Claims Specialist Jobs in Alpharetta, GA

Innovate healthcare fraud prevention by leading complex investigations, evaluating medical necessity, and collaborating with regulatory agencies to ensure quality member care and safeguard plan assets...

Unlock potential by leading complex investigations into healthcare fraud, waste, and abuse. Collaborate with regulatory agencies and internal teams to ensure compliance and safeguard member care while...

Develop and optimize health and welfare plans, ensuring compliance and efficient administration. Collaborate with TPAs, oversee claims performance, and enhance employee engagement through effective co...

Support clinical studies by assisting teams with tasks like medical monitoring and protocol management. Collaborate across functions and engage with stakeholders to ensure successful trial outcomes wh...

Provide legal counsel on regulatory and transactional matters, structuring and negotiating agreements while ensuring compliance with FCC regulations. Play a key role in supporting M&A activities and g...

Lead the planning and execution of diverse research projects, ensuring alignment with organizational goals. Collaborate with stakeholders to manage timelines, deliverables, and budgets while fostering...

Join a team that's transforming healthcare through data-driven insights. As a Senior Medical Economics Analyst, you'll lead analytics initiatives, mentor a team, and collaborate with leaders to enhanc...

Elevate your legal career by joining a dynamic Litigation team, where you'll gain hands-on experience in civil litigation, from case inception to trial, while enjoying a supportive environment and hyb...

Empower your career by joining a dynamic team focused on healthcare compliance auditing. Utilize your analytical skills to drive impactful audits and contribute to client deliverables while receiving...

Lead the charge in shaping strategic actuarial solutions for a dynamic healthcare portfolio. Drive team performance and collaboration to deliver impactful pricing and projections while navigating comp...

Empower clinical research excellence by managing projects that ensure compliance with regulatory requirements and drive successful study delivery from initiation to closeout. Collaborate with interdis...

Drive underwriting excellence by managing referral decisions, enhancing guidelines, and optimizing processes for a growing cyber and technology E&O portfolio, ensuring timely and well-documented outco...

Reimagine sourcing strategies by optimizing operations and supplier relationships. Lead initiatives that drive cost savings and sustainability while ensuring compliance and data integrity. Collaborate...

Drive strategic sourcing initiatives by optimizing services operations and supplier relationships. Collaborate with stakeholders to implement efficient processes, ensuring compliance and delivering co...

Elevate your career by leading a dynamic team in complex actuarial projects, driving innovative solutions for clients while ensuring compliance with regulations and standards. Embrace technology and m...

Shape the future of Surety pricing by owning and enhancing the SDI pricing model. Collaborate with underwriting leadership, conduct complex analyses, and mentor peers to drive strategic business decis...

Drive GRC initiatives by building and testing security controls, assessing risks, and automating evidence collection. Collaborate with teams to enhance compliance and support audits while ensuring eff...

Elevate provider clinical operations by leading modernization initiatives, managing teams, and driving process improvements. Utilize your expertise to enhance service delivery and foster client relati...

Join us to enhance Business Continuity Management systems through innovative solutions, ensuring compliance and effective automation. Collaborate with teams to optimize processes and provide technical...

Drive impactful Medicaid and CHIP program improvements by leading project teams, providing expert insights, and developing innovative solutions for complex pharmacy-related challenges in a dynamic con...

Unlock potential by conducting thorough MLR examinations, ensuring compliance with federal and state regulations. Collaborate with teams to analyze data, review documentation, and enhance audit proced...

Join a team that's transforming home and specialty insurance solutions through data-driven analysis and innovative project management, delivering value to customers and driving growth in a dynamic env...

Engage with clients to drive digital transformation in Life Insurance. Lead teams in process optimization, platform modernization, and AI adoption while delivering high-quality consulting services and...

Join a team that's dedicated to optimizing privacy management processes and compliance technology. This role supports platform administration, user engagement, and operational improvements, ensuring e...

Lead a high-performing underwriting team to drive profitable growth and deliver customer-focused solutions in Medicare underwriting across multiple segments. Collaborate with cross-functional partners...