- Molina Healthcare (Macon, GA)
- …Contracted Provider disputes and appeals to ensure adherence with Molina claims processing standards and provider contractual agreements. Includes responsibility ... including 2 years in a manager role. * Experience reviewing all types of medical claims (eg CMS 1500, Outpatient/Inpatient, Universal Claims , Surgery,… more
- Cognizant (Atlanta, GA)
- …+ 1 year of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review/quality assurance procedures. + Must ... ET **Experience:** A minimum of 2 years of claim processing is required. **Travel:** None required **About the role:**...is required. **Travel:** None required **About the role:** As Claims Processor (with Facets), you will be responsible for… more
- Sedgwick (Atlanta, GA)
- …total loss evaluations, and related expenses to effectively negotiate first and third party claims . + Knowledge of total loss processing , State salvage forms and ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Commercial Auto Claims Representative **PRIMARY PURPOSE** : To analyze and process low to mid-level… more
- Sedgwick (Atlanta, GA)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner, Auto Bodily Injury (Litigation Required) **PRIMARY PURPOSE** : To analyze ... and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of… more
- CRC Insurance Services, Inc. (GA)
- …Responsible for overseeing, managing and supporting all activities of the claims employees and operations of the department. **ESSENTIAL DUTIES AND ... change from time to time. 1. Manage the supervision and coordination of the claims department and staff. 2. Organize and disseminate information that affects the … more
- Elevance Health (Atlanta, GA)
- …The **Clinical Document Improvement Director** is responsible for leading encounter processing , diagnostic documentation and claims integrity across CareBridge. ... / revenue cycle management (RCM) organizations, with specific understanding in end-to-end claims / encounter processing , as well as ensuring compliance with… more
- Guardian Life (Atlanta, GA)
- …MS Word/Excel/PP + College degree preferred or equivalent work experience + Claim processing experience preferred or working knowledge of claims processes + ... As the ** Claims Case Manager I** , **Supplemental Insurance,** you...corresponding type of service codes and benefit amounts for processing + Assess file to determine if benefits are… more
- GuideOne Insurance (Atlanta, GA)
- … Claims Adjuster, you will serve as a real partner to our members by processing claims accurately and efficiently so they can resume their life's work without ... and cause of loss on routine to more complicated claims , which includes but is not limited to policy...and AD&D, long-term disability and short-term disability insurance + Medical , dental and vision plans to meet your unique… 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,...bonus programs (unless covered by a collective bargaining agreement), medical , dental, vision, short and long term disability benefits,… more
- CVS Health (Atlanta, GA)
- …all dollar amount level on customer service platforms by using technical and claims processing expertise. + Applies medical necessity guidelines, determine ... communications, organizational, and interpersonal skills. **Preferred Qualifications** + DG system claims processing experience. + Demonstrated ability to handle… more