- Elevance Health (Tampa, FL)
- …healthcare fraud in order to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding, ... and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying and developing enterprise-wide specific… more
- Elevance Health (Miami, FL)
- …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... research and responds to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues and to audit … more
- ChenMed (Miami, FL)
- …**ESSENTIAL JOB DUTIES/RESPONSIBILITIES:** + Analyzes and interpret enrollment, revenue, and claims (utilization and unit cost) data to identify and solve business ... and execution of actions to improve those results). + Prepares ad-hoc analysis for claims and KPIs of medical costs for executive leadership + Develops a deep… more
- Community Health Systems (Naples, FL)
- …and system performance. **What We Offer** + Competitive Compensation + Comprehensive Benefits : Medical, Dental, Vision, Life Insurance + Generous PTO & Extended ... Safety Officer or collaborate with one to support quality and safety initiatives. ** Claims & Litigation Management** + Oversee legal claims processes, including… more
- MyFlorida (Chattahoochee, FL)
- …include: + This position serves as the Hospital Health Care Risk Manager /Safety Officer and is highly responsible professional, managerial and administrative work to ... property damage, or other preventable loss or negligent acts. The Risk Manager /Safety Officer is responsible for the overall coordination of the incident reporting… more
- Molina Healthcare (Jacksonville, FL)
- …models to support analytical and operational use cases, including healthcare claims and utilization data. * Collaborate with cross-functional teams, including data ... monitor, and troubleshoot Hadoop-based infrastructure using tools such as Cloudera Manager , Ambari, and Zookeeper. * Enforce data quality, security, and compliance… more
- ChenMed (Greenacres, FL)
- …needed to maintain workflow and meet/ complete deadlines as assigned by the Pharmacy Manager or Pharmacist on duty. + Processes claims for 3rd party ... receipt; removing outdated drugs. + Maintains knowledge of asset protection techniques, creates claims for order errors and damaged goods. + Maintains a safe and… more
- Walgreens (Lynn Haven, FL)
- …Supports the efficient workflow of the pharmacy and assists the pharmacy manager in identifying ways to optimize pharmacy financials, inventory management and ... interpersonal. + Participates and assists in community events as requested by Store Manager , Healthcare Supervisor, District Manager or Pharmacy Manager .… more
- Walgreens (Daytona Beach, FL)
- …Supports the efficient workflow of the pharmacy and assists the pharmacy manager in identifying ways to optimize pharmacy financials, inventory management and ... in accordance to regulations, company policies and standards. Assists pharmacy manager with establishing procedures that promotes the efficient workflow of the… more
- Trinity Health (Fort Lauderdale, FL)
- …use Excel and other Microsoft 365 tools.** **Position Highlights and Benefits :** **Comprehensive benefit packages available, including medical, dental, vision, ... work of assigned staff including the monitoring of competencies. Develops with manager goals and objectives, conducts annual performance appraisals with manager … more