- Danaher Corporation (Atlanta, GA)
- …pay. We offer comprehensive package of benefits including paid time off, medical /dental/vision insurance and 401(k) to eligible employees. Note: No amount ... coding and reimbursement. + Support customers with approved resources for denied claims , payer coverage expansion and inadequate reimbursement. + Respond to and… more
- Evolent (Atlanta, GA)
- …operations this individual also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our behavioral health reviewers: ... into a proprietary system generating cases for both the medical and behavioral health reviewers. These requests may be...prior authorization requests and/or relevant health care experience in claims or appeal & grievances is required. + Ability… more
- Elevance Health (Atlanta, GA)
- …of the care management plan and modifies as necessary. + Interfaces with Medical Directors and Physician Advisors on the development of care management treatment ... of reimbursement, as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of utilization/care management… more
- Centene Corporation (Augusta, GA)
- …related field or equivalent experience. Two years of managed care or medical group experience, provider relations, quality improvement, claims , contracting ... utilization management, or clinical operations. Project management experience at a medical group, IPA, or health plan setting. Proficient in HEDIS/Quality measures,… more
- Elevance Health (Atlanta, GA)
- …background. **Preferred Skills, Capabilities, and Experiences:** + Healthcare experience preferred; medical claims experience a plus. + Extensive hands-on ... and incentive bonus programs (unless covered by a collective bargaining agreement), medical , dental, vision, short and long term disability benefits, 401(k) +match,… more
- Prime Therapeutics (Atlanta, GA)
- …Scientist designs and develops processes to support clinical program using eligibility, medical , and pharmacy administrative claims . This position is responsible ... study design, measurement and publishing results of complex pharmacy and medical health insurance clinical programs. **Responsibilities** + Design, develop… more
- Samsung SDS America (Duluth, GA)
- …+ Investigate and report service failures, accidents, misconduct, security incidents, or claims to the appropriate departments for timely resolution. + Prepare and ... suite of programs to support our employees: + Top-notch medical , dental, vision and prescription coverage + Wellness program...and savings plan + Flexible spending accounts + Life insurance + Paid Holidays + Paid Time off +… more
- Elevance Health (Atlanta, GA)
- …of the care management plan and modifies as necessary. + Interfaces with Medical Directors and Physician Advisors on the development of care management treatment ... rates of reimbursement, as applicable. + Assists in problem solving with providers, claims or service issues. **Minimum Requirements:** + Requires BA/BS in a health… more
- Elevance Health (Atlanta, GA)
- …the market + Develops and analyzes business performance reports (eg for claims data, provider data, utilization data) and provides notations of performance ... preferred. + Minimum of 5 years in healthcare industry in medical economics, provider finance, healthcare analytics, or actuarial services preferred. Please… more
- Lowe's (Suwanee, GA)
- …off for vacations, holidays and sick time, as well as access to top-tier medical , dental and vision insurance . For information about our benefit programs and ... dialogue with third-party logistics vendor partners to address and resolve claims and complaints related to In-Home Customer Delivery experiences. + Engage… more
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