- 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 (Columbus, GA)
- **Performance Quality Analyst III ( Claims ** ) **Location** : This role requires associates to be in-office 1 days per week, fostering collaboration and connectivity, ... Alternate locations may be considered. The **Performance Quality Analyst III ( Claims ** ) is responsible for driving service quality excellence by evaluating… more
- 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
- 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
- Sedgwick (Atlanta, GA)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead I Workers Comp (Calif Exp) **PRIMARY PURPOSE:** To supervise the… more
- 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
- 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
- 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
- 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...and minimum of 2 years of experience in handling claims appropriately in accordance with the corporate claim philosophy,… more
- 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