- Molina Healthcare (Atlanta, GA)
- …Qualifications** **REQUIRED QUALIFICATIONS:** + At least 6 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or ... Provides lead level support as a highly capable business analyst who serves as a key strategic partner in...operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to… more
- Molina Healthcare (Augusta, GA)
- …Qualifications** **REQUIRED QUALIFICATIONS:** + At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or ... **Job Description** **Job Summary** The Health Plan Operations, Payment Integrity Program Manager is an individual contributor role designed for a highly capable… more
- Molina Healthcare (Atlanta, GA)
- …Qualifications** **REQUIRED QUALIFICATIONS:** + At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or ... for all PI solutions. + Leads efforts to improve claim payment accuracy, claim referrals, adjustment analysis...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more
- Molina Healthcare (Atlanta, GA)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... teams in ensuring the accuracy and compliance of Coordination of Benefits (COB) claim pricing and processing. This role will focus on identifying, reviewing, and… more
- Elevance Health (Atlanta, GA)
- …invoices. + Performs claim and trend analysis, validation and recovery of claims payment errors. **Minimum Requirements:** + Requires a BA/BS and a minimum of ... **Recovery Audit Analyst I** **Location:** _Hybrid1:_ This role requires associates...is responsible for auditing and facilitating the recovery of claims overpayments as identified by our business partners. Responsible… more
- BrightSpring Health Services (Valdosta, GA)
- …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 ... balancing and reporting.* Maintain open communication with Billing Specialist, Cash Application Analyst and Operations.* Send cash transfer & check requests to the… more
- Elevance Health (Atlanta, GA)
- **Title: Grievance/Appeals Analyst I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... employment, unless an accommodation is granted as required by law._ The **Grievance/Appeals Analyst I** is an entry level position in the Enterprise Grievance &… more
- Elevance Health (Atlanta, GA)
- **Rating/ Claims Systems Implementation Advisor** **Location:** Norfolk, VA; Atlanta, GA (preferred). This role requires associates to be in-office 1 - 2 days per ... not eligible for current or future visa sponsorship._ The **Rating/ Claims Systems Implementation Advisor** will have expert-level experience in...of study and a minimum of 6 years systems analyst or business analyst experience; or any… 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 IQA reports to a associate director or a manager . One or many IQAs may be engaged in… more
- State of Georgia (Fulton County, GA)
- Financial Analyst 2 Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/71231/other-jobs-matching/location-only) New ... - Finance and Business Operations is recruiting for an experienced Financial Analyst II. Under limited supervision and according to Generally Accepted Accounting… more