• Medical Director - Medicare Grievances…

    Humana (Atlanta, GA)
    …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... + Medical utilization management experience, + working with health insurance organizations, hospitals and other healthcare providers, patient… more
    Humana (05/14/25)
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  • Technical Assistant

    CRC Insurance Services, Inc. (GA)
    …by the division of CRC Group offering the position. CRC Group offers medical , dental, vision, life insurance , disability, accidental death and dismemberment, ... system and follow-up for receipt of policies, endorsements, inspections, correspondence, claims , etc. from outside sources. 4. Maintain account files in accordance… more
    CRC Insurance Services, Inc. (05/16/25)
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  • Sr Director, Performance Suite Analytics

    Evolent (Atlanta, GA)
    …compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...in the Performance Suite where Evolent does not pay claims + Establish ideal data transfer protocols during client… more
    Evolent (05/02/25)
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  • Sr. Group Market Development Manager - HCP, Pelvic…

    Medtronic (Atlanta, GA)
    …compensation are available to those regular employees who work 20+ hours per week: Health , Dental and vision insurance , Health Savings Account, Healthcare ... Manager** to manage the healthcare professional (HCP) Market Development team within Pelvic Health . We are looking for a player coach that is passionate about… more
    Medtronic (05/14/25)
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  • Utilization Management Representative I

    Elevance Health (Columbus, GA)
    …Capabilities and Experiences** + Medical terminology training and experience in medical or insurance field preferred. For candidates working in person or ... make an impact:** + Managing incoming calls or incoming post services claims work. + Determines contract and benefit eligibility; provides authorization for… more
    Elevance Health (05/23/25)
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  • Investigator

    Highmark Health (Atlanta, GA)
    …**EXPERIENCE** **Required** + 3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations **Preferred** + ... prevent further improper payments.Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. +...in Financial Analysis in an acute care hospital or health insurance setting + 1 year in… more
    Highmark Health (05/08/25)
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  • Chief Counsel | Health Affairs - Office…

    Emory Healthcare/Emory University (Atlanta, GA)
    …and Non Compete Agreements, Patient Care Related Issues, Risk Management, Litigation, and Insurance . + Familiarity with health care IT issues, including ... to the excellence of our academic community. **Description** The Chief Counsel for Health Affairs (CCHA) will oversee all legal matters for Emory Healthcare. They… more
    Emory Healthcare/Emory University (03/20/25)
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  • Investigator Assistant

    Elevance Health (Atlanta, GA)
    …be considered. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to ... recover, eliminate and prevent unnecessary medical -expense spending. The **Investigator Assistant** is responsible for providing administrative support to the… more
    Elevance Health (05/23/25)
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  • Customer Care Representative I

    Elevance Health (Atlanta, GA)
    …and external customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims . + Analyzes ... zone below:** 4:50am-8pm Pacific Time 6:50am-10pm Central Time 7:50am-11pm Eastern Time Elevance Health is a health company dedicated to improving lives and… more
    Elevance Health (03/11/25)
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  • Coding Auditor Educator

    Highmark Health (Atlanta, GA)
    …all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the ... **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs...internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of… more
    Highmark Health (05/09/25)
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