- CVS Health (Atlanta, GA)
- …(this will change once they are out of training). As a Care Management Associate you will be supporting comprehensive coordination of medical services including Care ... clinical staff Identifies triggers for referral into Aetna's Case Management , Disease Management , Mixed Services, and other...service delivery under the direction of nurse or medical director in the most appropriate setting at the most… more
- State of Georgia (Fulton County, GA)
- …Specific, additional experience in the analysis of medical services documentation and related claims 2) Utilization Review 3) Case Management 4) Analysis of CPT ... Fraud Division. Job Summary Under the direction of the Fraud Unit Director , assists in healthcare investigations by: reviewing provider and recipient records, by… more
- Stantec (Atlanta, GA)
- …and forecasting. - Experience with scheduling large, complex projects. - Experience with claims management for design projects. - Sound knowledge and experience ... Claims /Risk mitigation. - Oversee and approve development and management of the Project Scope WBS. - Oversee and...Internal (PGC) Monthly Reports; issue following review with Design Director . - Responsible for the formulation of the Project… more
- MSC Industrial Supply Co. (Mableton, GA)
- … claims loss analysis evaluations for CFC associates in conjunction with corporate claims management efforts at the CSC. + Recommends solutions to avoid ... mentoring, MVP Team, ES&H training, Workers Compensation support for claims and issues and return to work, Incident investigation...all times. + Works with all CFC and branch management to address opportunities and initiatives at the site.… more
- Zurich NA (Atlanta, GA)
- …Diploma or Equivalent and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate ... and 8 or more years of experience in the Claims or Underwriting Support area AND + Knowledge of...property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We… more
- Zurich NA (Atlanta, GA)
- …Diploma or Equivalent and 10 or more years of experience in the Claims , Underwriting support areaOR + Zurich Certified Insurance Apprentice including an Associate ... and 8 or more years of experience in the Claims or Underwriting Support areaAND + Knowledge of Microsoft...property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We… more
- Zurich NA (Atlanta, GA)
- …Diploma or equivalent and 10 or more years of experience in the claims or underwriting support areaOR + Zurich approved Apprenticeship program including an associate ... and 8 or more years of experience in the Claims or Underwriting Support area. + Knowledge of Microsoft...property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …with providers, negotiate contracts (where necessary), and ensure quality of care. CLAIMS MANAGEMENT : + Oversee TPA claim processing, ensure accurate and ... timely payment of claims , and identify areas for cost reduction. COMPLIANCE AND...conduct internal audits, and manage corrective action plans. FINANCIAL MANAGEMENT : + In conjunction with Sr. Director ,… more
- Georgia Military College (Milledgeville, GA)
- …include, but are not limited to: Administrative Responsibilities | Assist with the management of the daily operation of the Athletic Training Room. | Supervise ... physician referrals. | Submission of JC athlete medical insurance claims . | Maintaining JC athlete medical records. | Assist...willing to travel). Teams will be appointed by the Director of Sports Medicine and the Athletic Director… more
- Molina Healthcare (Columbus, GA)
- …CMS, HHS to reconcile data. + Responsible for encounter submissions, rejection management & resolution for all lines of business including internal strategic ... Ability to influence across multiple organizational functions - Payment Integrity, Claims , Encounters, Finance, and Actuarial + Proven experience in managing complex… more