- CVS Health (Atlanta, GA)
- …+ Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. + Applies medical necessity guidelines, ... every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a… more
- AIG (Atlanta, GA)
- …your mark in: Claims Operations and Legal Departments As a Senior Legal Processing Specialist in the Claims Operations and Legal Departments, you will ... to manage risk. Join us as a Senior Legal Processing Specialist to play your part in...balancing legal research with data-driven reporting. + Support the Claims Operations and Legal teams with legal processing… more
- Sedgwick (Atlanta, GA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist Sr - Commercial Coverage Specialist **PRIMARY PURPOSE** ... **:** To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims ; to… more
- Axis (Alpharetta, GA)
- …part in the selection process. **About the Team** AXIS is hiring a Senior Claims Specialist , E&S Property, to support its expanding presence in North America's ... coverage, liability, and settlement value. + Leading initiatives to enhance claims processing efficiency and accuracy within the team. + Collaborating with legal… more
- Molina Healthcare (Macon, GA)
- …communicate written and verbal + Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using claims ... incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims . ( _Use for claims specific positions only_ )… more
- CVS Health (Atlanta, GA)
- …Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity ... every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a… more
- Axis (Alpharetta, GA)
- …payments, ensuring these are processed accurately and promptly, including monitoring and processing of claims bordereaux and ISO searches and reporting Ensure ... analyze the claim exposure, determine the proper course of action, and pursue claims to conclusion Set accurate and timely claim reserves and make referrals to… more
- Robert Half Accountemps (Alpharetta, GA)
- …position requires an individual with strong organizational skills who can handle claims processing , customer service, and administrative tasks with efficiency ... Description We are looking for a Claims Support specialist to join our...Requirements * Minimum of 2-3 years of experience in claims processing or low-touch claim handling. *… more
- Cognizant (Atlanta, GA)
- … processing is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist , you will be responsible for timely and accurate ... * 1 year of Facets experience. * Experience in the analysis and processing of claims for payments, utilization review/quality assurance procedures. * Must… more
- Elevance Health (Atlanta, GA)
- …+ Requires a HS diploma or equivalent and minimum of 4 years claims processing and/or customer service experience; or any combination of education ... **Financial Operations Recovery Specialist Lead** **Location:** _Hybrid1:_ This role requires associates...higher level degree preferred. + Leadership experience in a claims processing environment preferred Please be advised… more