- Highmark Health (Atlanta, GA)
- …charges. The incumbent will also conduct or assist with provider and subscriber investigations to verify the validity of services and charges; will monitor internal ... facility and professional provider over-payments. + Investigation Support: Assist with investigations : Assist in the interviews of customers and providers to obtain… more
- State of Georgia (Fulton County, GA)
- Participation Direction Coordinator - Atlanta Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/68892/other-jobs-matching/location-only) New ... Job Sign Up for Job Alerts Job Description Job Title: Participation Direction Coordinator - Atlanta Pay Grade: L Work Designation: Remote Job Summary: Under the… more
- Cardinal Health (Atlanta, GA)
- …regulations, standards and operating procedures. + Demonstrates ability to perform investigations / root cause analysis and develop corrective actions. + ... Demonstrates an understanding of the requirements and has the ability to perform gap assessments to those requirements. + Demonstrates an understanding of quality concepts such as: cost of quality, analytical metrics and / or statistics, trending, quality… more
- Cardinal Health (Atlanta, GA)
- …+ Experience conducting and documenting patient health insurance benefit investigations , prior authorizations, and appeals, preferred (2+ years) + Knowledge ... of Medicare, Medicaid and Commercially insured payer common practices and policies, preferred + Critical and creative thinking, preferred + Knowledge of Medical/Pharmacy billing and coding, preferred + Strong attention to detail is vital + Bilingual, preferred… more
- Cardinal Health (Atlanta, GA)
- …of applicable regulations, standards, and operating procedures. + Conduct investigations /root cause analysis and formulate corrective action recommendations. + Show ... an understanding of the program requirements and be capable of conducting gap assessments based on those requirements. + Uphold quality standards that adhere to company, regulatory, and HIPAA policies and procedures. + Collaborate across various functions,… more
- Cardinal Health (Atlanta, GA)
- …regulations, standards, and operating procedures. + Demonstrates ability to perform investigations / root cause analysis and develop corrective actions. + ... Demonstrates an understanding of the requirements and has the ability to perform gap assessments to those requirements. + Demonstrates an understanding of quality concepts such as: cost of quality, analytical metrics and / or statistics, trending, quality… more
- State of Georgia (Fulton County, GA)
- …The position filled through this announcement will serve in the Investigations section of our Medicaid Fraud Division. Duties & Responsibilities: Investigators ... conduct health care fraud investigations . Assists criminal justice personnel, including, but not limited...* Demonstrates skills to be a witness and/or evidence coordinator on behalf of the prosecuting attorneys to ensure… more
- BioLife Plasma Services (Duluth, GA)
- …to EHS guidance regarding employee incidents. + You can be a Pandemic Coordinator when authorized by EHS and support investigations associated with pandemic ... threats within the local community as indicated by EHS or Medical Affairs. **What you bring to Takeda:** + High school diploma or equivalent to including graduate equivalent of a recognized educational nursing program with state requirements + Currently… more
- Dow (Marietta, GA)
- …to operate plant personnel for learning purposes. Ensures thorough and timely pre- investigations occur + Works with continuous improvement and plant resources to ... team members on plant process + Develops a strong partnership with the activity coordinator /gate keeper and provides back up to these roles, as needed + Maintains… more