- Prime Therapeutics (Atlanta, GA)
- …analysis to include 3 years of experience in Pharmacy Benefit Management (PBM), claims processing , healthcare, and/or related field. + Previous experience using ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- Prime Therapeutics (Atlanta, GA)
- …needs. + Provides clinical operations input and support of client specific claims processing programs, coordinates implementations of clinical projects and ... assurance of Service Level Agreement performance, assurance of accuracy of claims payment and administrative policies, rate maximization through ongoing benefit… more
- Molina Healthcare (Columbus, GA)
- …in Medicaid, Medicare, and Marketplace lines of business. + Familiarity with QNXT claims processing platform. + Knowledge of legal procedures related to complex ... across a wide range of subrogation case types-including automobile-related claims (eg, no-fault/PIP), workers' compensation, general liability, medical malpractice,… more
- Peachtree Orthopedics (Atlanta, GA)
- …+ Responsible for a variety of medical office /clerical tasks relating to claims processing ; contact patients and responsible parties to resolve past-due ... with minimal or no assistance necessary. + Independently assess claims edits and other billing messages to resolve any... edits and other billing messages to resolve any claims denials to ensure prompt resolution. + Responsible for… more
- Molina Healthcare (Augusta, GA)
- …of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms ... executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other… more
- Mass Markets (GA)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... to complete account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts, policies, and procedures… more
- Mass Markets (GA)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... and retention. + Respond to customer inquiries regarding coverage, benefits, claims , and other insurance-related questions. + Maintain accurate and up-to-date… more
- Mass Markets (Savannah, GA)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... to complete account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts, policies, and procedures… more
- Mass Markets (Savannah, GA)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... to resolve issues when needed + Accurately document and process customer claims in appropriate systems + Utilize knowledge base and training to accurately… more
- Mass Markets (Savannah, GA)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... with other teams as needed + Accurately document and process customer claims and interactions + Follow scripts, policies, and procedures while using training… more