- 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
- Highmark Health (Atlanta, GA)
- …incumbent to work closely with the section's Accountant, Accounting Coordinators, Associate Analyst , providing, guidance, feedback, training, motivation, and ... for non-payment, Completing write-offs as appropriate, Coordinating AR issues affecting claims or inquiry processing with Membership and Billing personnel.Lead or… more
- Molina Healthcare (Augusta, GA)
- …have experience working in Medicare + Must have experience analyzing claims . **Job Qualifications** **REQUIRED EDUCATION:** Associate 's Degree and/or equivalent ... to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr. Analyst works with health plans and operations departments to assess, oversee,… more
- Evolent (Atlanta, GA)
- …Stay for the culture. **What You'll Be Doing:** Job Description ** Analyst , Integration Quality** Integration testing in the healthcare ecosystem requires complete ... exercised to ensure source to target integrity. The IQ Analyst (IQA) performs analysis, reporting, and technical testing across...the most valuable defects. The IQA reports to a associate director or a manager. One or many IQAs… 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
- Point32Health (GA)
- …direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst is responsible per State and Federal regulations for the professional and ... and have the judgment to seek out guidance as needed. The Analyst is responsible for the accurate coordination, efficient administration and resolution of… 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
- Regions Bank (Atlanta, GA)
- …section of the system. **Job Description:** At Regions, the Fraud Strategy Analyst performs analysis and interpretation of fraud-based threats by gathering and ... self-starter + Strong data and analytics capabilities + Previous experience with fraud claims is highly preferred for this role + Experience with fraud claims… 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