- Humana (Atlanta, GA)
- …level by driving real impact and shaping the future of claims management? As a Senior Pharmacy Claims Professional , you will play a pivotal role in ... and take the lead on building solutions that make a difference! The Senior Pharmacy Claims Professional analyzes and answers inquiries regarding… more
- Humana (Atlanta, GA)
- **Become a part of our caring community and help us put health first** The Senior Pharmacy Claims Professional adjudicates pharmacy claims and ... process pharmacy claims for payment. The Senior Pharmacy Claims Professional work assignments involve moderately complex to complex issues where… more
- CenterWell (Atlanta, GA)
- …community and help us put health first** As an **Accounts Receivable Specialist/Healthcare Claims Denials Specialist** , you will: + Ensure the coordination of claim ... timely reimbursement of receivables. + Research, resolve, and prepare claims that have not passed the payer edits daily....at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of… more
- Walgreens (Lawrenceville, GA)
- **Job Description:** Our pharmacy technician positions have undergone an exciting transformation, moving from a transaction-based environment to a much more ... patient-centric one. As a Walgreens Pharmacy Technician or Pharmacy Technician Apprentice, you'll...those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a… more
- Elevance Health (Atlanta, GA)
- **Account Service Manager Sr - Pharmacy Account Management** **Location:** This position will work a hybrid model (remote and office). The ideal candidate will live ... plan design, researching and resolving phone and written inquiries, resolving claims , benefit and enrollment issues. + Presents monthly, ad hoc, mid-year,… more
- Humana (Atlanta, GA)
- …frameworks to maximize ability of limited resources to achieve growth. **The Senior Strategy Advancement Professional ** will support initiatives to develop and ... assess, and translate state requirements into actionable go-to-market strategy. The Senior Strategy Advancement Professional will consult with growth partners… more
- Elevance Health (Atlanta, GA)
- …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying ... **Investigator Senior ** **Supports the Payment Integrity line of business**...to recover corporate and client funds paid on fraudulent claims . **How will you make an impact:** + Claim… more
- Elevance Health (Atlanta, GA)
- …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying ... **Investigator Senior ** **Location:** This position will work a hybrid...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
- Humana (Atlanta, GA)
- …informaticists to define various clinical concepts and extract clinical information from medical, pharmacy , and lab claims for analytics and modeling purposes + ... + Healthcare or managed care working experience + Experience working with medical, pharmacy , lab claims + Experience working with big data and using… more
- Elevance Health (Atlanta, GA)
- … claims processing, enrollment, and benefit administration. + Experience with pharmacy prescription drug claims testing, benefits and clinical testing + ... work here will be Test Program Management for our pharmacy business system integrations. **Location:** This position will work...skills. + Ability to prepare status and metrics to senior leadership team. + Ability to work in a… more
- Elevance Health (Atlanta, GA)
- …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for identifying and ... healthcare fraud in order to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding,… more
- WTW (Atlanta, GA)
- …specialty consulting services including clinical/health management program design, pharmacy solutions, disability/absence management strategies and claims ... audit services. Product based solutions such as our pharmacy purchasing coalition round out our broad-based suite of...data and create client deliverables drafts for review by senior colleagues. **Love your work.** You will partner with… more
- RELX INC (Alpharetta, GA)
- Senior Director-Product ManagementAre you a thought leader and innovator seeking a new opportunity? Would you like to lead a team to solve complex business problems? ... Team leads the strategy and development of Healthcare solutions, leveraging provider, claims , and consumer data to provide insights for Healthcare Payer, Provider,… more