Top 549 Claims supervisor Jobs in Georgia

Manager, Payment Integrity - Intake & Demand
Centene —Georgia
- $87,700 - $157,800 a year
- Full-time
- Remote
- Management
- Mid-level
- Fair chance
- Paid holidays
- Health insurance
2d
Workers' Compensation Claims Supervisor
CorVel Corporation —Lawrenceville, GA
- $73,345 - $113,247 a year
- Full-time
- Remote
- 5 years
- Computer literacy
- Public speaking
- Health savings account
- Disability insurance
Quick Apply
3d
Quality Control Assistant Manager
Confidential —Rome, GA
- $75,000 - $78,000 a year
- Full-time
- Microsoft Word
- Background check
- Microsoft Excel
- Health savings account
- Health insurance
Quick Apply
RN Case Manager - Rome, GA
Truhealth —Rome, GA
- Full-time
- CPR Certification
- Nursing
- RN License
- Paid holidays
- Health insurance
Quick Apply
3d
Bilingual Personal Injury Legal Case Manager
Barrios Virgüez Attorneys —Duluth, GA
- From $55,000 a year
- Full-time
- Spanish
- English
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Construction Safety and Compliance Manager
Carlisle Construction, LLC —Pine Mountain, GA
- Full-time
- CPR Certification
- Construction site
- Ability to walk for extended periods
- Disability insurance
- Health insurance
Quick Apply
2d
Contract Manufacturing Manager
Schweid & Sons —College Park, GA
- $120,000 - $150,000 a year
- PRN
- 7 years
- Microsoft Excel
- Up to 50% travel
- Paid holidays
- Health insurance
Project Manager – Exterior Restoration
Sky Pro Roofing and Construction —Suwanee, GA
- $85,000 - $180,000 a year
- Full-time
- Spanish
- Mid-level
- Ability to lift 50 pounds
Quick Apply
Product Marketing Manager
Fluidra North America —Atlanta, GA
- 6 years
- Marketing
- Engineering
- Free parking
- Paid holidays
Site Construction Manager
NewCold —Atlanta, GA
- Full-time
- 7 years
- Construction site
- Warehouse
10d
Onsite Pallet Repair Manager — Big-Box DC Reverse Logistics
Pallet Supply LLC —Lake Park, GA
- $83,000 - $90,000 a year
- Full-time
- Background check
- Spanish
- Management
- Health insurance
- Dental insurance
Quick Apply
Technical Sales Manager: Health & Wellness, Food & Bev - Kennesaw, GA
ADM —Kennesaw, GA
- $92,800 - $172,800 a year
- Overtime
- Hybrid work
- Background check
- Up to 50% travel
- Customer service
- Paid parental leave
- Health savings account
Onsite Supervisor
Surge Staffing —Gainesville, GA
- $25 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Management
Quick Apply
3d
Lease-Up Community Manager
ECI Management LLC —Richmond Hill, GA
- Basic math
- Mid-level
- High school diploma or GED
- Paid holidays
- Flexible spending account
Quick Apply
Field Reimbursement & Payer Relations Manager - Remote
Avanos Medical —Georgia
- $135,000 - $157,000 a year
- Full-time
- Up to 50% travel
- HIPAA
- Bachelor's degree
- Health insurance
- 401(k) matching
Office Manager
Confidential —Atlanta, GA
- $60,000 - $64,000 a year
- Full-time
- Dental office
- Mid-level
- In-person
- Health insurance
- Dental insurance
Quick Apply
2d
Construction Operations Manager
TopGun Staffing Inc —Norcross, GA
- $125,000 - $165,000 a year
- Full-time
- Background check
- Construction site
- Office
- Relocation assistance
- Health insurance
Quick Apply
3d
Human Resources Manager
Genesis Technical Staffing —Watkinsville, GA
- 5 years
- Office
- Bachelor's degree
- Health insurance
- Retirement plan
Quick Apply
Revenue Cycle Manager
Confidential —Atlanta, GA
- $55,000 - $65,000 a year
- Full-time
- Clinic experience
- Mid-level
- In-person
- Health insurance
- 401(k)
Quick Apply
4d
Storm Restoration Representative & Customer Relations Manager
Big House Construction LLC —Marietta, GA
- $50,000 - $85,000 a year
- Contract
- Sales
- Ability to walk for extended periods
- No experience needed
Quick Apply

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Manager, Payment Integrity - Intake & Demand

Centene -
Georgia

Apply Now

Job Details

Full-time
$87,700 - $157,800 a year
2 days ago

Benefits

Paid holidays
Health insurance
401(k)
Tuition reimbursement
Paid time off

Qualifications

Medical terminology

Full Job Description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose:
Develop, implement and manage strategic fraud, waste and abuse activities by maintaining state and federal requirements and monitoring trends/schemes

Monitor business processes and systems to assure integrity and compliance in billing and claims payment
Lead teams of analysts to appropriately investigate all possible fraud, waste and abuse referrals
Develop customized fraud plans to meet contract and federal requirements
Develop educational materials to identify/validate waste activities as requested by the health plan and on an ad-hoc basis
Respond to RFP request and implement new policies per contractual obligation
Attend state/federal meetings as required by specific contracts
Prepare/present the FWA program to state/federal personnel upon request, specifically during readiness reviews, and immediately following the go live or upon state agency personnel changes
Review post-payment cases with appropriate parties to obtain refund
Prepare and distribute monthly and quarterly saving reports
Performs other duties as assigned
Complies with all policies and standards

Education/Experience:
Bachelor’s degree in Business, Healthcare, Criminal Justice, related field, or equivalent experience. 4+ years of medical claim investigation, compliance or fraud and abuse experience. Thorough knowledge of medical terminology required. Previous experience in managed care environment and as a lead or supervisor of staff, including hiring, training, assigning work and managing performance preferred.

License/Certification: Medical records or coding license preferred.

Pay Range: $87,700.00 - $157,800.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Apply Now

Refine Your Search

claims supervisor jobs in georgia

Manager, Payment Integrity - Intake & Demand

Workers' Compensation Claims Supervisor

Quality Control Assistant Manager

RN Case Manager - Rome, GA

Bilingual Personal Injury Legal Case Manager

Construction Safety and Compliance Manager

Contract Manufacturing Manager

Project Manager – Exterior Restoration

Product Marketing Manager

Site Construction Manager

Onsite Pallet Repair Manager — Big-Box DC Reverse Logistics

Technical Sales Manager: Health & Wellness, Food & Bev - Kennesaw, GA

Onsite Supervisor

Lease-Up Community Manager

Field Reimbursement & Payer Relations Manager - Remote

Office Manager

Construction Operations Manager

Human Resources Manager

Revenue Cycle Manager

Storm Restoration Representative & Customer Relations Manager

I want to receive the latest job alert for claims supervisor in georgia

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