- TEKsystems (Atlanta, GA)
- …to determine next steps. 2. Rebilling & Appeals Submission + Focus on claims ready for appeal-already vetted and prioritized. + Write appeal letters, make calls ... + Determine reasons for denials and appropriate appeal pathways. + Escalate claims when necessary and recommend strategic actions. + Collaborate with analysts to… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …a minimum of 5 business days. **Company benefits:** Comprehensive medical, dental , vision, prescription drug coverage, company provided basic life, accidental death ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …a minimum of 5 business days. **Company benefits:** Comprehensive medical, dental , vision, prescription drug coverage, company provided basic life, accidental death ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… 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 ... fraud and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …a minimum of 5 business days. **Company benefits:** Comprehensive medical, dental , vision, prescription drug coverage, company provided basic life, accidental death ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
- AECOM (Atlanta, GA)
- …+ Work with management and staff to resolve pre-litigation disputes and potential claims + Manage various types of litigation matters and claims utilizing ... experience at an engineering, architecture or construction company + Claims /litigation handling, including management of outside counsel, relating to architecture,… more
- 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 ... fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. + Researches new healthcare related questions… 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
- 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 ... but are not limited to: + Assists in synchronization of data among multiple claims systems and application of business rules as they apply to each database. +… more