- Elevance Health (Atlanta, GA)
- …healthcare analytics, and/or financial services highly preferred. + Comprehensive understanding of medical claims data. + Intermediate to Advanced expertise with ... **Advanced Analytics Analyst Senior - Medical Economics** **Location:**...Senior** measures financial performance of core Carelon products leveraging claims , authorization, and membership data to tell a detailed… more
- CVS Health (Atlanta, GA)
- …Excel and Microsoft Word **Preferred Qualifications** -2-4 years experience as a medical assistant, office assistant or claim processor -MedCompass, CEC, or ... Summary** **Position Summary** Responsible for initial review and triage of claims tasked for review. -Determines coverage, verifies eligibility, identifies and… more
- Elevance Health (Atlanta, GA)
- …not eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical ... into effective and accurate reimbursement criteria.** PRIMARY DUTIES: + Review medical record documentation in support of Evaluation and Management, CPT, HCPCS… more
- Elevance Health (Atlanta, GA)
- …formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Business Analyst III** is a member of ... **Business Analyst III** **Location** : This role requires associates...savings. This position plays a critical role in uncovering claims overpayments and guiding clients through implementation of data-driven… more
- Molina Healthcare (Atlanta, GA)
- …provider-submitted claims issues. This role requires a keen understanding of medical claims processing, strong analytical skills, and the ability to ... **Job Description** **Job Summary** Provides entry level analyst support for claims research activities....of relevant education and experience + Basic knowledge of medical billing and basic claims processes. +… more
- Cognizant (Atlanta, GA)
- About the role As a **Quality Analyst with Healthcare - Claims & Membership experience** . You will make an impact by designing and executing end-to-end test ... strategies that ensure the quality and reliability of healthcare claims and membership applications. You will be a valued member of the Quality Engineering team and… more
- Zelis (Atlanta, GA)
- …to all key performance components to achieve goals and results for the Zelis Claims Cost Solutions department. The Client Inquiry Analyst will support the ... shape who you are. Position Overview The Client Inquiry Analyst is responsible for the resolution of inquiries for...subject matter expert (SME) as it pertains to correct coding/ claim adjudication guidelines and the Zelis editing product. The… more
- Elevance Health (Atlanta, GA)
- **Provider Contract Cost of Care Analyst Senior** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and ... is granted as required by law. The **Provider Contract Cost of Care Analyst Senior** is responsible for providing analytical support to the Cost of Care… more
- Baylor Scott & White Health (Atlanta, GA)
- …2 Years of Experience in Healthcare Analytics + 2 years working with ACA and Medical Claims , MMR, MOR, MAO-002, MAO-004 and RAPs/EDS data + Experience with ... + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight...outbound encounter process. + Monitors and oversees the end-to-end claims encounter management workflow. + Identifies and interprets encounter… more
- Eliassen Group (Atlanta, GA)
- **Sr Guidewire Business Analyst ** **Anywhere** **Type:** Contract **Category:** Business Analysis **Industry:** Insurance **Workplace Type:** Remote **Reference ... **Shortcut:** http://careers.eliassen.com/fMinuT + Description + Recommended Jobs **Description:** Business Analyst will support Guidewire integrations,conducting requirements gathering sessions, writing… more
- Evolent (Atlanta, GA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** Senior Analyst , Client Analytics The Client Analytics team provides a unique opportunity to ... of our specialty programs and administrative platform. **Role Overview** The Senior Analyst role on Client Analytics will support both internal teams (EAS,… more
- Evolent (Atlanta, GA)
- …Stay for the culture. **What You'll Be Doing:** Job Description The Analyst , Performance Analytics - **RBM Cardiac** product focus, utilizes and develops analytic ... impact on the organization and patient health. This role supports both Medical Cost Management activities as well as Product Development efforts. **What You'll… 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 ... Economics, Math, or Computer Science **Preferred Experience** Preferred experience in Medical Economics and Strong Knowledge of Performance Indicators: + Proactively… more
- CVS Health (Atlanta, GA)
- …R, Alteryx, Trifacta, Linux OS, GCP/ AWS/ Azure * Experience working with medical and/or pharmacy claims data * Experience in healthcare industry, including ... our PBM Finance Enablement group as a Senior Reporting Analyst within our PBM Customer Reporting team. CVS Health...a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and… more
- Vontier (Atlanta, GA)
- …preferred locations for this opportunity. **Job Overview** The Quality Data Analyst Intern will support the Gilbarco Veeder-Root Quality organization by conducting ... analysis efforts by providing data-driven insights into failure trends and warranty claims . * Assist in documenting quality data processes, ensuring consistency, and… more
- CVS Health (Atlanta, GA)
- …heart, each and every day. **Position Summary** As a Healthcare Encounter Senior Analyst for claim reconciliation in the State Medicaid Encounters department, ... to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and… more
- Waystar (Atlanta, GA)
- …**(highly valued, but not required):** + Previous experience with ANSI X12 EDI transactions and/or medical billing claim forms (CMS 1500 or UB-04) + Prior use of ... As part of our award-winning Client Success Department, the Technical Support Analyst is responsible for providing superior support to our clients with the… more
- PNC (Atlanta, GA)
- …have an opportunity to contribute to the company's success. As a Loan Support Analyst within PNC's Midland organization, you will be based within the PNC Midland ... and also supports remote and hybrid work environments. As a Loan Support Analyst in PNC Midland's Insurance department you will be responsible for determining… more
- Elevance Health (Atlanta, GA)
- **Actuarial Analyst II** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing ... unless an accommodation is granted as required by law. The **Actuarial Analyst II** completes projects and performs complex actuarial studies. **How You Will… more
- Molina Healthcare (Atlanta, GA)
- **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities ... skills in data analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue, and vendor data.… more