- Cardinal Health (Atlanta, GA)
- …Legal function. **_Job Summary_** The Assistant General Counsel, Nuclear & Precision Health Solutions (NPHS) is responsible for providing outstanding legal advice to ... escalate appropriately + Effectively communicate with all levels of the Cardinal Health organization + Identify and collaborate with subject matter experts from… more
- Highmark Health (Atlanta, GA)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job creates data-driven insights which identify actionable opportunities and/or create ... to the Quadruple Aim of Healthcare: lower per capita health care costs, improved outcomes from and quality of...coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + 3 years… more
- CVS Health (Atlanta, GA)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...in accounting system. + Enter and process monthly fee claims for ancillary product offerings via claim system. **Required… more
- Evolent (Atlanta, GA)
- …growth opportunities at customer accounts + Strong knowledge of health plan operations, care/utilization management, claims processing, value-based ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...to identify opportunities and actions (including EMR, clinical, authorization, claims , SDoH, etc.); understanding of how to translate data… more
- Elevance Health (Atlanta, GA)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- Travelers Insurance Company (Alpharetta, GA)
- …and resolving assigned General Liability Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer ... **What Will You Do?** + Directly handles assigned severity claims . + Provides quality customer service and ensures file...litigation experience. **What Is in It for You?** + ** Health Insurance** : Employees and their eligible family members… more
- Travelers Insurance Company (Alpharetta, GA)
- …negotiating and resolving assigned Construction Defect and Latent Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer ... partners. **What Will You Do?** + Directly handles assigned claims . + Provides quality customer service and ensures file...the job. **What Is in It for You?** + ** Health Insurance** : Employees and their eligible family members… more
- Travelers Insurance Company (Alpharetta, GA)
- …negotiating and resolving assigned Construction Defect and latent Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer ... **What Will You Do?** + Directly handles assigned severity claims . + Provides quality customer service and ensures quality...the job. **What Is in It for You?** + ** Health Insurance** : Employees and their eligible family members… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …with the finance team to manage the budget and financial performance of the health plan, the VP Pharmacy for performance on pharmaceutical spending targets, and the ... with providers, negotiate contracts (where necessary), and ensure quality of care. CLAIMS MANAGEMENT: + Oversee TPA claim processing, ensure accurate and timely… more
- Sedgwick (Atlanta, GA)
- …and strategically manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional expertise to provide oversight, and directs the ... jurisdictions on complex claim issues. + Uses knowledge of all aspects of claims handling in evaluating exposure; recommends and directs action plans for issue or… more