- Molina Healthcare (Macon, GA)
- …guidelines + Coordinate the Market month-end close with Accounting staff; review all non-IBNR reserves for appropriateness monthly + Work collaboratively with ... impacting IBNR, including bed days and admits per 1,000, prescription drug utilization , billed dollars of inventory, and other measurable factors that may be… more
- Molina Healthcare (Atlanta, GA)
- …abuse, and over utilization by providers and recipients. The position will review claims data, medical records, and billing data from all types of healthcare ... providers that bill Medicaid/Medicare/Marketplace. **KNOWLEDGE/SKILLS/ABILITIES** + Ensure investigators are managing their cases effectively and in accordance with SIU policies, processes, quality standards, and procedures. + Ensure that investigators are… more
- Elevance Health (GA)
- …providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires a BA/BS ... ability to learn new computer programs/systems/software quickly. + Ability to manage, review and respond to emails/instant messages in a timely fashion. Please be… more
- Pfizer (Atlanta, GA)
- …of the Area and Region. + Ensuring effective territory representatives utilization of promotional material, making valuable contribution to the formulation of ... other value received, generally for public disclosure. Subject to further legal review and statutory or regulatory clarification, which Pfizer intends to pursue,… more
- Carter's/OshKosh (Braselton, GA)
- …the operational areas assigned. + Collect PTO request forms, timecard correction forms review for accuracy and provide to leaders for disposition. + Print and post ... Reports, etc.) + Assist in problem resolution and research issues. + Track utilization of supplies and prepare orders as necessary to maintain proper levels of… more
- ASM Research, An Accenture Federal Services Company (Atlanta, GA)
- …as needed (aside from on-call rotation). + Optimize system operations and resource utilization as well as perform system capacity analysis and planning. + Utilize ... and other platform specifications, and 4+ years of experience providing quality assurance review and the evaluation of new and existing software products. + US… more
- ChenMed (Riverdale, GA)
- …and explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... and identify post-SNF needs. + Enhances a collaborative relationship to maximize the patient's/family's ability to make informed decisions re: goals of care, palliative care and hospice. + Facilitates discharge to appropriate level of care and uses preferred… more
- Grant Thornton (Atlanta, GA)
- …and help you achieve more, confidently. Your day-to-day may include: + Review operational, financial, and administrative processes to assess risk, internal control, ... skills and qualifications: + Proficiency in EPIC or other EHR system utilization : Demonstrated experience in implementing or working with an EHR system (90%… more
- Fresenius Medical Center (Kennesaw, GA)
- …basis (IPPS and OPPS, ICD-10 and CPT updates) for outpatient coding. Quarterly review of AHA Coding Clinic. Attends or facilitates Quarterly Coding Updates and all ... excellent interpersonal skills + Knowledge of disease pathophysiology and drug utilization + Knowledge of MSDRG classification and reimbursement structures +… more
- Truist (Atlanta, GA)
- …(Required) **Work Shift:** 1st shift (United States of America) **Please review the following job description:** Service Delivery of Voice/VoIP/Mobility Telecom ... billing, auditing, and Customer Service Record (CSR) interpretation 9. Understanding/ utilization of ServiceNow **OTHER JOB REQUIREMENTS / WORKING CONDITIONS**… more