- Highmark Health (Atlanta, GA)
- …experience within one or more Epic modules. **Preferred** + 2+ years of Healthcare Revenue Cycle experience ( Claims , Patient Access, Billing) + Epic ... supporting the Epic Resolute Hospital Billing application. Responsibilities include business /systems analysis, requirements definition and documentation, system design, and… more
- Elevance Health (Atlanta, GA)
- …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- CVS Health (Atlanta, GA)
- …designs. + Completes financial forecasting and projection analysis to estimate future healthcare costs, revenue, and profitability. + Analyzes claims data to ... on these issues. Team members collaborate closely throughout the year with market business partners in addition to the broader actuarial team. **A Brief Overview**… more
- CVS Health (Atlanta, GA)
- …**Required Qualifications** + 3-5 years of data interpretation and analysis experience. + Healthcare background. + Experience with internal claims data and ... for the validation of existing fraud waste and abuse business rules and leads designed to detect aberrant billing...to determine the impact of the scheme on Aetna business . + Keep current with new and emerging fraud,… more
- TEKsystems (Atlanta, GA)
- …years of experience installing/supporting applications. + Experience in a healthcare related field preferred. + Current Epic certification required-Professional ... Billing, Professional Billing Claims + Working knowledge of personal computers and Microsoft...and TEKsystems Global Services We're a leading provider of business and technology services. We accelerate business … more
- Intermountain Health (Atlanta, GA)
- …Classification of Diseases ICD-10 and Diagnosis Related Groups (DRG) codes for claims concurrently while a patient is in a hospital. It ensures accurate ... codes in support of the provision of value-based care by Intermountain Healthcare to appropriate populations. It ensures compliance and accurate submission of… more
- Molina Healthcare (Atlanta, GA)
- …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of ... strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** Manages and provides direct oversight of Healthcare Analytics Team activities and personnel. Provides technical expertise,… more
- CVS Health (Atlanta, GA)
- …Experience in healthcare fraud, waste and abuse + Knowledge of Medicaid healthcare claims adjudication (QNXT) & regulatory reporting + Experience with data ... We are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a...skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud, waste,… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …+ Seven (7) years of experience in implementing technical requirements to support business applications as an Application Analyst ; OR a Bachelor's Degree and ... **Overview** **Be inspired. Be valued. Belong.** At Emory Healthcare we fuel your professional journey with better...Hospital and Professional Billing including SBO, as well as Claims and Remittance. This IT technologist role contributes as… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …Familiarity with interdisciplinary team collaboration is essential, particularly in healthcare or psychiatric environments. The primary role of this position ... as a provider on record for appropriate managed care intervention claims with responsibility for appropriate documentation, implementation, and monitoring of autism… more