- Humana (Atlanta, GA)
- **Become a part of our caring community and help us put health first** The Claims Review Representative makes appropriate claim decision based on strong ... procedures, contract provisions, and state and federal legislation. The Claims Review Representative performs advanced administrative/operational/customer… more
- Sedgwick (Atlanta, GA)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative - Workers Compensation (REMOTE- State License Required)) Are ... or equivalent combination of education and experience or successful completion of Claims Representative training required. **TAKING CARE OF YOU** + Flexible… more
- Sedgwick (Atlanta, GA)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative | Auto | Remote Are you looking for an opportunity to ... YOU AN IDEAL CANDIDATE?** Join our team as a Claims Representative focused on Property Damage and...and commercial lines policies and endorsements + Ability to review and assess Property Damage estimates, total loss evaluations,… more
- Ryder System (Atlanta, GA)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position handles worker's compensation claims under Ryder's self-insured, self administered worker's comp program....to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
- Ryder System (Atlanta, GA)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... Director Claims directs...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
- Insight Global (Norcross, GA)
- …of F&I products for the auto industry. Our customer is looking for Powertrain Claims Adjusters to join their team.. As an adjuster you will be responsible for ... adjudication of mechanical repair claims , tire claims and pre-paid maintenance ...and Field Support and functions as a customer service representative by explaining contract coverage and claim decisions to… more
- AIG (Atlanta, GA)
- …your skills and experience as a valued member of the team. Make your mark in Claims Our Claims teams are the proven problem solvers of choice for clients, ... and showcasing our service differentiation to create an unparalleled global claims handling experience. Through a robust stakeholder feedback loop and supported… more
- Humana (Atlanta, GA)
- …where your expertise truly makes an impact! As a Grievances & Appeals Representative , you'll be a go-to problem solver, turning complex challenges into clear ... that information is accurate. + Forwards appeals to CMS entity for further review . + Investigates and resolves member and practitioner issues. + Works within broad… more
- Highmark Health (Atlanta, GA)
- …position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist distribution. Interpret ... added benefits. Meet with all identified practices in assigned territory to review practice financial and quality performance. + Perform effective on-site visits… more
- Ryder System (Atlanta, GA)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling processes… more
- Highmark Health (Atlanta, GA)
- …for the implementation of effective Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a review ... the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code submission, analysis of the… more
- HNTB (Atlanta, GA)
- …issues, and potential changes to resolution. Oversees project staff in review of the contractor's activities, roles and responsibilities, communication protocols, ... Plans. On-site liaison to the client's legal department for resolution of claims , formal disputes and litigation. Capture lessons learned on policies, contractual… more
- CVS Health (Atlanta, GA)
- …representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances, ... and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the Accounts Receivable Supervisor include:** +… more
- Stantec (Atlanta, GA)
- …System selection to be based on Project/Client needs as well as proactive Claims /Risk mitigation. - Oversee and approve development and management of the Project ... Development and maintenance of the Project Risk Register, based on review of contract conditions, project-specific delivery requirements, client characteristics, and… more
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …maintain the effectiveness of Quality Systems for managing the batch record review and release process Quality Management Activities supporting all phases of ... compliance. + Manages reports and trends to the Management Representative to help in the preparation of Management reviews...above. + Improves supplier quality performance for batch record review and release process for OAPI GMP release of… more
- Prime Therapeutics (Atlanta, GA)
- …with various levels of leadership within the organization, acting as a representative of the broader Financial Systems team + Provide consulting services to ... experience, preferably leveraging AI + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience in… more
- Fresenius Medical Center (Atlanta, GA)
- …determining project specifications and review methodologies. Analyses will include review of claims data, analysis of medication utilization for global ... the consolidation, analysis and reporting of commercial revenue. Develops standards of review and analysis to facilitate accurate and timely analysis of all… more
- Fresenius Medical Center (Kennesaw, GA)
- …the maintenance of appropriate billing systems within the assigned function(s). + Review , investigate and resolve outstanding claims in coordination with ... location _within the United States_ PURPOSE AND SCOPE: The Insurance Representative provides general administrative support in the insurance collections process… more
- Burns & McDonnell (Atlanta, GA)
- …and consult with the Legal Department as required. + Expert in the review , negotiation, approval, and execution of prime contracts, subcontracts, and change orders. ... Request for Information (RFI's), submittals, change management, contract closeout, and claims mitigation. + Analyze and approve internal and external reports… more
- RxBenefits (Atlanta, GA)
- …team also assists with resolving client issues involving performance discrepancies, claims issues, and reporting. The successful Pharmacy Pricing Senior Manager will ... across internal stakeholders to foster collaborative and efficient work products + Review for accuracy and finalize all current account pricing comparisons for… more