- Molina Healthcare (Augusta, GA)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... that provider information is loaded accurately to allow for proper claims processing, outbound reporting and directory processes. **JOB QUALIFICATIONS** **Required… more
- The Hartford (Alpharetta, GA)
- …Disability and Absence Management Disability Team. The Short-Term Absence Management Disability Analyst quickly investigates claims to determine if the insured ... Ability Analyst - C410ANSr Ability Analyst -...quality customer service is required. + 2+ years of claim experience is preferred. + Associate or… more
- BrightSpring Health Services (Valdosta, GA)
- …BrightSpring Health Services is seeking a highly skilled and detail-oriented Accounts Receivable Process Analyst to join our team. As an A/R Process Analyst you ... report out. + Complete follow up process to ensure full adjudication of claims . + Identifies adjustments throughout the month for assigned Operations. + Timely… more
- Highmark Health (Atlanta, GA)
- …resolution of issues related to benefit interpretations, customer service inquiries, claims adjudication, benefits issues, membership and billing activity, etc. This ... relationships with key internal areas, such as Customer Service Operations ( Claims , Dental Benefits, Customer Service, Membership & Billing), Provider Data… more
- CVS Health (Atlanta, GA)
- …Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves learning the negotiation ... **Required Qualifications** + 3-5 years of experience in a medical claim background with understanding of benchmarking costs for medical services, supplies,… more
- Brown-Forman (Atlanta, GA)
- … claim settlement activities, including both insured and self-insured claims , ensuring accurate records and facilitating efficient resolution processes. + _Drive ... **What Makes You Unique** + Professional insurance designations such as ARM ( Associate in Risk Management) or CPCU (Chartered Property Casualty Underwriter). + Basic… more
- Humana (Atlanta, GA)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and expansion into new… more
- Highmark Health (Atlanta, GA)
- …recommends process improvements for efficiencies. May provide guidance to Associate level employees. **ESSENTIAL RESPONSIBILITIES** + Intake operational objectives ... 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
- 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
- Molina Healthcare (Savannah, GA)
- …and training materials as needed. **JOB QUALIFICATIONS** **Required Education** Associate 's Degree or equivalent combination of education and experience **Required ... formal training in Business Analysis and/or Systems Analysis + 1-3 years of Claims or Adjustment experience in Medicare and/or Medicaid + Familiarity with QNXT,… more