financial claims examiner ii Jobs in atlanta, ga

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Senior Analyst, Risk & Quality Reporting (Remote)

Molina Healthcare

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Remote or San Antonio, Texas, USA

Full-time

Job Description Job Summary The Sr Analyst, Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of the initiatives. Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists with research, development, and completion of special performance improvement projects including root cause
Posted 1 hour ago

AI Innovation Lead - Data Science Lab

Guardian Life Insurance Company

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Remote or New York, New York, USA

Full-time

Lead AI Innovation Lead - Data Science Lab Overview Guardian is on a transformation journey to evolve into a modern, forward-thinking insurance company committed to enhancing the wellbeing of its customers and their families. As part of the Data & AI team, this role presents a distinctive opportunity to collaborate with the CDAO and the Head of Data Science, actively contributing to Guardian's ongoing evolution. Guardian's Data & AI team spearheads a culture of data insights across Guardian,
Posted 46 days ago | Updated 9 hours ago

Remote Project Manager

Apex Systems

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Remote or Milwaukee, Wisconsin, USA

Full-time

Job#: 2083184 Job Description: Our great client has an immediate opening for a Remote Project Manager. If you are interested please apply with resume to . Looking for 4+ years experience as a project manager interacting with SW Engineering teams. -Insurance industry or call center/claims experience would be nice to have Plans, coordinates and actively manages the technical delivery plans of technical solutions across a portfolio of teams supporting technical and data platforms. Manages the end-
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Posted 10 hours ago

Senior Analyst, Medical Economics - REMOTE

Molina Healthcare

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Remote or Columbus, Georgia, USA

Full-time

JOB DESCRIPTION Job Summary The Senior Analyst, Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key business issues related to cost, utilization and revenue for multiple Molina Healthcare products. Designs and develops reports to monitor health plan performance and identify the root causes of medical cost trends. With those root causes identified, drives innovation by creating tools to monitor trend drivers and provide recommendations to
Posted moments ago

Guidewire UAT Test Lead

Eliassen Group

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Anywhere, US

Contract

Description: Job Summary: We are seeking an experienced UAT Test Lead with expertise in Guidewire insurance platform to join our team. The successful candidate will be responsible for leading User Acceptance Testing (UAT) activities for our Guidewire-based insurance systems, ensuring that all system changes meet business requirements and are thoroughly tested. This is a key role that requires strong technical, analytical, and leadership skills to ensure the successful delivery of business-crit
Posted 26 days ago | Updated 9 hours ago

Manager, Software Application Development - myPBM

CVS Health

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Remote or Richardson, Texas, USA

Full-time

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all w
Posted 49 days ago | Updated 9 hours ago

Systems Analyst III - EPIC Billing

Cleveland Clinic

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Remote or Cleveland, Ohio, USA

Full-time

At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day. We all have the power to help, heal and change lives - beginning with our own. That's the power of the Cleveland Clinic Health System team, and The Power of Every One. Job Title Systems Analyst - EPIC Billing Location Cleveland Facility Remote Location Department Job
Posted 60+ days ago | Updated 9 hours ago

Staff Software Development Engineer

CVS Health

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Remote or Buffalo Grove, Illinois, USA

Full-time

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all w
Posted 9 days ago | Updated 9 hours ago

Staff Full Stack Java Developer - myPBM

CVS Health

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Remote or Buffalo Grove, Illinois, USA

Full-time

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all w
Posted 15 days ago | Updated 9 hours ago

PBM Data Engineer

CVS Health

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Remote or Scottsdale, Arizona, USA

Full-time

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all w
Posted 60+ days ago | Updated 9 hours ago

Senior Analyst, Risk & Quality Reporting (Remote)

Molina Healthcare

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Remote or Columbus, Georgia, USA

Full-time

Job Description Job Summary The Sr Analyst, Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops custom health plan reports to support local interventions, provider outreach, and tracks outcomes of the initiatives. Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists with research, development, and completion of special performance improvement projects including root cause
Posted 1 hour ago

