
1001 - 5000 employees
Founded 1965
⚕️ Healthcare Insurance
🏛️ Government
🤝 B2B
Healthcare Insurance • Government • B2B
Palmetto GBA is one of the nation's largest providers of high-volume Medicare claims and transaction processing, contact center operations, and technical services for federal healthcare programs and commercial customers. The company serves as a Medicare Administrative Contractor (MAC) and supports enrollment, claims adjudication, provider and beneficiary services, specialized programs (e. g. , DMEPOS, Home Health & Hospice, Railroad Medicare), pricing and coding analysis, and third-party administrator functions. Headquartered in Columbia, South Carolina, Palmetto GBA operates across multiple Medicare jurisdictions and is part of the Celerian Group.
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1001 - 5000 employees
Founded 1965
⚕️ Healthcare Insurance
🏛️ Government
🤝 B2B
Healthcare Insurance • Government • B2B
Palmetto GBA is one of the nation's largest providers of high-volume Medicare claims and transaction processing, contact center operations, and technical services for federal healthcare programs and commercial customers. The company serves as a Medicare Administrative Contractor (MAC) and supports enrollment, claims adjudication, provider and beneficiary services, specialized programs (e. g. , DMEPOS, Home Health & Hospice, Railroad Medicare), pricing and coding analysis, and third-party administrator functions. Headquartered in Columbia, South Carolina, Palmetto GBA operates across multiple Medicare jurisdictions and is part of the Celerian Group.
• Identifying, developing, and implementing process improvements and automation solutions that enhance operational efficiency within the Audit Reimbursement Department. • Evaluates existing policies, procedures, and workflows to recommend improvements. • Collaborates with department stakeholders to streamline operations, reduce manual effort, improve accuracy, and support continuous improvement initiatives. • Compiles data for analysis and prepares reports and presentations for management using applicable programming languages and/or software products. • Reviews system enhancements/upgrades to determine applicability of customer file modification requirements. • Facilitates timely and accurate updates to reference files based on customer requests. • Coordinates testing and debugging of new or modified software. • Creates test matrices and supporting documentation. • Develops and executes formal test plans to ensure delivery of quality software applications. • Monitors software implementations for exceptions and to verify that changes to the systems' operational process had the desired effect. • Identifies and documents systems problems and assists in their resolution.
• Bachelor’s degree OR Four (4) years of job-related business experience OR Associate’s degree AND two (2) years of job-related work experience. • Two (2) years of job-related business systems analysis, research and/or customer support experience • Working knowledge of business support and systems concepts. • Ability to communicate effectively with technical and non-technical audiences, including the ability to express basic technical and business concepts to management, peers and the business units. • Good teamwork and interpersonal skills. • Good analytical and conceptual skills. • Fundamental understanding of user acceptance test plans and test matrices, project plans, and scope and design documents. • Working knowledge and understanding of how projects and implementations affect an organization and can effectively link it to business processes. • Working knowledge of mainframe electronic data processing system change methodology. • Knowledge of Microsoft Office applications.
• Subsidized health plans • Dental and vision coverage • 401 k retirement savings plan with company match • Life Insurance • Paid Time Off (PTO) • On-site cafeterias and fitness centers in major locations • Education Assistance • Service Recognition • National discounts to movies, theaters, zoos, theme parks and more
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