- Deloitte (Atlanta, GA)
- …Client project engagements in Deloitte Human Capital's Health Actuarial Plan & Insurance Center of Excellence (HAPI COE) which involve: + The independent calculation ... Plan Actuarial liabilities for Incurred But Not Paid (IBNP) claims and Loss Adjustment Expense (LAE) for products covering...6+ years of experience working in a consulting or insurance company environment* 2+ years of experience managing teams*… more
- Sedgwick (Atlanta, GA)
- …**QUALIFICATIONS** + On-site claims adjusting experience and/or experience as a Claims Professional for an Insurance /Reinsurance Carrier, Broker, or TPA. + ... Background in property, liability, and/or CAT claims preferred. + AIC and AIS professional ... claims preferred. + AIC and AIS professional insurance designations or State Licensed Insurance Adjuster… more
- Elevance Health (Atlanta, GA)
- …Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider ... create predictive impact decision making tools + Recommends policy changes and claim 's system changes to pursue cost savings. + Reviews results post-implementation… more
- Elevance Health (Atlanta, GA)
- …Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider ... practices, and specialty care procedures. + Recommends policy changes and claim 's system changes to pursue cost savings. + Reviews results post-implementation… more
- Elevance Health (Atlanta, GA)
- …Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider ... practices, and specialty care procedures and recommends policy changes and claim 's system changes to pursue cost savings. + Reviews results post-implementation… more
- Elevance Health (Atlanta, GA)
- …Provider selection logic; Provider setup configuration and roster loading/automation, claims system knowledge; external claim (EX) reviews/fixes; provider data ... and long term disability benefits, 401(k) +match, stock purchase plan, life insurance , wellness programs and financial education resources, to name a few. Elevance… more
- Insight Global (Atlanta, GA)
- …agile/scrum. * Self-motivated, flexible, organized, and accountable. * Experience in the insurance and claims interfaces (is highly desirable (though not ... content to motivate users to complete a task such as checking out, filing a claim , reviewing their account, etc. The pay for this role ranges on years of experience… more
- Highmark Health (Atlanta, GA)
- …and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting ... skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and...this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described… more
- Walmart (Douglas, GA)
- …assigned area of work Creates action plans to address audit findings Validates claim records work with workers compensation case managers for investigation of ... claims Asset Protection Security Possesses knowledge of Asset protection...Financial benefits include 401(k), stock purchase and company-paid life insurance . Paid time off benefits include PTO (including sick… more
- Waystar (Atlanta, GA)
- …**measurable business value** and directly improve customer outcomes (eg, better claim processing insights, faster payment reconciliation). + Establish **KPIs** to ... + Experience working with **healthcare data** and understanding RCM processes ( claims , billing, payments). + Familiarity with data orchestration tools (eg,… more