- Cardinal Health (Atlanta, GA)
- …coders, billers and other appropriate staff. This position will also support the Director with transactional audit diligence and integration planning, as well as ... and proactively provides guidance and trainings on policies. Reporting to the Director , Ethics & Compliance, this position supervises and manages audits to determine… more
- Grant Thornton (Atlanta, GA)
- …include but are not limited to co-sourced and outsourced internal audit , internal control assessments, enterprise risk management program assessments, tests of ... and implement internal controls + Support engagement Manager and/or Senior Manager/ Director in project management activities, such as preparing and managing… more
- Ankura (Atlanta, GA)
- …client delivery services across the firm . Ankura's Forensic Accounting and Claims Consulting (FACC) practice focuses on assisting corporations in the quantification ... and presentation of first party insurance claims as a result of a covered loss. Commonly...these insured losses, and then assists in the claim audit and settlement processes. Role Overview: Our Summer Internship… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- **Job Summary** We are seeking an experienced and dynamic Executive Director of R&D Global Quality to join our team. This pivotal role will be responsible for ... oversee clinical trial and submission support, lead the R&D audit program, engage with regulatory authorities, and maintain clinical...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Molina Healthcare (Augusta, GA)
- …by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and controls that ... you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer partners… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- **Job Summary** The Senior Director of Quality Strategy and Operations will be responsible for developing and delivering the Global Quality strategic plan, ... improvement and governance to areas such as training and audit . Foster a culture of operational excellence, ensuring best...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Molina Healthcare (Atlanta, GA)
- …and other guidance to assess compliance and support building regulatory compliance audit procedures. * At the direction of management, coordinates and performs ... and internal policies and procedures. * Supports the Operational Oversight Manager, Director , and team in the general development of the Operational Oversight… more
- NDCP (Duluth, GA)
- …potential The Workers' Compensation Manager (WC) is responsible for all WC-related claims management, including proactive management of WC claims to accelerate ... has experience adjusting workers' compensation lost time and medical only claims in an insurance company, third party administrator (TPA), or… more
- State of Georgia (Fulton County, GA)
- …Fraud Division. Job Summary Under the direction of the Fraud Unit Director , assists in healthcare investigations by: reviewing provider and recipient records, by ... to whether proper diagnostic and procedure codes were used in submitting claims to the Georgia Medicaid Program. Maintains a comprehensive understanding of current… more
- Sunrise Senior Living (Acworth, GA)
- …internal business controls. + Process and manage unemployment and worker's compensation claims and update claim activity as necessary. + Clearly communicate and ... completed for each business area. + Assist in providing audit materials and information as requested. + Meet business...members, and targeted referral sources. + Assist the Executive Director (ED) in completing the annual community budget. +… more