- AIG (Atlanta, GA)
- Claims , Quality Assurance Specialist - Worker's Compensation Join us as a Claims QA Specialist to make more of your specialist expertise and ... efficiency. How you will create an impact + Complete quality reviews on all files within program guidelines while...skill enhancement. What you'll need to succeed + Proven claims experience handling and auditing Workers Compensation… more
- Axis (Alpharetta, GA)
- …upon request for candidates taking part in the selection process. **Job Description: Senior Claims Specialist ** AXIS is seeking a Senior Claims Specialist ... Claims team reporting to the Manager of Casualty Claims . This position requires senior claims management...plus. **What will you do in this role?** + Auditing of Third-Party Administrators to ensure reserve adequacy. +… more
- Zurich NA (Atlanta, GA)
- …workstreams + Experience in a transactional, operational or customer service environment + Quality auditing experience + Knowledge of the insurance industry and ... Sr Supplier Medical Process Specialist 128416 Zurich North America is seeking am...continuous process and system enhancements to improve operational efficiencies, quality and/or timeliness. At Zurich North America Claims… more
- Elevance Health (Atlanta, GA)
- …at least one of the following: AA/AS or minimum of 15 years of experience in claims auditing , quality assurance, or recovery auditing . + Requires at ... spending. The **DRG Coding Auditor Principal** is responsible for auditing inpatient medical records on claims paid...and generate audit findings letters. + Validates accuracy and quality standards as set by audit management for the… more
- Elevance Health (Atlanta, GA)
- …at least one of the following: AA/AS or minimum of 5 years of experience in claims auditing , quality assurance, or recovery auditing . + Requires at ... auditing inpatient medical records and generating high quality recoverable claims for the benefit of...Health Information Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder. +… more
- Elevance Health (Atlanta, GA)
- …in applicable state(s). + Requires a minimum of 10 years of experience in claims auditing , quality assurance, or clinical documentation improvement, and a ... The **Diagnosis Related Group Clinical Validation Auditor-RN** is responsible for auditing inpatient medical records to ensure clinical documentation supports the… more
- Molina Healthcare (Macon, GA)
- …review, medical claims review, long-term services and supports (LTSS), claims auditing , medical necessity review and/or coding experience, or equivalent ... appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care. **ESSENTIAL JOB DUTIES:** + Facilitates… more
- State of Georgia (Fulton County, GA)
- …role or team leader role. + 7 years' experience in related fields; auditing , claims adjusting, eligibility determination or reviewing and analyzing requests for ... of the Refund and Service Section. Incumbent will provide quality control review of the work of the coordinator,...and assign the work items to coordinator and retirement specialist from workflow and workload distribution. + Monitor coordinator… more