- 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
- 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
- Axis (Alpharetta, GA)
- …Lines market in North America. As a direct report to the Head of Financial Lines Claims , the successful candidate will lead a sophisticated team of claims ... top talent and developing appropriate succession plans + Reviewing, processing , and assigning new D&O claims to...maintaining relationships with internal and external partners as their lead contact within the claims department for… 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)
- …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 (Macon, GA)
- …test assumptions through data, but lead with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... execute effective Payment Integrity strategies through both pre-payment and post payment claims reviews, aligning with industry and corporate standards as well as… 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)
- …test assumptions through data, but lead with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... Analysis** + Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. + Applies understanding of… 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