- Axis (Alpharetta, GA)
- …available upon request for candidates taking part in the selection process. **Job Description: Senior Claims Specialist** AXIS is seeking a Senior Claims ... Claims team reporting to the Manager of Casualty Claims . This position requires senior claims...Assurance - Comply with best practices measured by monthly Quality Assurance and Management Initiated Audit scores… more
- AIG (Atlanta, GA)
- Join us as a Senior Claims Adjuster to take on...to continuous improvement in Claims by supporting Quality Assurance / Regional Audit processes , ... key responsibilities within a world - class claims function. Make your mark in Claims ...claims expert and thought leader. + As a senior member of the team , you will act… more
- Trinity Health (Athens, GA)
- …Ability to develop methodologies for collecting and analyzing relevant data; to audit program processes, monitor quality , identify problems and their root ... of patient, non-patient and public areas to ensure compliance with RHM quality standards and regulatory requirements. Works to develop and manage program budgets… more
- AIG (Atlanta, GA)
- …Management (ERM), Internal Audit Group (IAG), Compliance, External Auditors and the Claims organization. How you will create an impact + Drive a strong control ... ensure necessary changes to controls are made based upon audit feedback (self-audits, internal audits, PwC audits). + Drive...plus. + Ability to influence and collaborate effectively with senior managers across claims . + Excellent written… more
- Sunrise Senior Living (Acworth, GA)
- **When you join Sunrise Senior Living, you will be able to use your unique skills to empower residents to live longer, healthier, and happier lives. Not only will ... and shed light on meaningful ways to serve, grow, and shine together.** **Sunrise Senior Living was again certified as a Great Place to Work(R) by Activated… more
- Molina Healthcare (Savannah, GA)
- …and you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer ... grievances, and member communications. * Exposure to downstream domains: Enrollment, Claims , Pharmacy/PDE, Network, Stars quality metrics. * Proven record… more
- Humana (Atlanta, GA)
- …a part of our caring community and help us put health first** CenterWell Senior Primary Care (PCO) is a growing provider organization that currently operates about ... 340+ senior focused primary care centers in 15 states. The...that supports the PCO is responsibility to assess, investigate, audit and validate the mitigation of compliance risk across… more
- Prime Therapeutics (Atlanta, GA)
- …in accordance with procedures or to present to management to recommend for audit or investigation. Serves as a corporate resource on fraud, waste and abuse ... Provide backup support to team members (SIU Coordinator and Senior SIU Specialist) in the performance of job duties...Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the… more