- Waystar (Atlanta, GA)
- …to deliver accurate, timely claim edit/authorization rule configurations. * Studying healthcare industry standards and staying up-to-date on industry changes and ... compliance issues, focusing on government/payer requirements for claims billing & coding/authorization * Leverage analytical tools (Excel, PowerBI, SQL Databases) to… more
- Humana (Atlanta, GA)
- …2 ensures contract compliance and performs analysis regarding pharmacy claims . Understands department, segment, and organizational strategy and operating objectives, ... 2 ensures contract compliance and performs analysis regarding pharmacy claims . Understands department, segment, and organizational strategy and operating objectives,… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …Competencies** **K** **nowledge** - Experience working in the pharmaceutical and/or healthcare industry. - Knowledge and experience with preparation of global ... clinical development, project management, quality assurance, etc.) in pharmaceutical or healthcare related industry. Experience with FDA or other health authority… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …Access, or payer experience + Thorough understanding and knowledge of US healthcare economics and the drivers of pharmaceutical demand, including pricing and ... chain and its business processes + Extensive experience in healthcare contracting and in-depth understanding of GPO/PBM/National and Regional...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Humana (Atlanta, GA)
- …encompasses critical functions including care coordination, quality measurement, billing, claims processing, and customer service, each essential to delivering a ... operational knowledge of core functional areas (care coordination, quality, billing, claims , and customer service). + Collaborate with each Insurance Operations… more
- Humana (Atlanta, GA)
- …and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are ... Office, ER, Telehealth, Home Health, and minor procedures + Experience with the Claims Life Cycle + Experience with coding/auditing Professional Inpatient Claims … more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …Design and optimize engagement models for key external stakeholders including healthcare professionals (HCPs), scientific experts, and advocacy groups + Develop ... engagement + Strong understanding of the US & Global healthcare landscape, including payer and policy environments + Excellent...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …Skills: **Qualifications** + 5+ years of relevant legislative experience, primarily in healthcare , including working with the federal branch and/or Congress ; or 5+ ... with shouldering and assessing risk. + In depth understanding of healthcare , pharmaceutical and biotechnology industry issues required + Demonstrated track record… more
- Mass Markets (GA)
- …technology solutions across a wide range of industries, including healthcare , retail, government, education, telecom, technology e-commerce, and financial services. ... RESPONSIBILITIES Key Responsibilities: + Provide information to customers about various healthcare options and insurance policies. + Help customers choose the… more
- PruittHealth (Norcross, GA)
- …supervisor oversees a team of billing professionals, maintains compliance with healthcare regulations, and drives continuous improvement in revenue cycle processes. ... all home infusion services. * Oversee the preparation and submission of insurance claims , verify patient benefits and payer contracts, and manage follow-up on denied… more