- CVS Health (Atlanta, GA)
- …override records within the RxClaim platform. As a Clinical Adjudication PA Support Analyst , you will play a vital role in supporting Prior Authorization (PA) ... working with large datasets. + 1-2 years of experience with RxClaim, including claim adjudication, prior authorization (PA) overrides, or plan benefits. + 1-2 years… more
- Quality Technology Services, LLC (Duluth, GA)
- The **Capital Strategy Analyst i** s responsible for the strategy, analysis, and communication of critical development project capital for active and future ... role is also eligible for a competitive benefits package that includes: medical , dental, vision, life, and disability insurance; 401(k) retirement plan; flexible… more
- Coinbase (Atlanta, GA)
- …is expected and fully supported. *Team/ Role Paragraph:* As a Pull Payments Analyst on the Payments Risk Analytics team, you'll be fully responsible for identifying ... experience * Strong knowledge of pull payment processes and experience with fraud claim investigations * A passion for fighting fraud and abuse, and the curiosity… more
- Elevance Health (Atlanta, GA)
- **Rating/ Claims Systems Implementation Advisor** **Location:** Norfolk, VA; Atlanta, GA (preferred). This role requires associates to be in-office 1 - 2 days per ... not eligible for current or future visa sponsorship._ The **Rating/ Claims Systems Implementation Advisor** will have expert-level experience in...of study and a minimum of 6 years systems analyst or business analyst experience; or any… more
- CGI Technologies and Solutions, Inc. (Atlanta, GA)
- **Senior Guidewire Business Analyst ** **Category:** Business Analysis (functional and technical) **Main location:** United States, Alabama, Birmingham **Alternate ... Full Time **Position Description:** We are seeking a seasoned Guidewire Business Analyst to support ongoing enhancements and steady-state operations for a regional… more
- Point32Health (GA)
- …and Federal regulatory requirements + Manage the collection of documents and records ( medical , claims , administrative) needed to fully research the appeal or ... direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst is responsible per State and Federal regulations for the professional and… more
- Elevance Health (Atlanta, GA)
- **Data Scientist Analyst ** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing ... unless an accommodation is granted as required by law. As a **Data Scientist Analyst ** , you will support the development of innovative analytics and AI solutions… more
- Molina Healthcare (Columbus, GA)
- **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities ... skills in data analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue, and vendor data.… more
- Sedgwick (Atlanta, GA)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Data Analyst Manager **PRIMARY PURPOSE OF THE ROLE:** To manage a staff of data ... growth opportunities + A diverse and comprehensive benefits offering including medical , dental vision, 401k, PTO and more Work environment requirements for… more
- Humana (Atlanta, GA)
- …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 ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more