- Molina Healthcare (Columbus, GA)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... care experience + Experience in one or more of the following: Claims , Provider Services, Provider Network Operations, Hospital or Physician Billing, or similar.… more
- Elevance Health (Atlanta, GA)
- …I** is responsible for accurate and timely maintenance of provider information on claims and provider databases. **How You Will Make an Impact** Primary duties may ... to: + Assists in synchronization of data among multiple claims systems and application of business rules as they...in good faith believes is the range of possible compensation for this role at the time of this… more
- Elevance Health (Columbus, GA)
- …with fraud and abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities ... prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses...in good faith believes is the range of possible compensation for this role at the time of this… more
- Elevance Health (Atlanta, GA)
- …in order to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health insurance policies, ... health insurance claims handling and provider network contracting. **How will you...in good faith believes is the range of possible compensation for this role at the time of this… more
- Prime Therapeutics (Atlanta, GA)
- …experience in at least one of the specific areas for position (eg, claims , eligibility, product, benefits, implementations or related area) + Must be eligible to ... strong client relations + Implementation experience + Thorough understanding of pharmaceutical claims data and general understanding of medical claims data;… more
- Sedgwick (Atlanta, GA)
- …Adjuster - Power/Energy (SE & SW Regions) **PRIMARY PURPOSE** : To investigate claims internationally of any size or complexity, against insurance or other companies ... according to type of insurance. + Estimates cost of repair, replacement, or compensation . + Prepares report of findings and negotiates settlement with claimant. +… more
- Sedgwick (Atlanta, GA)
- …role will be responsible for investigating and adjusting property and casualty claims , both residential and commercial, with little to no supervision. **ESSENTIAL ... of insurance. + Estimates cost of repair, replacement, or compensation . + Prepares report of findings and negotiates settlement...Attends litigation hearings. + Revises case reserves in assigned claims files to cover probable costs. + Assists in… more
- Zurich NA (Atlanta, GA)
- …Diploma or Equivalent and 14 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate ... and 12 or more years of experience in the Claims or Underwriting Support areaAND + Experience with Microsoft...+ Strong presentation skills + Results oriented At Zurich, compensation for roles is influenced by a variety of… more
- Elevance Health (Atlanta, GA)
- …Jira, Confluence, Bamboo and qTest is a plus. + Health insurance and medical claims knowledge preferred. + Quality certification such as CMQ, CQA, CQPA, CQT, CSQE, ... in good faith believes is the range of possible compensation for this role at the time of this...qTest is a plus. + Health insurance and medical claims knowledge preferred. **For candidates working in person or… more
- Molina Healthcare (GA)
- …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 ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical decision… more