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Address:
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3350 Peachtree Rd NE
Atlanta, GA 30326-1039
United States
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Phone:
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404-842-8000
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Url: |
http://www.bcbsga.com
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Type:
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Private
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Industry:
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Health Care Plans
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Employees:
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1000
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Description:
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Hospital & Medical Service Plans.
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Available Positions
Help negotiate, analyze, support and monitor contractual arrangements between Blue Cross and participating providers, and provide data and reimbursement analysis and recommendations to management on issues impacting reimbursement. Resolve payment rates, complete special projects, develop the physician fee schedule and analyze hospital reports, including financial analyses. Review and analyze physi
JOB SUMMARY:
Provides project management, direction, general mentoring, training and assistance on project management methodologies, tools and techniques and business case and project plan development. Lead the implementation of assigned corporate priority IT initiatives as assigned. Build and provide direction to project teams, create and foster communication among team members anticipate and ac
JOB SUMMARY
Assist with monitoring, controlling, processing and reconciliation of the payroll checks, and reports of the automated and manual payroll systems for active and retired, in state and out of state BCBS employees. Reconcile payroll ledger accounts on a monthly basis. Track and monitor the payment of benefit and employee related invoices and distribution payroll expenses such as health i
JOB SUMMARY:
Develop, implement, manage, and make sustainable, the Company’s continuous improvement initiative. Lead a team of professionals to achieve significant and lasting improvements in service levels, reduce cycle times, reduce administrative expenses, and colleague engagement. Mentor and train staff company-wide on continuous improvement. Develop, refine and monitor a set of corporate ope
Responsible for the coordination of assigned copy projects as related to the Commercial and Medicare segments as well as Blue Cross Blue Shield Association items. These projects include a variety of communication media including magazine inserts, Web site, ads related to the segments, brochures, direct mail, collateral, overhead and on-screen presentations, executive reports and presentations, ben
JOB SUMMARY:
Responsible for monitoring, analyzing, and formulating positions on federal and state legislation, regulations, and other national and local industry initiatives that present significant implications to Government Programs regarding benefit design, product performance and business strategy.
ESSENTIAL JOB FUNCTIONS:
1. Reviews legislation and legislative proposals to identify strate
JOB DESCRIPTION
JOB SUMMARY
Utilize the Case Management process of assessment, planning, implementation, coordination, monitoring, and evaluation on an ongoing basis. The process is dynamic and evolutionary, requiring continuous reassessments and revisions to the plan of care.
Hours will be either:
* (4) ten hour days, 8:15 am - 6:30 pm
or
* 5 days, 10:15 am - 6:30 pm
REPRESENTATIVE JOB DUTIE
JOB SUMMARY:
Perform on-site medical record reviews and quality assurance reviews of BCBSRI claims to ensure proper reimbursement within existing BCBSRI billing policies and reimbursement principles. Oversee compliance of the AHA Official Coding Clinic guidelines as well as Contract language.
REPRESENTATIVE JOB DUTIES:
* Perform on-site billing validation audits which include auditing inpatient a
JOB SUMMARY:
Ensure consistency in outcomes of divisional functions conducted by Health Management & Integration (HM&I) staff through ongoing training, monitoring, and evaluation. The incumbent will be responsible for developing quality behavioral health programs. Evaluate divisional processes to reduce corporate risk and serve as a consultant to management for improvement in overall efficiency o
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