- 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
- Highmark Health (Atlanta, GA)
- …and claims staff regarding the final adjudication of complex claims . Research and investigate conflicting benefit structures in multi-payor situations. ... is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a liaison between various… 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
- 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
- Humana (Atlanta, GA)
- …and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer Business and System Support team ... it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible for maintenance and support of… more
- Elevance Health (Atlanta, GA)
- **Senior Healthcare Economics Analyst ** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, ... eligible for current or future visa sponsorship._ The **Senior Healthcare Economics Analyst ** (Advanced Analytics Analyst Senior) creates statistical models to… more
- Elevance Health (Columbus, GA)
- D **ocumentation Analyst - Senior** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and ... unless an accommodation is granted as required by law. The **Documentation Analyst Senio** r position supports Georgia's Department of Behavioral Health and… 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
- Highmark Health (Atlanta, GA)
- …gather information. Define, understand, and manage project scope. Perform moderate/complex research to support evaluation of complex output requirements and formats. ... 5 - 7 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** + 3 -… more
- Point32Health (GA)
- …regulatory requirements + Manage the collection of documents and records (medical, claims , administrative) needed to fully research the appeal or complaint ... 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
- 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 (Savannah, 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 (Augusta, 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 (Macon, 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
- Chenega Corporation (Atlanta, GA)
- …, a **Chenega Professional Services'** company, is looking for a **Program** ** Analyst II** to support the Clinical and Environmental Microbiology Branch (CEMB). ... Analytics) and several Applied Environmental Labs (the Healthcare Environment Applied Research Team, Biofilm and Microbial Control team, and our Outbreak Response… 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
- Highmark Health (Atlanta, GA)
- …with a general understanding of data flows from various corporate systems (eg, claims , billing, lab, and Rx), to solve complex issues and problems. A comprehensive ... data including, but not limited to: medical/surgical physician and institutional claims and encounters, clinical data, prescription drug data, membership data,… more
- State of Georgia (Fulton County, GA)
- …Serves as job expert and resource in assigned areas. + Primary point of contact, analyst , and responder for civil litigation and claims against the Department: + ... with DOAS/RMS and AGO for tender of lawsuits, ante-litem notices, and claims . + Serves as the Department's designated employee resource and handles notices… more