Jr. Data Scientist, Machine Learning - Remote

ConsultNet, LLC

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Remote

Full-time

Title: Jr. Data Scientist, AI and Machine Learning Location : 100% Remote Target Start Date : ASAP Type: contract or contract to hire Pay Rate: DOE We're looking for an industry-leading Data Scientist focused on building production-level machine learning solutions. Rather than a research role, this position emphasizes applying ML/AI to real-world healthcare challenges-such as reducing costs and improving care quality. You'll work with structured and unstructured data (claims, membership, provi
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Posted 38 days ago | Updated 9 hours ago

Senior Automation Engineer

CVS Health

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Remote or Northbrook, Illinois, USA

Full-time

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all w
Posted 56 days ago | Updated 9 hours ago

Ivanti ITAM Data Architect

Skywalk Global

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Remote

Contract, Third Party

The Office of Information Services (OIS) is a shared service provider for the Oregon Health Authority (OHA) and Oregon Department of Human Services (ODHS). OIS provides the technology systems and services that support more than 18,000 OHA and ODHS agency staff at local offices and facilities around the state. These systems and services help the two agencies determine client service program eligibility; provide medical, housing, food, and job assistance; provide addiction, mental health, vocation
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Posted 16 hours ago

Ivanti ITSM/ITAM Admin

Innosoul inc

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Remote

Contract, Third Party

Job ID: OR-11127-25 Remote Ivanti ITSM/ITAM Admin (ITIL must) with Neurons, ITAM/CA SDM/APM migration, CMDB, asset tracking, configuration item/CI, SQL Server/MySQL/PostgreSQL/MS Access, ETL experience Location: Salem, OR (DHS/OHA) Duration: 6 Months Position: 1 This position is approved for remote or hybrid work. Remote onboarding will be required for the first day. Reference must Skills: Skills Database Data Analysis Advanced (7-9 Years) Yes Skills Database Data Modeling Advanced (7-9 Years)
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Posted 15 hours ago

Lead Data Scientist - AI

CVS Health

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Remote or Wellesley, Massachusetts, USA

Full-time

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all w
Posted 60+ days ago | Updated 9 hours ago

Data Management Operations Specialist

Guardian Life Insurance Company

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Remote or Bethlehem, Pennsylvania, USA

Full-time

Job Overview: We are seeking a highly skilled and proactive Data Management Operations Specialist to join our Data Management team in the insurance industry. This individual will play a critical role in supporting the Data Management Strategy and Operations Leader by overseeing the daily operations of our data management processes, ensuring the accuracy, accessibility, and compliance of data, and implementing strategic initiatives aimed at optimizing data governance and quality. This is a uniqu
Posted 60+ days ago | Updated 9 hours ago

Corporate Recruitment Specialist Executive and Non-IT recruitment

Pyramid Consulting, Inc.

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Atlanta, Georgia, USA

Contract

Immediate need for a talented Corporate Recruitment Specialist Executive and Non-IT recruitment. This is a 06+ months contract opportunity with long-term potential and is located in NYC, NY/Atlanta, GA /Charlotte, NC(Hybrid). Please review the job description below and contact me ASAP if you are interested. Job ID: 25-78374 Pay Range: $55 - $60/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on wor
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Posted 6 days ago | Updated 5 days ago

Business Systems Analyst (Provider, Hospitals, Revenue Cycle, Claims)

Saama Technologies, LLC

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Remote

Contract, Third Party

We are seeking a Sr. Business Systems Analyst (BSA) to support the Revenue Cycle and Claims domain for a hospital (Provider) ecosystem. The ideal candidate will play a pivotal role in analyzing data flows, understanding business processes, and delivering technology solutions that enhance operational efficiency across Registration, Scheduling, Billing, and Accounting. Key Responsibilities: Collaborate with stakeholders to gather, define, and document both current and future business and data need
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Posted 13 days ago

Senior Data Analyst - Remote (EST / CST time zone)

Connect Tech+Talent

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Remote

Full-time

Senior Data Analyst Remote - (EST / CST time zone) Full Time We are seeking an experienced Senior Data Analyst to join our client s Enterprise Data team. The ideal candidate will have 8+ years of hands-on experience, with a deep understanding of the P&C insurance domain, strong data modelling capabilities, and advanced skills in Snowflake. Experience working with Agency Management Systems such as EPIC and AMS360 is a significant advantage. Responsibilities: Develop and maintain robust data mo
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Posted 11 days ago | Updated moments ago