- Humana (Atlanta, GA)
- **Become a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... work closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of… more
- Molina Healthcare (Macon, GA)
- JOB DESCRIPTION Job Summary Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory ... with appropriate departments, developing and tracking remediation plans, and monitoring claims reprocessing through resolution. **Essential Job Duties** * Serves as … 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
- Public Consulting Group (Atlanta, GA)
- …To learn more, visit www.publicconsultinggroup.com . The Contract Support and RCM Analyst will support both the contractual administrative tasks and the entire claim ... through claim issue research. Additional this position will assist in performing claims processing, medical record audits for all implemented agencies, and assist… more
- Molina Healthcare (Augusta, 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
- Molina Healthcare (Augusta, GA)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... Hospital payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is… more
- Humana (Atlanta, GA)
- …and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer Business and System Support team ... it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible for maintenance and support of… more
- Molina Healthcare (Columbus, GA)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... as well as Reporting modules related to Quality/HEDIS for Medicaid , Marketplace and Medicare/MMP. + Analysis and reporting related...and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality… more
- Cognizant (Atlanta, GA)
- …digital transformation initiatives * Deep understanding of payer functions and Medicaid plan implementations, including enrollment, billing, claims , care ... **Health Payer Business Analyst , Senior Consulting Manager** **About the Role:** As...* Strong background in Healthcare industry, including health plans, claims , and provider operations * Project management and people… more
- Molina Healthcare (Savannah, GA)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable… more