- Prime Healthcare (Riverdale, GA)
- …of the benefits of working at Prime Healthcare: + Health, dental, and vision insurance options + Paid vacation, sick time and holidays + Bereavement leave, FMLA and ... 401K options + Tuition reimbursement options + Life, disability, and other insurance options + Many other amazing benefits Responsibilities Essential Duties and… more
- Elevance Health (Atlanta, GA)
- …healthcare fraud in order to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding, ... and claim systems for review of facility, professional and pharmacy claims + Responsible for identifying and developing enterprise-wide specific healthcare… more
- Sedgwick (Atlanta, GA)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr Vice President Business Transformation **PRIMARY PURPOSE** **:** The SVP Business ... of education and experience required. Experience in the financial services sector ( Insurance , Banking) is highly preferred. **Skills & Knowledge** + Proven track… more
- Utilities Service, LLC (Eastman, GA)
- …Hourly **Benefits:** + Company-sponsored Retirement Plan + Health Insurance (Medical/Dental/Vision) + Employee Assistance Program + Life, long-term/short-term ... disability insurance **Essential Functions & Responsibilities:** + Plans, coordinates, and...be delegated the authority to investigate incident reports, damage claims , etc., and to settle minor damage claims… more
- Evolent (Atlanta, GA)
- …public health, biology) + At least 5 years of professional experience in claims -based healthcare analytics with a payer, provider, vendor, managed care, or related ... healthcare consulting entity + Extensive knowledge of healthcare claims ; specifically, differences between institutional vs professional billing and various sites of… more
- Humana (Atlanta, GA)
- …an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and ... researching medical claims + Proficient in Microsoft Office (Word, Excel, Access,...parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-03-2026 **About… more
- CVS Health (Atlanta, GA)
- …detail-oriented Data Analyst to join our Special Investigation Unit within a leading health insurance organization. This is a full time role and is ideal for a data ... analyses to support investigations of potential fraud, waste, and abuse in Medicaid claims and provider activity. + Prepare timely and accurate Medicaid regulatory &… more
- Pilgrim's (Douglas, GA)
- …program by attending regularly scheduled meetings, providing supporting documentation for claims in litigation, and assist the Occupational Health Nurse/Third Party ... Administrator in effectively managing all open claims . + Provide training support to the organization and...outside agencies come on-site to conduct annual assessments (ie, insurance carrier, local fire department, OSHA, EPA, etc.) +… more
- Guidehouse (Atlanta, GA)
- …and validation activities across key modules such as provider, member, claims , and prior authorization. + Translate complex technical and system implementation ... + Strong understanding of Medicaid system modules, including eligibility, claims processing, provider enrollment, member management, prior authorization, and other… more
- Highmark Health (Atlanta, GA)
- …is a remote based role - looking for someone who has some claims experience and looking to become familiar with risk adjustment.** **ESSENTIAL RESPONSIBILITIES** + ... role or experience in a related operational area (eg claims , billing, customer service, etc.) **Preferred** + 1 -...**Preferred** + 1 - 3 years in the Health Insurance Industry **LICENSES OR CERTIFICATIONS** **Required** + None **Preferred**… more