- AIG (Atlanta, GA)
- Claim Compliance Reviewer Join us as a Claims Compliance Reviewer to make more of your specialist expertise and experience. Make your mark in ... claim adjudication or claim operations experience for multi-line commercial claims . Claim Audit or file review experience...multi-line commercial claims . Claim Audit or file review experience is desirable. + Knowledge of key regulatory… more
- Zurich NA (Atlanta, GA)
- …for: + Document claims file by accurately capturing and updating claims data/information in compliance with best practices for multi-party commercial line ... as appropriate. + Establish timely reserves and perform ongoing review throughout claims cycle within authority limit...location, role, skill set, and level of experience. In compliance with local laws, Zurich commits to providing a… more
- Zurich NA (Atlanta, GA)
- …for: + Document claims file by accurately capturing and updating claims data/information in compliance with best practices for single and multi-party ... as appropriate. + Establish timely reserves and perform ongoing review throughout claims cycle within authority limit...location, role, skill set, and level of experience. In compliance with local laws, Zurich commits to providing a… more
- CVS Health (Atlanta, GA)
- …. 10 years Medicare Advantage experience in any area such as: product, claims , compliance , or operations. . Familiarity of Special Needs Plans (SNP) ... partners, such as Benefit & Product Strategy, Benefits & Product claims configuration, Medicare Service Operations (MSO), Medical Policy & Program Solutions… more
- Lincoln Financial Group (Atlanta, GA)
- …customer experience and improve claim management effectiveness. + Monitors and implements claims policy and guidelines in compliance with claim objectives and ... ensure the fair, ethical and timely management of complex claims . **What you'll be doing** + Maintains knowledge on...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- AIG (Atlanta, GA)
- …and leading efforts on various Global Claim initiatives. You will have oversight of Claims Compliance activities across the Globe, acting as the primary liaison ... between Enterprise Risk Management (ERM), Internal Audit Group (IAG), Compliance , External Auditors and the Claims organization. How you will create an impact +… more
- AIG (Atlanta, GA)
- …with disabilities. If you believe you need a reasonable accommodation, please send an email to ###@aig.com . Functional Area: CP - Compliance AIG Claims , Inc. ... Director of Claim Regulatory Compliance Who we are American International Group, Inc....Claim Legal. + Align and strengthen controls for AIG Claims to ensure consistency and effective best practices. +… more
- Molina Healthcare (Atlanta, GA)
- … including but not limited to the Corporate Recovery Team, Corporate Claims Compliance Team, Support Services, Enrollment and Billing, Corporate Encounter ... with new databases, report monitoring, BOTs/Automation, etc. + Monthly business review meeting with executive leadership team, business stakeholders and ensures the… more
- Sedgwick (Atlanta, GA)
- …coverage policies, coding guidelines and utilization and practice guidelines. + Reviews medical claims and completes complex file review for Medicare Set- Asides ... to complete complex submissions revisions/updates in preparation for Medicare review and act as an internal resource regarding Centers...cost projections. + Serves as a consultant to Medicare Compliance Nurses on claims . + Applies clinical… 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 ... by a professional staff. Handles commercial lines bodily injury and property damage claims as well as insurance and contractual coverage issues. Assists Director in… more
- Sedgwick (Atlanta, GA)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Environmental Claims Specialist **Job Description Summary** To analyze complex or technically ... difficult environmental claims ; to provide resolution of highly complex nature and/or...Conducts or assigns full investigation to include complete coverage review and provides report of investigation pertaining to new… more
- HNTB (Atlanta, GA)
- …responsible for issue resolution, risk management, contract administration and compliance , and change management on alternative delivery mega transportation ... manage project communication in all mediums, oversee contract, state, and federal compliance ; oversee and manage project risks, issues, and potential changes to… more
- Fujifilm (Atlanta, GA)
- …training, and investigations. + Manage user access and updates required for compliance systems. + Assist with due diligence review and integration ... **Position Overview** The accomplished Senior Corporate Compliance Specialist will support FUJIFILM's Corporate Compliance...Claims Statute, and OIG's guidance of an effective compliance program) as well as applicable industry codes (eg,… more
- Travelers Insurance Company (Atlanta, GA)
- …evaluating, reserving, negotiating and resolving assigned serious and complex Specialty claims . Provides quality claim handling throughout the claim life cycle ... reserving, litigation management, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific… more
- AIG (Atlanta, GA)
- … claims on a regional basis including attending mediations and trials as necessary. Claims Handling: + Review assigned claim files to determine if recovery is ... member of the team. Make your mark in Marine Claims Our Claims teams are the proven...has occurred and future plan of action. + Ensures compliance with Statute of Limitations. + Researches, understands, and… more
- Travelers Insurance Company (Atlanta, GA)
- …serious and complex Life Science medical products, clinical trial and pharmaceutical bodily injury claims , as well as General Liability Coverage B claims and E&O ... reserving, litigation management, negotiation, and resolution) including maintaining full compliance with internal and external quality standards and state specific… more
- Oglethorpe Power (Tucker, GA)
- …vendor qualifications and monitoring vendor performance. + Assist in resolving any claims that may arise concerning vendor invoicing, performance, or other issues. + ... + Promote fair, ethical, and reasonable supply chain business principles. + Review Contract Terms. + Manage amendments of existing documents when language is… more
- State of Georgia (Fulton County, GA)
- …Specific, additional experience in the analysis of medical services documentation and related claims 2) Utilization Review 3) Case Management 4) Analysis of CPT ... to whether proper diagnostic and procedure codes were used in submitting claims to the Georgia Medicaid Program. Maintains a comprehensive understanding of current… more
- State of Georgia (Fulton County, GA)
- …claims to determine whether policy coverage extends to such incidents. Requests the claims and underwriting files of insurers for review to determine "good ... Life and Health Complaints Analyst is responsible for reviewing inquiries for compliance with applicable laws in determining eligibility for complaints. This role… more
- Leggett & Platt, Incorporated (Newnan, GA)
- …track completion and communicate aging items to the appropriate leadership. + Regularly review workers' compensation and other local claims to determine accident ... reduce or eliminate the frequency and severity of future claims to reduce the company's risk. The team you...Elite Comfort Solutions locations, including behavioral safety and regulatory compliance programs, to help the company lower its total… more