• Claims Rep I ( Health & Dental)

    Elevance Health (Atlanta, GA)
    …(word processing, spreadsheets, etc.) strongly preferred. + Previous experience working in health claims is strongly preferred. For candidates working in person ... ** Claims Representative I** **Location:** This role enables associates...: Illinois, Minnesota In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package,… more
    Elevance Health (08/29/25)
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  • Investigator Senior

    Elevance Health (Atlanta, GA)
    …research findings. + Health insurance experience required with understanding of health insurance policies, health insurance claims handling and provider ... Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity,...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
    Elevance Health (08/28/25)
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  • Investigator Senior

    Elevance Health (Atlanta, GA)
    …healthcare fraud in order to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health ... by law._ Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to… more
    Elevance Health (08/13/25)
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  • Specialist, Appeals & Grievances

    Molina Healthcare (Macon, GA)
    …+ Min. 2 years operational managed care experience (call center, appeals or claims environment). + Health claims processing background, including ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance… more
    Molina Healthcare (08/30/25)
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  • Senior Director, Finance - Emory Health…

    Emory Healthcare/Emory University (Atlanta, GA)
    …+ Leads the long-range financial strategy and annual operating plan for the Emory Health Plan. + Translates trends in claims , utilization, and healthcare market ... integrated health systems. + Deep knowledge of health plan operations, claims analysis, actuarial principles and healthcare finance. + Demonstrated ability… more
    Emory Healthcare/Emory University (07/15/25)
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  • Health Information Consultant Senior

    Elevance Health (Atlanta, GA)
    …analysis preferred. + Practical business experience preferred. + Experience in healthcare claims , health care benefits/total rewards and data analysis preferred. ... ** Health Information Consultant Senior** **Location:** This role requires...an accommodation is granted as required by law. The ** Health Information Consultant Senior** is responsible for identifying opportunities… more
    Elevance Health (08/21/25)
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  • AI/ML Health Data Science Senior Consultant

    Guidehouse (Atlanta, GA)
    …and value sets, such as ICD-10, DRG, and CPT + Experience with commercial health datasets, eg, claims , encounters, risk scoring, HEDIS measures, etc. + Knowledge ... to Obtain Public Trust **What You Will Do** **:** As an AI/ML Health Data Science Senior Consultant with Guidehouse you will present during meetings, summits,… more
    Guidehouse (08/25/25)
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  • Medical Director - Florida

    Humana (Atlanta, GA)
    …health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex ... as a focus on collaborative business relationships, value based care, population health , or disease or care management. Medical Directors support Humana values, and… more
    Humana (07/29/25)
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  • Medical Director - NorthEast Region

    Humana (Atlanta, GA)
    …health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex ... management, utilization management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation. **Preferred… more
    Humana (07/25/25)
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  • Business Architect Sr - Claims Systems

    Elevance Health (Atlanta, GA)
    …an accommodation is granted as required by law. The **Business Architect Sr. - Claims Systems** will be part of Elevance Health 's National Operations Command ... **Business Architect Sr. - Claims Systems** **Location:** This role requires associates to...EdWard, OPAL, OBI, EDI. Please be advised that Elevance Health only accepts resumes for compensation from agencies that… more
    Elevance Health (08/21/25)
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