- IQVIA (Atlanta, GA)
- **Patient Support Medical Claims Processing ...+ High School Diploma or equivalent + Experience in claim processing required + Medical ... a 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative** to...claims from HCPs or patients and vetting the claim against program specific business rules to determine if… more
- CVS Health (Atlanta, GA)
- …enhance and improve member satisfaction and retention by providing accurate and timely resolution in processing medical claims . You will be a key link in ... with heart, each and every day. Reviews and adjudicates claims in accordance with claim processing...willingly to change, and a positive, willing attitude. Prior medical claim processing experience is… more
- CVS Health (Atlanta, GA)
- …competently, accurately and efficiently. **Preferred Qualifications** - 18+ months of medical claim processing experience - Self-Funding experience ... or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, completes… more
- CenterWell (Atlanta, GA)
- …Qualifications** + High School Diploma or the equivalent + Minimum of two years medical claims processing experience preferred + Knowledge of healthcare ... and support agency personnel encompassing all aspects of insurance and non-Medicare claims processing . + Prepare input data forms to update computer… more
- Sedgwick (Atlanta, GA)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
- Sedgwick (Atlanta, GA)
- …expertise preferred. **Skills & Knowledge** + Subject matter expertise in worker's compensation claims and/or liability claims processing + Ability to obtain ... FUNCTIONS and RESPONSIBILITIES** + Proactively and strategically manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional… more
- Molina Healthcare (Columbus, GA)
- …**Job Duties** + Performs clinical/ medical reviews of retrospective medical claim reviews, medical claims and previously denied cases, in which ... billing and coding regulations, and Molina policies; validates the medical record and claim submitted support correct...ensure medical necessity and appropriate/accurate billing and claims processing . + Identifies and reports quality… more
- Sedgwick (Atlanta, GA)
- …Coverage Specialist **PRIMARY PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex ... and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to… more
- The Coca-Cola Company (Atlanta, GA)
- …safe and empowered, lets you bring your best self to work. **Skills:** Insurance Claims Processing ; Microsoft Office; Communication; Claims Processing ; ... The Risk Claims Consultant is an integral part of the...vendors. **What You'll Do for Us:** + **Manage Insurance Claim Process** + Conduct initial analysis to determine applicable… more
- Molina Healthcare (Macon, GA)
- …Contracted Provider disputes and appeals to ensure adherence with Molina claims processing standards and provider contractual agreements. Includes responsibility ... from start to finish of the claim disputes to include intake, processing , decisioning,...a manager role. * Experience reviewing all types of medical claims (eg CMS 1500, Outpatient/Inpatient, Universal… more