• Claims Intake Department Claims

    AIG (Atlanta, GA)
    …work and live. We encourage colleagues to give back to the causes they care most about, supporting these efforts through our Volunteer Time Off and Matching Grants ... range of products to customers through a diversified, multichannel distribution network. Claims Our claims professionals support AIG policyholders through some… more
    AIG (01/16/25)
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  • Director, Payment Integrity (Payer Operations…

    Molina Healthcare (GA)
    …Coordination of Benefits experience. + Experience with **_BPaaS solutions_** and Medicaid Managed Care programs. + Strong understanding of **_SQL and relational ... optimizing operational process designs, setting procedural standards, and overseeing vendor operations to ensure compliance with key performance indicators (KPIs)… more
    Molina Healthcare (12/09/24)
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  • Sr Analyst, Medical Economics (NY Medicaid Market)…

    Molina Healthcare (Macon, GA)
    …healthcare vendor , commercial health insurance company, large physician practices, managed care organization, etc.) + Proficiency with Microsoft Excel ... utilized in medical coding/billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk… more
    Molina Healthcare (01/13/25)
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  • Manager, Fraud and Waste * Special Investigations…

    Humana (Atlanta, GA)
    …7+ years of related compliance and/or special investigation experience in managed care or CMS. + Prior health insurance claims experience + Demonstrated ... Attend federal CMS and state fraud meetings with other managed care organizations, as well as state...exciting interviewing technology provided by Modern Hire, a third-party vendor . This technology provides our team of recruiters and… more
    Humana (12/19/24)
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  • Business Consultant

    HealthEdge Software Inc (Atlanta, GA)
    …Practical understanding of the healthcare system with regards to Medicare, Medicaid, managed care , and commercial payment methodologies, payment integrity, and ... and maintenance of provider rate and/or claim editing provisions in a claims adjudication system and/or third-party vendor application. + Working knowledge… more
    HealthEdge Software Inc (12/18/24)
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  • Talent Acquisition Manager

    Mass Markets (Savannah, GA)
    …when a search is best served by using an outside resource + Review current vendor lists and develop a method to determine what resource should be retained as ... preferred vendors + Negotiate vendor contracts and manage all vendor relationships...the basis of age, ancestry, color, family or medical care leave, gender identity or expression, genetic information, marital… more
    Mass Markets (10/28/24)
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  • Associate Director, Global Labeling Lead - Remote

    Takeda Pharmaceuticals (Atlanta, GA)
    Vendor Management + Oversight and accountability for labeling activities managed by external vendor (s) for assigned products, ensuring seamless coordination, ... 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
    Takeda Pharmaceuticals (01/15/25)
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