• Senior Research Advisor, RWD/Clinical…

    The Cigna Group (Atlanta, GA)
    …not limited to the following: + Efficiently query multiple data types (medical and pharmacy claims , EMR, lab, chargemaster) using SQL to identify populations of ... Deep healthcare data (eg, PBM experience, Provider Networks, Billing, Medical and Pharmacy claims ), statistical analysis experience, and an understanding of all… more
    The Cigna Group (02/04/25)
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  • Healthcare Claims Denials Specialist

    CenterWell (Atlanta, GA)
    …agencies, and the timely reimbursement of receivables. + Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate ... Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances. + Clear payment variances,...at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of… more
    CenterWell (01/17/25)
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  • Investigator Senior

    Elevance Health (Atlanta, GA)
    …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying ... **Investigator Senior ** **Supports the Payment Integrity line of business**...to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health… more
    Elevance Health (01/30/25)
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  • Investigator Senior

    Elevance Health (Atlanta, GA)
    …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying ... **Investigator Senior ** **Location:** This position will work a hybrid...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
    Elevance Health (01/28/25)
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  • Business Intelligence Analyst (Business…

    Elevance Health (Atlanta, GA)
    **Business Intelligence Analyst (Business Information Analyst Senior )** **Location:** This position will work a hybrid model (remote and in office 1 - 2 days per ... Indianapolis, IN. The **Business Intelligence Analyst (Business Information Analyst Senior )** is responsible for analyzing, reporting, and developing recommendations… more
    Elevance Health (02/04/25)
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  • Associate Actuary - Primary Care Organization

    CenterWell (Atlanta, GA)
    …+ Experience with Medicare Advantage + Experience with member level claims **Additional Information** **Scheduled Weekly Hours** 40 **Pay Range** The compensation ... many other opportunities. Application Deadline: 03-02-2025 **About us** About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive,… more
    CenterWell (01/29/25)
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  • Cognos Framework Manager - Remote

    Prime Therapeutics (Atlanta, GA)
    …operations systems, particularly those that may be in use in a Pharmacy Benefit Management setting ( Claims Processing, Prior Authorization, Telephony, ... considering the business needs and direction. Experience serving as the senior member on business intelligence or analytics/data warehousing projects with… more
    Prime Therapeutics (01/28/25)
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