- 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
- AIG (Atlanta, GA)
- …of operations support and optimization + Collaborate with enabling teams, including Global Claims COEs, Claims Legal, Compliance , IT, and Claims ... of non-technical claims support to critical business activities, including business review , watch list and pipeline report, and real estate. + Drives a… more
- Sedgwick (Atlanta, GA)
- …reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service ... the authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated claims , serious vocational rehabilitation … more
- Sedgwick (Atlanta, GA)
- …reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service ... the authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated claims , serious vocational rehabilitation … 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
- Elevance Health (Atlanta, GA)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and ... opportunities for fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. + Researches new… 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
- WestRock Company (Atlanta, GA)
- …party claims administrators * Assist with the preparation and review of claim/loss data for semi-annual actuarial evaluations and quarterly reserve monitoring ... for designing, implementing, and managing the company\u2019s casualty insurance claims processes, including workers\u2019 compensation, employer\u2019s liability, automobile, general… more