- Molina Healthcare (Atlanta, GA)
- …identifies and recommends updates to policies, SOPs, and job aids to improve claims quality and efficiency. + Collaborates with external departments and ... **Job Description** **Job Summary** The Senior Claims Research Analyst provides senior-level support for claims processing and claims research. The Sr. … more
- Molina Healthcare (Macon, GA)
- JOB DESCRIPTION Job Summary Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory ... standard operating procedures (SOPs) and job aids to increase the quality and efficiency of claims processing. * Fields claims questions from the operations… more
- WelbeHealth (Atlanta, GA)
- …Plan Services team helps ensure excellent care delivery for our participants, and the Claims Audit Analyst plays a pivotal role in ensuring timely and accurate ... corrections + Provide feedback to the Oversight & Monitoring Manager on claims processing errors, quality improvement opportunities, and configuration change… more
- Highmark Health (Atlanta, GA)
- …medical terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information ... reviews, evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards.… more
- Highmark Health (Atlanta, GA)
- …is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a liaison between various ... including but not limited to, Clinical Strategy, Sales/Client Management, Customer Service, Claims , and Medical Policy. The person in this position must fully… more
- Elevance Health (Atlanta, GA)
- **Business Information Analyst II - HEDIS Quality Analytics** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering ... analytics to improve the delivery of care. The **Business Information Analyst II** will be responsible for analyzing, reporting and developing recommendations… more
- Molina Healthcare (GA)
- **JOB DESCRIPTION** **Job Summary** The Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. This position designs ... on how to use reports related to Risk and Quality /HEDIS for Medicaid, Marketplace and Medicare/MMP. **Job Duties** +...plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates + Assists and… more
- Molina Healthcare (GA)
- **Job Description** **Job Summary** The Sr Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops ... on how to use reports related to Risk and Quality /HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists with research,...plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates + Assists and… 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 -...create a positive team environment that achieves Group Benefit Claims culture initiatives and objectives Qualifications: + 1+ yeas… more
- Molina Healthcare (Macon, GA)
- JOB DESCRIPTION Job Summary Provides lead level analyst support for configuration information management activities. Responsible for accurate and timely ... implementation and maintenance of critical information on claims databases, synchronizing operational and claims systems data and application of business rules… more
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