- Molina Healthcare (Columbus, GA)
- **Job Description** **Job Summary** The Senior Analyst will serve a key role on the RADV (Risk Adjustment Data Validation) team, contributing to the end-to-end data ... Databricks, not all required elements are neatly organized or centralized. The analyst will be expected to investigate and connect disparate data sources, with… 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
- Molina Healthcare (Macon, GA)
- …+ SQL expertise + Excel expertise + Medicare, Medicaid, Marketplace claims expertise **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting ... and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made… more
- Molina Healthcare (Atlanta, GA)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings. **KNOWLEDGE/SKILLS/ABILITIES** + Develop ad-hoc reports using SQL programming, SQL Server… more
- Norstella (Atlanta, GA)
- Sr. Medical Analyst Company: MMIT Location: Remote , United States Date Posted: Jul 30, 2025 Employment Type: Full Time Job ID: R-1370 **Description** **Why ... market faster and support patients in need. We are seeking a Senior Medical Analyst to join our team and drive data-driven healthcare initiatives. In this role, you… 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
- 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
- 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
- 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 ... a best in class office environment; and also supports remote and hybrid work environments As a Loan Support... and hybrid work environments As a Loan Support Analyst in PNC Midland's Insurance department you will be… more
- Highmark Health (Atlanta, GA)
- …2 years of Coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + 1 year of Project leadership in ... 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office- or Remote -based Teaches / trains others Occasionally Travel from the office to… more