- Elevance Health (Atlanta, GA)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- Evolent (Atlanta, GA)
- …fostering trust, expertise and cooperation. + Extract, manage, and analyze claims and operational data using industry-standard metrics. + Process and validate ... raw unadjudicated claims data. **Qualifications Required and Preferred:** + Bachelor's degree,...Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are… more
- Elevance Health (Atlanta, GA)
- …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... research and responds to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues and to audit … more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …in ERP system. + Manage 3PL processes for inventory, returns and claims , recall activities and reporting, and product destructions. + Manage inventory reporting ... basic life, accidental death & dismemberment, short-term and long-term disability insurance , tuition reimbursement, student loan assistance, a generous 401(k) match,… more
- Lowe's (Suwanee, GA)
- …time, as well as access to top-tier medical, dental and vision insurance . For information about our benefit programs and eligibility, please visit ... with the third-party logistics partner to address and resolve claims (customer and cargo), updates Lowe's claims ...resolve claims (customer and cargo), updates Lowe's claims portal + Process vendor credit for items returned… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …third-party data assets, including Xponent Plantrak, DDD, HCOS, Claims Data, Specialty pharma, omnichannel data, SalesForce/Veeva (Call/Sample/Detail), etc. ... basic life, accidental death & dismemberment, short-term and long-term disability insurance , tuition reimbursement, student loan assistance, a generous 401(k) match,… more
- Sedgwick (Atlanta, GA)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Hotel Coordinator **PRIMARY PURPOSE:** To provide carrier support by assisting ... adjusters, carrier supervisors and outside contractors. + Maintains effective relationships with insurance carriers as well as across multiple lines of business and… more
- Humana (Atlanta, GA)
- …looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and ... provider contract payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments. Analyzes, enters… more
- Sedgwick (Atlanta, GA)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Provider Network Specialist **PRIMARY PURPOSE** **:** To ensure clients and Managed ... respective MCO. + Communicates with clients relative to their MCO status. + Ensures claims management system parameters are set for MCO flags. + Responds to client… more
- Sedgwick (Atlanta, GA)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Assistant Vice President **PRIMARY PURPOSE** : To provide strategic recommendations ... locations/offices; provides expert medical and product support to Sedgwick claims and clinical staff. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs… more