- Elevance Health (Atlanta, GA)
- **Title: Grievance/ Appeals Analyst I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... unless an accommodation is granted as required by law._ " The **Grievance/ Appeals Analyst I** is an entry level position in the Enterprise Grievance &… more
- Elevance Health (Atlanta, GA)
- **Grievance/ Appeals Analyst Senior** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... onboarding and skill development. Shift hours: 8:00am - 4:30pm EST** The **Grievance/ Appeals Analyst Senior** is responsible for reviewing, analyzing, and… more
- Highmark Health (Atlanta, GA)
- …of a grievance/appeal; documents, investigates, refers and coordinates grievances and appeals ; initiates a case file for each grievance and appeal; ensures ... all involved parties. + Participate in workgroup meetings to address trends in appeals and grievances and to work on process improvement initiatives with cross… more
- State of Georgia (Fulton County, GA)
- Eligibility and Enrollment Analyst (State Based Exchange) Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/70188/other-jobs-matching/location-only) New ... Sign Up for Job Alerts Under supervision, the Eligibility and Enrollment Analyst is responsible for reviewing and updating program policies and operational… more
- State of Georgia (Fulton County, GA)
- Judicial Security Analyst Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/70206/other-jobs-matching/location-only) New ... Up for Job Alerts Job Summary The Judicial Security Analyst analyzes evidence, crime reports, and databases to assist...security for the Supreme Court of Geogia, Court of Appeals of Georgia, the Georgia State-wide Business Court, and… more
- Evolent (Atlanta, GA)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Analyst , Client Analytics** Integrate and analyze claims and enrollment data from multiple ... Evolent's clinical services (ie, specialty care, utilization management, care management, appeals & grievances) + Using analytical tools to integrate various data… more
- Molina Healthcare (Atlanta, GA)
- …+ Experience working with complex, often highly technical teams + Appeals & Grievance, healthcare services, or claims background **Preferred License, Certification, ... Association** Certified Business Analysis Professional (CBAP), Certification from International Institute of Business Analysis preferred To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job… more
- Intermountain Health (Atlanta, GA)
- …updates to charging/coding/NCCI regulations and/or errors, and regarding audits and appeals , to facilitate corrective action planning for improved processes. 7. ... Complies with all CMS, Federal and State regulations, and payor guidelines, and ensures consistent and compliant application with charge/coding capture, charge editing, and audit and reimbursement practices. Researches and collaborates on regulation updates to… more
- Carter's/OshKosh (Atlanta, GA)
- …Welfare plan administration for US and Canada, including benefits, enrollment, appeals , medical, dental, vision, life insurance, voluntary benefits, HSA/FSA & COBRA ... in partnership with third party administrators - for both the Full-time and Part-time US and Canada populations. - Serve as day-to-day lead for full-time and part-time US and Canada benefits payroll process for assigned benefits, including oversight of… more
- State of Georgia (Fulton County, GA)
- …investigation. SUPERVISION : + Legal services division staff including paralegal and analyst . MINIMUM QUALIFICATIONS : + Three years of directly related experience. ... Hearings, and before an Administrative Law Judge, the Georgia Court of Appeals , and the Georgia Supreme Court. + Experience interacting directly with the… more
- Intermountain Health (Atlanta, GA)
- **Job Description:** The HIM Coding Audit Training Analyst Coordinator provides advanced training to hospital coding staff, compliance, CDI, physicians, and clinical ... providers, clinical staff, compliance and the CDI team. + Audits and creates appeals for all payer and regulatory denials and downgrades and provides in-depth coding… more
- Centene Corporation (Atlanta, GA)
- …a key part in outpatient and psych/neuro psych testing note reviews, appeals , and occasional peer-to-peer consultations, as well as participating in Utilization ... Unrestricted License (PhD or PsyD) Upon Hire required** Board Certified Behavior Analyst (BCBA) BCBA-D Upon Hire preferred: Pay Range: $86,000.00 - $154,700.00 per… more