- Merck (Atlanta, GA)
- …key customers/personnel to understand practice structure, business model, key influencers Managed Care Organization (MCO), employers, state and local ... Partners with National Account Executives (NAEs) to maintain strong focus on Managed Care pull-through + Shares learning and best-practices from one customer to… more
- State of Georgia (Fulton County, GA)
- …reports for claims paid after a member's Date of Death for fee-for-service and managed care programs. The desired candidate will collaborate with the Office of ... to ensure compliance with reporting requirements for investigations and overpayments for managed care plans. The candidate will also direct a diverse range of… more
- Molina Healthcare (GA)
- …a clerical role in a claims, and/or customer service setting - preferably in managed care , or equivalent combination of relevant education and experience. * ... Qualifications** * Claims recovery experience. * Health insurance experience in a managed care setting. To all current Molina employees: If you are interested in… more
- Molina Healthcare (Atlanta, GA)
- …medical facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.) + Strong Knowledge of SQL ... utilized in medical coding/billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk… more
- Molina Healthcare (Macon, GA)
- …+ Proven experience handling provider disputes, appeals, and overpayment recoveries in a managed care or payer environment. + In-depth knowledge of medical and ... + At least 4 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent combination of… more
- J&J Family of Companies (GA)
- …business plans. + Experience interacting with KOLs, organized customers, and managed care organizations. + Effective communication, presentation, and ... and by appropriately leveraging the expertise of others (eg, Managed Markets ADs, Medical Affairs, Sales Operations, etc.). For...- 480 hours within one year of the birth/adoption/foster care of a child Condolence Leave - 30 days… more
- Molina Healthcare (Macon, GA)
- …Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and HEDIS ... scrapping, and cleaning of data. + 5+ Years of experience in Managed Care Organization executing similar techno functional role that involves writing complex SQL… more
- PruittHealth (Norcross, GA)
- …timeliest manner. 7. Applies knowledge of specific payer billing/payment rules, managed care contracts, reimbursement schedules, eligible provider information ... governmental programs, regulations and billing processes, commercial third-party payers, and/or managed care contracts and coordination of benefits * Familiarity… more
- Molina Healthcare (GA)
- …environment. Additional required experience for Corporate Operations: * Analytical experience within managed care operations. * Knowledge of managed ... care enrollment processes, encounter processes, provider and contract configuration, provider information management, claims processing and other related functions. **Preferred Education** Bachelor's Degree **Preferred Experience** * Six years proven… more
- Sun Pharmaceuticals, Inc (Atlanta, GA)
- …and regional thought leaders/healthcare professionals (HCPs) as well as payers and managed care accounts, providing the consistent delivery of educational and ... to these HCPs and also, internal SUN sales and managed markets constituents. Duties and Responsibilities: + Interact with...with others + Comply with all applicable SUN Health Care Compliance SOPs and US regulations Qualifications: + Doctorate… more