- Actalent (Alpharetta, GA)
- …Description We are seeking a dedicated Pharmacy Technician - Prior Authorization Specialist to join our team. This role involves managing coverage determination ... with Microsoft applications. + Managed care knowledge. + Familiarity with Medicare/ Medicaid . + Experience with remote work setups. Work Environment This position… more
- Molina Healthcare (Atlanta, GA)
- …legal processes (Commercial insurance, Medicare, Medicare Advantage, Medicare Part D, Medicaid , Tricare, Pharmacy, etc.) + Experience with UNET, Comet, Macess/CSP, ... Association** + AAPC Certified Medical CPC, CPMA, CPCO or similar specialist preferred + Certified Fraud Examiner and/or AHFI professional designations preferred… more
- Cardinal Health (Atlanta, GA)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will ... with secondary insurance company when necessary. + Bills supplemental insurances including all Medicaid states on paper and online. + Mails all paper claims. + Acts… more
- Trinity Health (Chamblee, GA)
- …medical and dental appointments. + Verify insurance eligibility, including Medicare, Medicaid , and Commercial plans. + Document appointment reasons and classify ... required. + Certification in medical insurance carriers, patient scheduling, or medical office specialist preferred. + At least 1 year of customer service or patient… more
- PruittHealth (Norcross, GA)
- …Professional certifications such as Certified Professional Biller (CPB), Certified Coding Specialist (CCS), or Certified Revenue Cycle Professional (CRCP) are highly ... payer compliance standards. **Preferred Qualifications** * Experience with Medicare, Medicaid , and commercial insurance billing for infusion services. * Familiarity… more
- Evolent (Atlanta, GA)
- …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... or sanction by any state or federal health care program, including Medicare or Medicaid , and is not identified as an "excluded person" by the Office of Inspector… more
- Banner Health (GA)
- …with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General ... or an Associate's degree in a health care field. Requires Certified Coding Specialist (CCS) or Certified Outpatient Coder (COC) or Certified Professional Coder (CPC)… more
- Waystar (Atlanta, GA)
- …various technologies in our diverse, fast-paced, & growing environment. The Senior Specialist DBA will also analyze system performance, perform system health checks, ... hospitals and health systems, and is connected to over 5K commercial and Medicaid /Medicare payers. We are deeply committed to living out our organizational values:… more