- WelbeHealth (Atlanta, GA)
- …Plan Services team helps ensure excellent care delivery for our participants, and the Claims Audit Analyst plays a pivotal role in ensuring timely and accurate ... At WelbeHealth, we are transforming the reality of senior care by providing an all-inclusive healthcare option...Provide feedback to the Oversight & Monitoring Manager on claims processing errors, quality improvement opportunities, and… more
- 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
- Grant Thornton (Atlanta, GA)
- As a Healthcare Process Risk Senior Associate, you will get the opportunity to grow and contribute to our clients' business needs by helping them understand their ... include but are not limited to co-sourced and outsourced internal audit , internal control assessments, enterprise risk management program assessments, tests of… more
- Aflac (GA)
- …training for all claims specialist to understand how we can improve quality for the department. The next phase includes getting more granular with the data, ... 2026 Summer Intern-Individual Claims The Company: Aflac Columbus The Location: GA,...looking to optimize our processes to provide the best quality to our policyholders. Most recently, we kicked off… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …actions (CAPAs). + Monitor audit trends and escalate recurring issues to senior leadership. ** Quality Systems & Compliance** + Support the implementation and ... **Job Summary** The Senior Manager of Global Quality Management...standards across global clinical trials. This role provides hands-on quality oversight, supports audit and inspection readiness,… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …leading, and optimizing one or more prioritized CoEs within the Global Quality Operations organization-such as Inspection Readiness, Audit Effectiveness, or ... The Senior Manager, Centers of Excellence (CoEs) is responsible...execution of one or more CoEs (eg, Inspection Readiness, Audit Effectiveness) aligned with global quality priorities.… more
- Molina Healthcare (Columbus, GA)
- …care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department with HEDIS measure deep dive to support HEDIS audit and revenue ... **Job Description** **Job Summary** The Analyst, Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and… more
- CGI Technologies and Solutions, Inc. (Atlanta, GA)
- …corporate and regulatory standards. Professionalism: Maintain high standards of productivity and audit quality while serving as a professional representative of ... **Remote Senior Inpatient Auditor - MS-DRG & Clinical Validation**...of a structured professional ecosystem that prioritizes continuous learning, quality management, and career mentorship. **Your future duties and… more
- Cardinal Health (Atlanta, GA)
- …in problem-solving, research and problem/dispute resolution. **_Job Summary_** The Senior Coordinator, Prior Authorization is responsible for obtaining, documenting, ... with payers and provider offices to secure timely approvals. The Senior Coordinator proactively manages upcoming expirations to prevent order delays, meets… more
- Humana (Atlanta, GA)
- …part of our caring community and help us put health first** The Senior Fraud and Waste Professional conducts investigations of allegations of fraudulent and abusive ... practices. The Senior Fraud and Waste Professional work assignments involve moderately...ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Begins to influence department's strategy. Makes decisions… more