- Prime Therapeutics (Atlanta, GA)
- …fuels our passion and drives every decision we make. **Job Posting Title** Lead Claims Processor, Government Programs **Job Description** Adjudicate or submit ... and adjustments as required. + Implementation and maintenance of claims processing programs and procedures + Verify...and administrative duties as required by business need. + Lead and implement positive changes with a high level… more
- Humana (Atlanta, GA)
- …to lead cross-functional initiatives, apply your expertise in healthcare claims , and shape the future of operational excellence in a dynamic, mission-driven ... help us put health first** As a Process Improvement Lead , you'll play a key role in analyzing and...+ 2+ years of demonstrated expertise in end-to-end healthcare claims operations, including claim ingestion, processing , system… more
- Axis (Alpharetta, GA)
- …determine coverage, liability, and settlement value. + Leading initiatives to enhance claims processing efficiency and accuracy within the team. + Collaborating ... associations for knowledge enhancement. + Demonstrate the capability to lead process enhancement initiatives within a claims ...and directing the development of training materials relevant to claims processing . + Show a commitment to… more
- Elevance Health (Atlanta, GA)
- …+ Requires a HS diploma or GED and a minimum of 3 years of claims processing experience; or any combination of education and experience which would provide ... ** Claims Auditor I** **Virtual:** This role enables associates...and stop loss submission, including decision methodology, system or processing errors, and monetary discrepancies. + Provide feedback on… more
- AIG (Atlanta, GA)
- …Law Firms with an annual spend of less than $500K for Insurance Claims processing and adjudication commodities. This shall include; + Negotiate commercial ... customers to manage risk. Join us as a Senior Claims Law Firm Analyst to play your part in...from AIG's Law Firm contract template; + Participate and lead Law Firm pricing negotiations; + Document and summarize… more
- Elevance Health (Atlanta, GA)
- …The **Clinical Document Improvement Director** is responsible for leading encounter processing , diagnostic documentation and claims integrity across CareBridge. ... cycle management (RCM) organizations, with specific understanding in end-to-end claims / encounter processing , as well as ensuring...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- Elevance Health (Atlanta, GA)
- ** Claims Representative I** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... Monday - Friday, with possible OT on Saturday and Sunday. The ** Claims Representative I** is responsible for successfully completing the required basic training.… more
- Elevance Health (Atlanta, GA)
- …The role requires a candidate with a strong understanding of data analysis, claims processing , and audit processes associated with healthcare payment models. ... **Rating/ Claims Systems Implementation Advisor** **Location:** Norfolk, VA; Atlanta,...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- Molina Healthcare (Augusta, GA)
- …test assumptions through data, but lead with contextual knowledge of claims processing , provider contracts, and operational realities. + Create succinct ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Molina Healthcare (Atlanta, GA)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims ... accuracy and compliance of Coordination of Benefits (COB) claim pricing and processing . This role will focus on identifying, reviewing, and validating Medicaid… more