- Molina Healthcare (GA)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... reports. + Generates Provider Related reports to facilitate and support Provider Services/Provider Problem Research & Resolution. **JOB QUALIFICATIONS** **Required… more
- CVS Health (Atlanta, GA)
- …day. **Position Summary** -Responsible for initial review and triage of claims tasked for review. -Determines coverage, verifies eligibility, identifies and ... management services and health care team. -Performs non-medical research and support -Adheres to Compliance with PM Policies and Regulatory Standards. -Maintains… more
- CVS Health (Atlanta, GA)
- …abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and ... during interactions with internal and external partners. + Provide Trial Testimony in support of Criminal or Civil proceedings. + Gives presentations to internal and… more
- Molina Healthcare (Macon, GA)
- …and test analytics, enforcing test quality standards, and providing whole project support and oversight. In addition to integration with other projects. Responsible ... + SQL expertise + Excel expertise + Medicare, Medicaid, Marketplace claims expertise **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting… 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 ... coordination, and ownership of high-value deliverables-distinct from a pure data analyst role. **Job Duties** **Business Leadership & Operational Ownership** +… more
- Elevance Health (Atlanta, GA)
- …week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office ... meet financial and operational targets. As a Clinical Content Analyst , you'll research and interpret CMS, CPT/AMA and other...and finally data validation. Your goal is to develop claims editing logic and content that promote payment accuracy… more
- The Hartford (Alpharetta, GA)
- …Master, and will be responsible for delivering high-quality, scalable, and secure solutions that support our Claims operations. This role will have a Hybrid work ... leader to oversee the development and maintenance of our Claims application ecosystem. This role is pivotal in driving...the US without company sponsorship. The company will not support the STEM OPT I-983 Training Plan endorsement for… more
- Highmark Health (Atlanta, GA)
- …to work closely with the section's Accountant, Accounting Coordinators, Associate Analyst , providing, guidance, feedback, training, motivation, and support . This ... of Quote to ID card status to customers, including Groups, Sales and Support teams within the company. Responsible for resource planning, budget compilation and… more
- UIC Government Services and the Bowhead Family of Companies (Kingsland, GA)
- …GA. to provide oversight and supervision of BOMS personnel providing material support and services to Program Executive Office Ships (PEO Ships), PMS300. PMS300 ... + Responsible for the day-to-day duties of BOMS personnel in support of all requirements/deliverables provided to PMS300. Provide direction and supervision… more
- AIG (Atlanta, GA)
- GenAI Product Manager with Claims ExperienceBe part of something groundbreakingAt AIG, we are making long-term investments in a brand-new, innovative Generative AI ... insurance and beyond, and we need your help.With the support and investment needed to explore new frontiers in...key part of that transformation. As a GenAI Product Analyst you will have the opportunity to make a… more