• External Audit Facilitator

    Elevance Health (Atlanta, GA)
    **External Audit Facilitator** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while ... a dynamic and adaptable workplace. Alternate locations may be considered. The **External Audit Facilitator** is responsible for managing the process for claims more
    Elevance Health (05/23/25)
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  • Manager, Compliance Audit & Analysis

    Emory Healthcare/Emory University (Atlanta, GA)
    …in your career and be what you want to be. We provide: * Comprehensive health benefits that start day 1 * Student Loan Repayment Assistance & Reimbursement Programs ... Location:** Atlanta, GA **Description** + Reporting to the Director, Compliance Audit and Analysis, oversees audits, monitoring, and education for hospital and… more
    Emory Healthcare/Emory University (04/30/25)
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  • Manager, Claims Operations & Research

    Molina Healthcare (Columbus, GA)
    **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage ... amount and benefit interpretation. Monitors and controls backlog and workflow of claims \. Oversees analysis of complex claim inquiries and reimbursement issues using… more
    Molina Healthcare (06/07/25)
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  • Complex Claims Director, Severity

    AIG (Atlanta, GA)
    …point for colleagues . + You will also contribute to continuous improvement in Claims by supporting Quality Assurance / Regional Audit processes , ensuring ... Join us as a Senior Claims Adjuster to take on key responsibilities within...spent at work to offer benefits focused on your health , wellbeing and financial security-as well as your professional… more
    AIG (05/30/25)
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  • Senior Claims Specialist

    Axis (Alpharetta, GA)
    …request for candidates taking part in the selection process. **Job Description: Senior Claims Specialist** AXIS is seeking a Senior Claims Specialist to join ... Claims team reporting to the Manager of Casualty Claims . This position requires senior claims management...practices measured by monthly Quality Assurance and Management Initiated Audit scores as well as the implementation of Management… more
    Axis (03/26/25)
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  • Senior Commercial Auto Liability Claims

    CRC Insurance Services, Inc. (GA)
    …(United States of America) **Please review the following job description:** Process claims , which includes evaluating policy for coverage; working with the insured, ... adjusters, agents and attorneys on the claim and coordinating the payment of claims . In addition, prepare reports such as loss runs and monthly bordereau.… more
    CRC Insurance Services, Inc. (05/16/25)
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  • Commercial Auto Liability Claims Adjuster

    CRC Insurance Services, Inc. (GA)
    …(United States of America) **Please review the following job description:** Process claims , which includes evaluating policy for coverage; working with the insured, ... adjusters, agents and attorneys on the claim and coordinating the payment of claims . In addition, prepare reports such as loss runs and monthly bordereau.… more
    CRC Insurance Services, Inc. (05/16/25)
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  • Claims Sr. Quality & Training Specialist…

    Trustmark (Atlanta, GA)
    …communities. **About the role** This role is a dedicated training position for Claims that resides in the Knowledge Management & Customer Experience group. The ... primary function of this role is to train and audit new and existing staff in all products including...claim handling process and procedures and experience in handling claims appropriately in accordance with the corporate claim philosophy,… more
    Trustmark (06/04/25)
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  • DRG Coding Auditor Principal

    Elevance Health (Atlanta, GA)
    …Group (DRG) methodology, including case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for ... appeals may only be reviewed by other DRG Coding Audit Principals (or Executives). **How you will make an...you will make an impact:** + Analyzes and audits claims by integrating advanced or convoluted medical chart coding… more
    Elevance Health (06/05/25)
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  • Diagnosis Related Group Clinical Validation…

    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 ... coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise, mastery of… more
    Elevance Health (06/04/25)
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