- PruittHealth (Norcross, GA)
- …* Knowledge of principles, methods, and techniques related to compliant healthcare billing/collections * Familiarity with Insurance Claims management functions ... all Insurance billing services by final/higher level auditing, correcting, and submitting claims . Ensures that billing services are timely, accurate, and allow for… more
- Molina Healthcare (Atlanta, GA)
- JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to ... to ensure that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals and… more
- Molina Healthcare (Atlanta, GA)
- JOB DESCRIPTION Provides support for claims activities including reviewing and resolving **Provider No Surprises Act** cases in accordance with the standards and ... ensure that internal and/or regulatory timelines are measured correctly. * Researches claims using support systems to determine **Provider No Surprise Act** cases… more
- Oracle (Atlanta, GA)
- …and predictive analytics. * Apply generative AI to synthesize insights from multi-modal healthcare data (eg, EHRs, imaging, claims , and demographics) to enhance ... Oracle Health Data Intelligence (HDI) is leading the charge in transforming healthcare with innovative data and AI solutions. We're seeking a highly skilled… more
- Molina Healthcare (Savannah, GA)
- JOB DESCRIPTION Job Summary Leads and manages team responsible for claims activities including reviewing and resolving member and provider complaints, and ... oversees necessary correspondence in accordance with regulatory requirements. * Ensures claims production standards set by the department are met. * Maintains… more
- Emory Healthcare/Emory University (Atlanta, GA)
- **Overview** **Be inspired. Be rewarded. Belong. At Emory Healthcare .** At Emory Healthcare we fuel your professional journey with better benefits, valuable ... in advancing our culture of safety, providing leadership and direction to Emory Healthcare 's Risk Management team. + Reporting directly to the Vice President Risk… more
- Molina Healthcare (Savannah, GA)
- …to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance ... assures timeliness and appropriateness of responses per state, federal and Molina Healthcare guidelines. + Responsible for meeting production standards set by the… more
- Molina Healthcare (Macon, GA)
- …Responsible for accurate and timely auditing of critical information on claims databases. Maintains critical auditing and outcome information. Synchronizes data ... among operational and claims systems and application of business rules as they...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- Molina Healthcare (Atlanta, GA)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... Hospital payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is… more
- Molina Healthcare (Atlanta, GA)
- … healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare financial terms ... related to cost, utilization and revenue for multiple Molina Healthcare products. Analyzes data and dashboard reports to monitor...and manage information from large data sources. + Analyze claims and other data sources to identify early signs… more