- Prime Therapeutics (Atlanta, GA)
- …fuels our passion and drives every decision we make. **Job Posting Title** Treasury Claims Analyst Senior - Remote **Job Description** The Senior Treasury Claim ... for providing guidance to the Accounting, Finance, Information Technology and Claims operation functions, as well as Pharmacy Networks and Government Programs.… more
- Humana (Atlanta, GA)
- **Become a part of our caring community and help us put health first** A Claims Review Representative 2 is responsible for analysis of overpaid claims and makes ... appropriate determinations based on strong knowledge of claims procedures, contract provisions, and CMS guidelines. The ...work in Eastern Standard Time Zone + Position is Remote As part of our hiring process, we will… more
- Zurich NA (Atlanta, GA)
- Claims Call Center Representative 116763 Zurich is a leading multi-line insurer that serves its customers in global and local markets. Zurich's customers include ... corporations. We are seeking confident, outgoing, and self-motivated Customer Care Professionals to join our dedicated contact center team...want to talk to you. You will work 100% remote from your home office. This role offers an… more
- Takeda Pharmaceuticals (Atlanta, GA)
- …in order to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director, Global Labeling Lead where you will be responsible for the ... labeling requirements to be provided to patients and Health Care Providers while minimizing the risk of write-offs. +...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
- Houston Methodist (Atlanta, GA)
- …Classification (APC) Coordinator position is responsible for reviewing and correcting all claims edits related to the APC grouper, National Correct Coding Initiative ... key operational staff/stakeholders to ensure proper coding, charging, and compliant claims . **PEOPLE ESSENTIAL FUNCTIONS** + Promotes a positive work environment and… more
- Humana (Atlanta, GA)
- …functionality and payment methodologies to the Operations staff. + Work with non-Operations _i_ Care staff to learn about new _i_ Care products, processes and ... support company collaboration. + Assist Operations staff with daily claims , enrollment and provider services issues in a manner...available resources. (ie DHS and CMS websites, contracts, _i_ Care brochures, _i_ Care policies and procedures,… more
- Humana (Atlanta, GA)
- …put health first** Business Intelligence Engineers on the Provider Intelligence and Claims Analytics (PICA) team solve complex business problems and issues using ... of action. About Our Team The Provider Intelligence and Claims Analytics (PICA) team is a blend of experts...business outcomes and decisions **Additional Information** This role is " remote /work at home" and can be based anywhere in… more
- Intermountain Health (Atlanta, GA)
- …departments across multiple service lines within the enterprise. **This is a 100% remote position** **however, currently we are unable to consider candidates for ... remote opportunities in the following states: California, Hawaii, Illinois,...lead, mentor, and/or train new employees. Minimum Qualifications + Associate 's degree. Education must be obtained through an accredited… more
- Humana (Atlanta, GA)
- …Science, finance, Statistics, Economics or related field + Experience working with Claims , Billing and Reconciliation or related healthcare data + Expertise in ... and Root Cause Analysis (RCA) experience **Additional Information** **Work Style** : Remote **HireVue Statement** : As part of our hiring process for this… more
- Evolent Health (Atlanta, GA)
- …role either requesting or submitting prior authorization requests and/or relevant health care experience in claims or appeal & grievance. - **Required** ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...with other Client Service Leaders including our Client Service Associate Director and Director may also be available. **What… more
- Humana (Atlanta, GA)
- …The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director reviews cases of diverse ... of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and/or Commercial products +...protect member PHI / HIPAA information This is a remote position reporting to Grievance and Appeals Director or… more