- Molina Healthcare (Augusta, 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 (Macon, 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 (Augusta, 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
- Elevance Health (Atlanta, GA)
- …model with PulsePoint sites used for collaboration, community, and connection The **HEDIS Research Analyst ** is responsible for serving as an expert in HEDIS ... procedures. + Develops and analyzes business performance reports (eg for claims data, provider data, utilization data) and provides notations of performance… 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
- AIG (Atlanta, GA)
- …the way we help customers to manage risk. Join us as a Senior Analyst , Business Data Analysis to play your part in that transformation. It's an opportunity ... is at the heart of everything we do, from underwriting risks to processing claims . The Information Technology (IT) team equips our colleagues with the latest tools… more
- Aflac (GA)
- …environment is documented and tracked; provides input on various committees (product, claims review, business process, etc.) * Performs research to collect ... Mkt Conduct Compliance Analyst II The Company: Aflac Columbus The Location:...corrective actions to ensure continued compliance; assists in the research and/or coordination of responses to regulatory inquiries; forwards… 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
- Elevance Health (Atlanta, GA)
- **Business Information Analyst Sr.** **Location:** This position will work a hybrid model (remote and in office 1 - 2 days per week). Candidates must live within 50 ... miles of one of Elevance's Pulse Point locations. **The Business Information Analyst Sr.** is responsible for providing utilization management services, and we're… 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
- Molina Healthcare (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
- BrightSpring Health Services (Valdosta, GA)
- …proper coding and comments for all outstanding balances.* Provide any additional research for accounts designated on the critical accounts list, code and comment ... prior to monthly Critical Account call.* Rebill claims for any outstanding AR that is collectible. Provide detail comment in aging with payment date. Field questions… 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
- Molina Healthcare (GA)
- **Knowledge/Skills/Abilities** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience...functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired + Multiple data systems and… 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 (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
- Kemper (Alpharetta, GA)
- …that delivers on our promises._ **Position Summary:** Kemper Auto is seeking a Senior Market Analyst , to work out of our Kemper office in Alpharetta, GA. A member of ... services, data processing requests, pricing and budget analysis, sales support and claims + Analyze the profitability of program based on written premium, loss… 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
- US Tech Solutions (Atlanta, GA)
- …customer's account receivable and ensure payment recovery on invalid short payments/ claims . Disputes are researched utilizing SAP, Customer and third-party websites ... proper account order hold or releases * Ability to research cash application matters on customer account * Evaluate...on deductions issues unless the issue is resolved * Research Cash Applications done on customers from Bank Statements… more