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Knowledge and experience with Medicaid, managed care, MMIS, health claims payment and processing, population health management, or other similar areas | Highly desired. Job Title- Test Lead Engineer Location- 2MLK Jr Dr, SE West Tower - 16th Floor (Hybrid) The Georgia Department of Community Health (DCH) is in the process of transforming existing legacy Medicaid Enterprise Systems (MES) into modern, loosely coupled, seamlessly integrated, modular systems where the exchange of data and processes is seamless and automatic.
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With 98% of cyber insurance claims in the past five years coming from small and mid-size businesses with revenue under $2B, providing an integrated solution to help manage risk is more critical than ever.
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Keywords: Claim, Claims, Adjuster, Examiner, Counsel, Claim Manager, Claims Specialist, Attorney, J.D., Juris, JD, Claims Attorney, Claims Counsel, Claim Counsel, Claim Attorney, GL, Liability, Commercial Claims, Litigation.
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The role sits within the Group Claims function and reports to the Group Claims Data and Insights Manager, the data scientist will be part of a global agile scrum delivery team and will be expected to work with the team to meet the sprint goals, which drive towards the data platform product vision.
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As AVP, Claim Manager , you will be responsible for product quality, and performance of the liability claims professionals on your team and supporting the VP Claims Manager. You may be responsible for maintaining a minor caseload, as determined to be appropriate by the VP Claims Manager.
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Knowledge and experience with Medicaid, managed care, MMIS, health claims payment and processing, population health management, or other similar areas. Knowledge and experience with Medicaid, managed care, MMIS, health claims payment and processing, population health management, or other similar areas.
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If so, we are looking for a Full or Part-time Materials Engineer/Materials Scientist with broad design and manufacturing expertise to join our national Materials Science practice group to provide investigation, analysis, reports, and testimony where technical and scientific answers are needed to help resolve civil and criminal litigation and insurance claims.
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The Senior Claims Examiner will play a pivotal role in managing and adjudicating complex insurance claims, ensuring accuracy, efficiency, and adherence to company policies and regulatory guidelines.
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Report all claims, accidents, and incidents to HR (Human Resources) and the Area/Regional VP immediately, while handling appropriately, with urgency, care, and concern. Adhere to Evolution's employment and payroll policies and procedures to limit exposure to employment claims and litigation.
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Extensive knowledge of medical billing and coding procedures, insurance claims processing, and healthcare revenue cycle management. Overseeing and managing the entire revenue cycle process, including patient registration, insurance verification, billing, coding, claims submission, payment posting, and account reconciliation.
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Evaluate and assess both new business and renewal large claims/disclosure, clinical and claims data to identify known and potential risks and make potential cost recommendations to the stop loss underwriting team.
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Proactively manage all employee injury claims to minimize lost time and light duty claims. Work with corporate claims staff to ensure that all liability and worker's compensation claims are handled promptly and effectively and, in an effort, to reduce financial liability as well as recoup on all subrogatable claims.
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Work with key members of therapeutic area offices (e.g., executives, providers, administrators, billing and coding staff, claims departments, revenue cycle managers) in order to appropriately support patient access to products.
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Included are processes related to prescription fulfillment and billing and claims processing, as well as customer service written and verbal inquiries. CarelonRx's Advanced Home Delivery and Specialty Pharmacy is looking to hire a Quality Assurance (QA) Specialist.
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Founded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022. Reserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims.
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claims job in Atlanta, GA
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