- Elevance Health (Atlanta, GA)
- …CPT/HCPC coding guidelines and terminology. + *Bachelors degree strongly preferred. + Claims processing experience. + Experience in Medicare/Medicaid is a plus. ... Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity,...abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- **About Otsuka Precision Health ** Founded on Otsuka's rich history in delivering breakthrough innovations to solve complex problems for patients, Otsuka Precision ... Health (OPH) is the next step in our evolution....offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed,… more
- Sedgwick (Atlanta, GA)
- …federal/state leave of absence eligibility review; and to ensure the ongoing processing of claims . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Informs ... live within the United States. **PRIMARY PURPOSE** **:** To process claims and determine accommodation options following written guidelines and procedures pursuant… more
- Elevance Health (Atlanta, GA)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. + Researches...dealing with Healthcare Fraud Please be advised that Elevance Health only accepts resumes for compensation from agencies that… more
- Mass Markets (GA)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... as a trusted partner in the industry. We are seeking a Spanish-speaking Licensed Health Insurance Agent. As a key member of our team, you will be responsible… more
- Delta Air Lines, Inc. (Atlanta, GA)
- …in areas such as employee wellness, predictive analytics (using medical and pharmacy claims ), and health plan design. + Design and oversee the execution ... How you'll help us Keep Climbing (overview & key responsibilities) Health Analytics and Data Engineering General Manager will lead and manage our Wellness data… more
- Kemper (Alpharetta, GA)
- …denials and releases. + Promote compliance with Standard Operating Procedures in the processing of all claims . + Supervisors and Managers: Analyze management ... and exposure assignment of newly reported losses to appropriate Claims Adjusters. + Periodically review exposures and pending inventory...enjoy great benefits:** * Qualify for your choice of health and dental plans within your first month. *… more
- CVS Health (Atlanta, GA)
- …analytical, critical-thinking, and problem-solving skills. **Preferred Qualifications** + Claims processing experience. + Customer service experience. ... At CVS Health , we're building a world of health...provider participation and pricing inquiries. + Analyze post-paid healthcare claims as it relates to pricing needs. + Apply… more
- Evolent (Atlanta, GA)
- **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health ... care, we seek to connect the pieces of fragmented health care system and ensure people get the same...in the Performance Suite where Evolent does not pay claims + Establish ideal data transfer protocols during client… more
- Elevance Health (Atlanta, GA)
- …of systems capabilities and business operations is strongly preferred. + Claims Processing , Medical Coding, Overpayment Concepts experience strongly preferred ... + Facets and/or MACESS experience preferred Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement… more