- Point32Health (GA)
- …regulatory requirements + Manage the collection of documents and records (medical, claims , administrative) needed to fully research the appeal or complaint ... direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst is responsible per State and Federal regulations for the professional and… more
- Highmark Health (Atlanta, GA)
- …+ Intake operational objectives and gather information. May perform routine research and evaluate basic output requirements and formats. Communicate business ... 3 - 5 years of experience in a Business Analyst or Business Process Analyst role or...role or experience in a related operational area (eg claims , billing, customer service, etc.) **Preferred** + 1 -… more
- AutoZone, Inc. (Atlanta, GA)
- … capacity to include but not limited to the following: assist with onboarding; research claims to ensure accuracy and consistency with internal guidelines and ... and communicate flawlessly with Merchandising and Vendors to successfully resolve claims and recover all vendor funding dollars due AutoZone. **Responsibilities**… more
- BrightSpring Health Services (Valdosta, GA)
- …proper coding and comments for all outstanding balances.* Provide any additional research for accounts designated on the critical accounts list, code and comment ... prior to monthly Critical Account call.* Rebill claims for any outstanding AR that is collectible. Provide detail comment in aging with payment date. Field questions… more
- Bank of America (Kennesaw, GA)
- Senior Fraud Analyst II (Consumer Credit Card) 2nd Shift Kennesaw, Georgia **To proceed with your application, you must be at least 18 years of age.** Acknowledge ... must be at least 18 years of age.** Acknowledge (https://ghr.wd1.myworkdayjobs.com/Lateral-US/job/Kennesaw/Senior-Fraud- Analyst -II--Consumer-Credit-Card--2nd-Shift\_25036361) **Job Description:** At Bank of America, we are… more
- Evolent (Atlanta, GA)
- …audiences. + Synthesize complex analyses into succinct presentations. + Perform research and analysis of complex healthcare claims , eligibility, and ... make recommendations based on relevant findings. + Extract, manage, and analyze claims and operational data using industry-standard metrics. + Process and validate… more
- Molina Healthcare (Savannah, GA)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... development of large, complex, critical configuration maintenance processes/solutions + Research and review new tools and techniques and provide...life cycle + Gains a deep understanding of Molina claims life cycle and all processes that affect … more
- Molina Healthcare (GA)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... Related reports to facilitate and support Provider Services/Provider Problem Research & Resolution. **JOB QUALIFICATIONS** **Required Education** Associate degree or… more
- Molina Healthcare (Macon, GA)
- …major projects of considerable complexity, prepares system design specifications, conducts research to resolve customer initiated issues related to core systems ... + Creates, reviews, analyzes and estimates project requests. + Performs research and analysis of customer initiated inquiries and requests, leveraging extensive… more
- CVS Health (Atlanta, GA)
- …in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases ... Outlook products, Database search tools, and use in the Intranet/Internet to research information. * Strong communication and customer service skills. * Ability to… more