- Molina Healthcare (Atlanta, GA)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting,… more
- AIG (Atlanta, GA)
- …we are reimagining the way we help customers to manage risk. Join us as Claims Business Analyst to play your part in that transformation. It's an opportunity ... and efficiency. How you will create an impact The Claims Business Analyst partners with North America...proven track record of delivering results. + Ability to lead and motivate other in a virtual and remote… more
- Axis (Alpharetta, GA)
- …is available upon request for candidates taking part in the selection process. ** Claims Business Analyst ** **How does this role contribute to our collective ... success?** We are seeking a Claims Business Analyst to join our Business...will be responsible to the Agile value stream team lead , ensuring alignment with our Agile principles and goals.… more
- AIG (Atlanta, GA)
- …are reimagining the way we help customers to manage risk. Join us as a Senior Claims Law Firm Analyst to play your part in that transformation. It's an ... will create an impact Full Time US-based employment, the Claims Law Firm Analyst shall be responsible...from AIG's Law Firm contract template; + Participate and lead Law Firm pricing negotiations; + Document and summarize… more
- Molina Healthcare (GA)
- …**Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Molina Healthcare (Atlanta, GA)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... and regulatory guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in… 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 ...Eg, Medicare Exclusion POC + Acts as a team lead , assigning and prioritizing work for other team members… more
- Prime Therapeutics (Atlanta, GA)
- …and assumptions to define additional resource needs; collaborate with Business Systems Analyst Resource Lead or Resource Manager to determine work assignments ... Provide work plan and detailed estimate based on scope; lead scope management, prioritization and drive scope trade off...within project + Educate and advance business systems analyst practice within the Claims IT team… more
- CVS Health (Atlanta, GA)
- …in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases ... for clinical and legal review. - Documents all appropriate case activity in case tracking system. - Prepares and presents referrals, both internal and external, in the required timeframe. - Facilitates the recovery of company lost as a result of fraud matters.… more
- Elevance Health (Atlanta, GA)
- **Actuarial Analyst III** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing ... accommodation is granted as required by law. The **Actuarial Analyst III** completes very diverse and complicated projects and...Make An Impact:** + Analyze and monitor weekly incurred claims , paid claims , pharmacy, lab results, and… more