- Molina Healthcare (Atlanta, GA)
- **Job Description** **Job Summary** The Senior Claims Research Analyst provides senior-level support for claims processing and claims research . ... The Sr. Analyst , Claims Research serves as a senior-level subject matter expert in...regulatory and contractual requirements. + Leads and manages major claims research projects of considerable complexity, initiated… more
- Molina Healthcare (Atlanta, GA)
- JOB DESCRIPTION **Job Summary** Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory ... inquiries and projects. * Interprets and presents in-depth analysis of claims research findings and results to leadership and respective operations teams. *… more
- Carrington (Atlanta, GA)
- …amazing team and work remote from home! The Loss Claim Recovery Analysis Analyst is responsible for performing financial reconciliation on all liquidated loans and ... to mitigate losses for both Carrington Mortgage Services and its clients. Research must be completed on incurred losses to determine responsibility, find bill… more
- Public Consulting Group (Atlanta, GA)
- …claim issue research . Additional this position will assist in performing claims processing, medical record audits for all implemented agencies, and assist with ... claim issue research . Additional this position will assist in performing claims processing, medical record audits for all implemented agencies, and assist with… more
- Newell Brands (Sandy Springs, GA)
- …you can be your best, every day. The **Front-End Innovation (FEI)** Business Model Analyst **Manager / Sr. Manager** will play a key role within the business FEI ... proposition, from inception of the core idea (including benefits, claims , branding) to the business model recommendation. They will...core job to be done. The FEI Business Model Analyst (Manager / Sr. Manager) is also responsible for… more
- Axis (Alpharetta, GA)
- …for candidates taking part in the selection process. **Senior Insurance Compliance Analyst ** Job Family Grouping: Product Development & Support Job Family: Senior ... Analyst , Product Development & Support **How does this role...product on both an admitted and non-admitted basis + Research statutes, regulations, bulletins and cases to provide guidance… more
- Evolent (Atlanta, GA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** **Lead Analyst , Performance Analytics - Oncology & Member Product Focus** **Overview:** Evolent is ... seeking an experienced and strategic **Lead Analyst , Performance Analytics** to lead data-driven initiatives focused on oncology and member-centric products. This… more
- Norstella (Atlanta, GA)
- Sr. Medical Analyst , RWD Company: MMIT Location: Remote, United States Date Posted: Nov 20, 2025 Employment Type: Full Time Job ID: R-1548 **Description** At ... to extract meaningful insights from **real-world data (RWD)** sources, including ** claims , laboratory results, billing codes, and electronic health records (EHRs)**… more
- WTW (Atlanta, GA)
- …**The Role** We are seeking an organized and detail-oriented Retirement Plan Compliance Analyst to join our team. As a compliance analyst you will ... **Other:** Keep abreast of laws and regulations impacting employee benefits, claims procedures, and notice requirements by using our legal database subscriptions… more
- Molina Healthcare (Atlanta, GA)
- …Responsible for accurate and timely auditing of critical information on claims databases. Maintains critical auditing and outcome information. Synchronizes data ... among operational and claims systems and application of business rules as they...review standards and methodology * Leads peer reviews * Research and review new audit tools and techniques and… more
- Highmark Health (Atlanta, GA)
- …intake of operational objectives and information gathering. May perform routine research and evaluate basic output requirements and formats. Communicate business ... 1 - 3 years of experience in a Business Analyst or Business Process Analyst role or...role or experience in a related operational area (eg claims , billing, customer service, etc.) **Preferred** + 0 -… more
- Elevance Health (Atlanta, GA)
- …Coordinates research and responds to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues and ... eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing… more
- Molina Healthcare (Atlanta, GA)
- … research , financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable financial ... **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the...basis using SQL, Excel, and other reporting software. * Research , develop, analyze and recommend cost savings opportunities in… more
- Molina Healthcare (Atlanta, GA)
- … research , financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable financial ... **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the...basis using SQL, Excel, and other reporting software. + Research , develop, analyze and recommend cost savings opportunities in… more
- Molina Healthcare (Atlanta, GA)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... and Identifying targeted Interventions and tracking outcome. Assist with research , development, and completion of special performance improvement projects.… more
- Evolent (Atlanta, GA)
- …fostering trust, expertise and cooperation. + Extract, manage, and analyze claims and operational data using industry-standard metrics. + Process and validate ... raw unadjudicated claims data. **Qualifications Required and Preferred:** + Bachelor's degree, preferably with a quantitative major (eg actuarial, statistics,… more
- Molina Healthcare (Atlanta, GA)
- …emerging technologies. **KNOWLEDGE/SKILLS/ABILITIES** + With limited supervision, the Sr. Analyst , Data is responsible for data compilation, data management, data ... trends + Works with internal, external and enterprise individuals as needed to research , develop, and document new standard reports or processes + Consolidates data… more
- AIG (Atlanta, GA)
- …expertise to assist with pricing the Commercial Property business. The Actuarial Analyst will be responsible for profitability studies, portfolio deep dives, working ... partner with reserving actuaries in assessing the impact of loss trends and claims emergence, and partner with underwriters in assessing the impact of changes in… more
- Molina Healthcare (Atlanta, GA)
- …Procedures, Standard Operating Procedures and other internal guidelines. + Review, research , analyze and evaluate information to assess compliancy between a process ... compliance related. + Coordinate, facilitate and document audit walkthroughs. + Research , collect or generate requested documentation. Provide timely and accurate… more
- CVS Health (Atlanta, GA)
- …information and adheres to company policies regarding confidentiality. -Assist in the research and resolution of claims payment issue **Required Qualifications** ... Summary** **Position Summary** Responsible for initial review and triage of claims tasked for review. -Determines coverage, verifies eligibility, identifies and… more