- Elevance Health (Atlanta, GA)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. + Researches...be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with… more
- Elevance Health (Atlanta, GA)
- …Specialist III** is responsible for the discovery, validation, recovery, and adjustments of claims overpayments. May do all or some of the following in relation to ... adjustments. **How you will make an impact:** + Audits paid claims for overpayments using various techniques including systems-based queries, specialized reporting,… more
- Elevance Health (Atlanta, GA)
- …healthcare fraud in order to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding, ... and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying and developing enterprise-wide specific… more
- Saia, Inc (Suwanee, GA)
- …packed with opportunity - from learning new skills and advancing to competitive compensation and great benefits. It's all here and it's exactly what _going further_ ... reporting metrics. Provides support in customer service, routing, billing, and claims resolution. **Major Tasks and Responsibilities** + Compiles and presents data… more
- Elevance Health (Atlanta, 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...be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with… more
- Elevance Health (Atlanta, GA)
- …decisions. **How You Will Make An Impact:** + Analyze and monitor weekly incurred claims , paid claims , pharmacy, lab results, and authorizations to identify cost ... and actuarial software tools. + Experience working with large administrative claims datasets and healthcare cost/utilization metrics. + Ability to apply actuarial… more
- Robert Half Technology (Suwanee, GA)
- …exceptional customer service by addressing inquiries, resolving complaints, and managing claims in line with legal regulations. * Support sales and promotional ... and task execution. * Maintain accurate records of customer interactions and claims to support efficient resolution and reporting. * Collaborate with internal teams… more
- Robert Half Legal (Atlanta, GA)
- …mediations, and depositions to achieve favorable outcomes. * Analyze claims involving transportation accidents, product liability, and premises liability. * ... Work closely with a team to defend claims against motor carriers, medical transportation companies, and other...to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on… more
- Prime Therapeutics (Atlanta, GA)
- …Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of ... data + Develop financial pricing models to monitor performance against pharmacy claims data and identify financial pricing opportunities to drive savings and/or meet… more
- CDM Smith (Columbus, GA)
- …and maintaining a project risk register. Claim management: Early support for claims and disputes on the project. Identify contractual requirements to maintain and ... prosecute claims , and assist project team in managing to those...motor vehicle record as well as drug testing. **Additional Compensation :** All bonuses at CDM Smith are discretionary and… more