such as JIRA, Confluence, Visio, and MS Office. * Ability to manage dependencies and communicate effectively across teams. * Familiarity with SQL and wireframing tools is a plus. * CCBA or CBAP certification preferred. Nice to Have: * Experience with… more