- Molina Healthcare (GA)
- …for reviewing and resolving member & provider complaints and communicating resolution to members (or authorized) representatives in accordance with the standards ... to appeals and grievances. + Elevates appropriate appeals to the Appeals Specialist . + Generates and mails denial letters. + Assists with interdepartmental issues… more
- PruittHealth (Norcross, GA)
- …of Private billing and are skilled at problem solving and account resolution . This position will work under general supervision. This position will function ... DUTIES, AND RESPONSIBILITIES:** * Prepare and transmit Georgia Private Billing claims . * Research, correct and re-bill outstanding Private Billing claims… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …**RESPONSIBILITIES:** + Versatile in all aspects of the Revenue Cycle through Resolution of all patient claims . + This position updates demographic ... and insurance information for accuracy on all patients. + Collects and follows up on all accounts assigned prior to, during or after admission and discharge. + Communicates EHC's financial policies to all patients. + Identifies patients who require financial… more
- Molina Healthcare (Atlanta, GA)
- …Provides subject matter expertise and responsibility for oversight, production, and resolution of Health Plan Payment Integrity (PI) recovery concepts. This role ... and finance partners to proactively identify issues and implement resolution strategies. + Serves as a thought partner to...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more
- Molina Healthcare (GA)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... and finance partners to proactively identify issues and implement resolution strategies. + Serves as a thought partner to...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more
- Molina Healthcare (Augusta, GA)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... and finance partners to proactively identify issues and implement resolution strategies. + Serve as a thought partner to...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more
- Highmark Health (Atlanta, GA)
- …of the change or problems and takes appropriate steps to effect resolution . (10%) + Reviews and interprets medical information, classifies that information into ... or Outpatient): Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) + AAPC Credentials (Outpatient): Certified Professional Coder… more