- 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
- 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 ... identify and troubleshoot claim discrepancies by utilizing benefit and provider contracts, regulatory requirements and various claims related resources + Strong… more
- Elevance Health (Atlanta, GA)
- …non-complex grievances and appeals in accordance with external accreditation and regulatory requirements, internal policies and claims events requiring ... and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize...regulatory standards and requirements. + As such, the analyst will strictly follow department guidelines and tools to… more
- Highmark Health (Atlanta, GA)
- …MUST BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, ... proactively identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their impact on operational… more
- Elevance Health (Columbus, GA)
- **Grievance/Appeals Analyst Senior** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... skill development. Shift hours: 8:00am - 4:30pm EST** The **Grievance/Appeals Analyst Senior** is responsible for reviewing, analyzing, and processing complex pre… more
- Prime Therapeutics (Atlanta, GA)
- …decision we make. **Job Posting Title** Sr. Applied Stars and Quality Analytics Analyst - Remote **Job Description** The Senior Health Data Analyst provides ... programs that align with Prime's strategic imperatives and will lead high-complexity analysis and special projects as required. **Responsibilities** +… more
- Brown-Forman (Atlanta, GA)
- …and a drive to make a global impact? Join Brown-Forman and take the lead in optimizing our insurance programs. This isn't just about managing policies; it's about ... and Partnership:_ Ensure our global insurance programs consistently comply with local regulatory and tax requirements across our international footprint. You'll be a… more
- Highmark Health (Atlanta, GA)
- …5 years with coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + 3 years of project leadership ... and non-technical, and internal and external audiences, and the ability to lead through influence + Healthcare industry expertise and experience, knowledge about the… more