- Prime Therapeutics (Atlanta, GA)
- …our passion and drives every decision we make. **Job Posting Title** Lead Claims Processor, Government Programs **Job Description** Adjudicate or submit claims ... cause analysis and provide additional training as needed. Resolve claims edits and suspended claims . **Responsibilities** + Adjudicate or submit claims and… more
- Sedgwick (Atlanta, GA)
- …Work(R) Fortune Best Workplaces in Financial Services & Insurance Commercial Auto Claims Representative **PRIMARY PURPOSE** : To analyze and process low to mid-level ... auto and transportation claims . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Processes auto property...+ Processes auto property damage and lower level injury claims ; assesses damage, makes payments, and ensures claim files… more
- Elevance Health (Atlanta, GA)
- ** Claims Auditor I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... an accommodation is granted as required by law._ The ** Claims Auditor** **I** is responsible for pre and post...and post payment and adjudication audits of high dollar claims for limited lines of business, claim types and… more
- Robert Half Accountemps (Alpharetta, GA)
- Description We are looking for a Claims Support specialist to join our team in Alpharetta, Georgia. This Contract position requires an individual with strong ... organizational skills who can handle claims processing, customer service, and administrative tasks with efficiency...and review the accuracy of information for newly received claims in accordance with coverage guidelines. * Update claim… more
- Molina Healthcare (Atlanta, GA)
- **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of claims ... cost control standards. **KNOWLEDGE/SKILLS/ABILITIES** + Evaluates the adjudication of claims using standard principles and state specific policies and regulations… more
- Molina Healthcare (Macon, GA)
- …clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains ... days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and...fraudulent billing practices, waste, overpayments, and processing errors of claims . ( _Use for claims specific positions… more
- Elevance Health (Atlanta, GA)
- **Clinical Documentation and Claims Integrity Director** **Location:** Alternate locations may be considered. This position will work a hybrid model (remote and ... is responsible for leading encounter processing, diagnostic documentation and claims integrity across CareBridge. The ideal candidate has experience working… more
- GuideOne Insurance (Atlanta, GA)
- As a Commercial Casualty Claims Adjuster, you will serve as a real partner to our members by processing claims accurately and efficiently so they can resume ... + Investigates coverage and cause of loss on routine to more complicated claims , which includes but is not limited to policy review, interviewing all parties… more
- AIG (Atlanta, GA)
- …need to know: The Complex Director is Senior Adjuster role in Primary Claims responsible for investigating, evaluating, and negotiating General and Auto Liability ... claims nationwide which may have unique coverages and exposures...experience. + Experience resolving moderate to high severity injury claims . + Experience evaluating coverage and risk transfer. +… more
- CVS Health (Atlanta, GA)
- …we do it all with heart, each and every day. **Position Summary** The **Senior Claims Benefit Specialist** will review and adjust SF ( _self-funded_ ), FI ( _fully ... insured_ ), Reinsurance, and/or RX claims . They will adjudicate complex, sensitive, and/or specialized ...claims . They will adjudicate complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. This person… more