- Evolent (Atlanta, GA)
- …data using industry-standard metrics. + Process and validate raw unadjudicated claims data. **Qualifications Required and Preferred :** + Bachelor's degree, ... such as DRGs, Revenue Codes, CPT Codes, RVUs, bundled payments, etc. is preferred + Working knowledge of healthcare claims ; specifically, differences between… more
- CVS Health (Atlanta, GA)
- …to join our PBM Customer Reporting group as a Senior Reporting Analyst within our Compliance Pharmacy Payments. CVS Health strives to continuously innovate ... a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and...years of experience writing scripts in SQL and/or SAS. ** Preferred Qualifications** + Experience with any of these a… more
- Molina Healthcare (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
- PNC (Atlanta, GA)
- …have an opportunity to contribute to the company's success. As a Loan Support Analyst within PNC's Midland organization, you will be based in office within the PNC ... and also supports remote and hybrid work environments As a Loan Support Analyst in PNC Midland's Insurance department you will be responsible for determining… 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 ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
- CGI Technologies and Solutions, Inc. (Atlanta, GA)
- **Senior Guidewire Business Analyst ** **Category:** Business Analysis (functional and technical) **Main location:** United States, Alabama, Birmingham **Alternate ... Full Time **Position Description:** We are seeking a seasoned Guidewire Business Analyst to support ongoing enhancements and steady-state operations for a regional… more
- Prime Therapeutics (Atlanta, GA)
- …and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance ... Analyst assists in the implementation of Prime's compliance programs,...stakeholders to research and resolve regulatory inquiries/complaints related to claims , contracting and pharmacy reimbursement. Works directly with business… more
- WEG Electric Corp. (Duluth, GA)
- Sr. Trade Compliance Analyst **Department:** Logistics **Location:** Duluth, GA **About the Role:** WEG Electric Corp. has an excellent opportunity for a Global ... Trade Compliance Analyst . The Global Trade Compliance Specialist will interpret International...resolve discrepancies in import filings. + Prepare and submit claims forduty drawbackin accordance with CBP requirements. + Manage… 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
- CVS Health (Atlanta, GA)
- …heart, each and every day. **Position Summary** As a Healthcare Encounter Senior Analyst for claim reconciliation in the State Medicaid Encounters department, ... or more years of experience using Excel in a professional or academic setting. ** Preferred Qualifications** - 2 or more years of professional work experience in a… more