- CVS Health (Atlanta, GA)
- …override records within the RxClaim platform. As a Clinical Adjudication PA Support Analyst , you will play a vital role in supporting Prior Authorization (PA) ... working with large datasets. + 1-2 years of experience with RxClaim, including claim adjudication, prior authorization (PA) overrides, or plan benefits. + 1-2 years… more
- Quality Technology Services, LLC (Duluth, GA)
- …are:** As a key member of our People Services Team as a **Business Systems Analyst ** , you are going to play an important role in optimizing critical business ... who assist or participate in the investigation of any complaint or discrimination claim . The "Know Your Rights" Poster is included here: Know Your Rights (English)… more
- Waystar (Duluth, GA)
- …As part of our award-winning Client Success Department, the Technical Support Analyst is responsible for providing superior support to our clients with the ... not required):** + Previous experience with ANSI X12 EDI transactions and/or medical billing claim forms (CMS 1500 or UB-04) + Prior use of Salesforce or another… more
- Coinbase (Atlanta, GA)
- …is expected and fully supported. *Team/ Role Paragraph:* As a Pull Payments Analyst on the Payments Risk Analytics team, you'll be fully responsible for identifying ... experience * Strong knowledge of pull payment processes and experience with fraud claim investigations * A passion for fighting fraud and abuse, and the curiosity… more
- Quality Technology Services, LLC (Duluth, GA)
- The **Capital Strategy Analyst i** s responsible for the strategy, analysis, and communication of critical development project capital for active and future ... who assist or participate in the investigation of any complaint or discrimination claim . The "Know Your Rights" Poster is included here: Know Your Rights (English)… more
- Molina Healthcare (Savannah, GA)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... life cycle + Gains a deep understanding of Molina claims life cycle and all processes that affect ...claims life cycle and all processes that affect claims payment + Develops and maintain standards and best… more
- Evolent (Atlanta, GA)
- …into succinct presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based on relevant ... findings. + Extract, manage, and analyze claims and operational data using industry-standard metrics. + Process and validate raw unadjudicated claims data.… more
- Sysco (College Park, GA)
- …to work first and/or second shift.** **Job Summary:** The Leave of Absence Analyst is responsible for managing employee leave and return to work processes, ensuring ... + **Return to Work:** Review and audit Return to Work process for claims , including Return to Work transitional program, process with external vendor and internal… 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 ... advanced SQL queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. * Build and maintain efficient… more
- Molina Healthcare (Macon, GA)
- **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr. Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by translating ... advanced SQL queries to extract, validate, and analyze healthcare data, including claims , pharmacy, and lab datasets. + Build and maintain efficient ETL pipelines… more