- Prime Therapeutics (Atlanta, GA)
- …requestors to resolve questions regarding requested software changes, and participate with Quality Assurance and UAT resources to review related test cases ... career? Come build the future of pharmacy with us. **Job Posting Title** IT Analyst **Job Description** The IT Business Systems Analyst is responsible for… more
- Humana (Atlanta, GA)
- …+ Creating and executing comprehensive test plans + Ongoing Medicare Pricer maintenance, quality assurance , and compliance + Determine root causes driving issues ... health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer...closely with IT, the pricing software vendor, CIS BSS, claims operations, and other business teams involved in the… more
- Point32Health (GA)
- …is compliant with the regulatory requirements set-forth by NCQA (National Committee for Quality Assurance ), DOI (Dept of Insurance), CMS, DOL and any state ... leading not-for-profit health and well-being organization dedicated to delivering high- quality , affordable healthcare. Serving nearly 2 million members, Point32Health… more
- Humana (Atlanta, GA)
- …Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance , and compliance + Determining root causes driving issues ... 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… more
- AIG (Atlanta, GA)
- …and control requirements according to defined processes, policies and standards. + Lead quality control and quality assurance activities, such as developing ... risk. Join us as a Privileged Access Management Technical Analyst to play your part in that transformation. It's...of everything we do, from underwriting risks to processing claims . The Information Technology team equips our colleagues with… more
- Highmark Health (Atlanta, GA)
- …coding principles are incorporated into policy criteria. + **Policy Publication & Quality Assurance :** Manage the full publication process for assigned policies. ... Conduct peer reviews of other policies as part of the quality assurance process to ensure accuracy, clarity, and consistency. + **Consultative & Expert Role:**… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …(typically developing peers, trainees, or volunteers). + Oversees all operations including quality assurance and policies and procedures in conjunction with ... as a provider on record for appropriate managed care intervention claims with responsibility for appropriate documentation, implementation, and monitoring of autism… more
- Public Consulting Group (Atlanta, GA)
- …effectiveness. **Duties and Responsibilities** + Provides leadership, management, and direction to the Quality Assurance Analyst team. + Leads and manages ... Third Party Administrator Services + Enhance Health and Public Safety Services + Claims Processing Services and Solutions + Consulting and Advisory Services + Cost… more