- Molina Healthcare (Atlanta, GA)
- …Operations teams . Interprets, communicates, and presents, clear in-depth analysis of claims research results, root cause analysis, remediation plans and fixes, ... SKILLS & ABILITIES: . 2-5 years of experience in medical claims processing, research , or a related field . Demonstrates familiarity in a variety… more
- Public Consulting Group (Atlanta, GA)
- …Project and Grants Management + Assessments and Feasibility Studies Analyzes claims for accuracy, provides client support, documents inquiries, supervises staff, ... process improvements. **Duties and Responsibilities** + Analyzes and reviews claims for accuracy, completeness and eligibility. + Provides leadership, supervision… more
- Molina Healthcare (Atlanta, GA)
- …processing issues + Interprets, communicates, and presents, clear in-depth analysis of claims research results, root cause analysis, remediation plans and fixes, ... cross functionally across multiple business areas. **KNOWLEDGE/SKILLS/ABILITIES** + Provides research and analytics associated with medical claims processing… more
- Molina Healthcare (Atlanta, GA)
- …+ Must have experience in research , review and audits for adjudication rates of claims + Must be able to work in cross functional teams + Must have experience ... accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes… more
- Sumitomo Pharma (Atlanta, GA)
- …and to clean up historical utilization that is routinely submitted with Medicaid claims . In addition, the analyst will load Medicaid claim information into ... assets, and in-house advanced technology capabilities, we aim to accelerate discovery, research , and development to bring novel therapies to patients sooner. For… more
- Bank of America (Kennesaw, GA)
- Consumer Product Strategy Analyst III - Digital Fraud Strategies Analyst Charlotte, North Carolina;Belfast, Maine; Plano, Texas; Richmond, Virginia; New York, ... for senior management LOB Job Description: As a Client Protection Fraud Strategy Analyst , you will capitalize on your technical abilities and strategic thinking to… more
- Molina Healthcare (Atlanta, GA)
- …ability to work independently, self-navigate organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, ... and existing health plans. + Completes analysis on retroactive claims reports + Pre and post validation of complex...Requires assistance with schema from Tech resource or Lead Analyst . + Writes Requirements for BRDs/FRDs and Reports. +… more
- Elevance Health (Atlanta, GA)
- **Provider Contract/CofC Analyst Sr.** **Location:** This position will work a hybrid model (remote and in-office, 1 - 2 days per week). Candidates must live within ... miles of one of Elevance's Pulse Point locations. The **Provider Contract/Cost of Care Analyst Sr.** is responsible for analytical support to the Cost of Care and/or… more
- Bank of America (Kennesaw, GA)
- Account Takeover and Device Policy Analyst Charlotte, North Carolina;Belfast, Maine; Plano, Texas; Richmond, Virginia; Fort Worth, Texas; New York, New York; Boston, ... fraud risk and create mitigation strategies. As a Client Protection Fraud Policy Analyst , you will capitalize on your Fraud knowledge strategic thinking to solve… 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
- Bank of America (Kennesaw, GA)
- Fraud Analytics and Innovation Senior Analyst Newark, Delaware;Plano, Texas; Richmond, Virginia; Fort Worth, Texas; New York, New York; Boston, Massachusetts; ... in managing competing priorities **Desired Qualifications:** + Fraud and/or Claims background with focus on Account Takeover a plus...+ Data and Trend Analysis + Innovative Thinking + Research **_It is unlawful in Massachusetts to require or… more
- Bank of America (Kennesaw, GA)
- Fraud Analytics and Innovation Senior Analyst Newark, Delaware;Plano, Texas; Richmond, Virginia; Fort Worth, Texas; New York, New York; Boston, Massachusetts; ... degree in a quantitative discipline such as mathematics, statistics, operations research , finance, or business ▪ Advanced analytical and quantitative skills with… more
- Molina Healthcare (Atlanta, GA)
- …other end users for operational and strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** + Performs research and analyses on a variety of topics related to the overall ... audits, compliance, recoveries, coordination with other departments. + Consolidates research and analyses into summarized findings and may develop recommendations… more
- Molina Healthcare (Atlanta, GA)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... of assigned reports, document reporting processes and procedures. + Assist with research , development and completion of special projects as requested by various… more
- Molina Healthcare (Atlanta, GA)
- …+ Actively participates in all stages of project development including research , design, programming, testing and implementation to ensures the released product ... operational processes including but not limited to Enrollment, UM, Claims & Care Management** **Preferred License, Certification, Association** Certified Business… more
- Molina Healthcare (Atlanta, GA)
- …analysis. + Works with internal, external and enterprise clients as needed to research , develop, and document new standard reports or processes. + Implements and ... to support the departments goals. + SQL, Databricks, Python + Claims knowledge/QNXT **JOB QUALIFICATIONS** **Required Education** Associate's Degree or equivalent… more
- Molina Healthcare (Atlanta, GA)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings. **KNOWLEDGE/SKILLS/ABILITIES** + Develop ad-hoc reports using SQL programming, SQL… more
- Lumen (Atlanta, GA)
- …together Product, Sales, Commercial Enablement, Creative and Brand, Corporate Communications, Analyst Relations and the Campaign teams together to plan, build, ... messaging to develop value propositions, differentiators, messaging, proof points, and claims + Develops sales enablement materials to ensure sales understanding at… more
- Baylor Scott & White Health (Atlanta, GA)
- …analytics to support our organization. We seek a stakeholder-facing statistical analyst that will be responsible for the extraction, analysis and interpretation ... of cost saving initiatives. Partnering with their Manager and peers to research and investigate current and new utilization trends with meaningful statistical… more