- Prime Therapeutics (Atlanta, GA)
- …claims , contracting and pharmacy reimbursement. Works directly with business partners across the enterprise. **Responsibilities** + Executes compliance procedures ... and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance… more
- Elevance Health (Atlanta, GA)
- …will not be considered for employment, unless an accommodation is granted as required by law. The **Actuarial Analyst II** completes projects and performs ... **Actuarial Analyst II** **Location:** This role requires associates to...data including risk reporting and forecasting. + Calculates monthly claims liability reserves, develops merit rating factors and prepares… more
- Molina Healthcare (Columbus, GA)
- **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities ... skills in data analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue, and vendor data.… more
- CVS Health (Atlanta, GA)
- …and innovation. * Constantly work to understand data structures and their business context ** Required Qualifications** * 2+ years of experience supporting ... our PBM Finance Enablement group as a Senior Reporting Analyst within our PBM Customer Reporting team. CVS Health...a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and… more
- Molina Healthcare (Savannah, GA)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...life cycle + Gains a deep understanding of Molina claims life cycle and all processes that affect … more
- Emory Healthcare/Emory University (Atlanta, GA)
- …aligns with the university calendar. JOB DESCRIPTION: + Board Certified Behavioral Analyst (BCBA) II (Behavioral Clinical Practitioner BCPII ) in the Emory Autism ... as the provider on record for appropriate managed care intervention claims with responsibility for appropriate documentation, implementation, monitoring, and billing… more
- Sedgwick (Atlanta, GA)
- …(8) years of related experience or equivalent combination of education and experience required to include four (4) years business experience in an insurance ... Fortune Best Workplaces in Financial Services & Insurance Data Analyst Manager **PRIMARY PURPOSE OF THE ROLE:** To manage...related field and four (4) years statistical analysis required . Supervisory experience preferred. **Taking Care of You** +… more
- AutoZone, Inc. (Atlanta, GA)
- …and communicate flawlessly with Merchandising and Vendors to successfully resolve claims and recover all vendor funding dollars due AutoZone. **Responsibilities** ... Support the Manager with all 3rd Party teams in analyst capacity to include but not limited to the...not limited to the following: assist with onboarding; research claims to ensure accuracy and consistency with internal guidelines… more
- Evolent (Atlanta, GA)
- …data using industry-standard metrics. + Process and validate raw unadjudicated claims data. **Qualifications Required and Preferred:** + Bachelor's degree, ... reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the...presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based… more
- Molina Healthcare (Augusta, GA)
- **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by ... translating healthcare business needs into technical solutions. This role works closely...queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. * Build and… more