- Cardinal Health (Tallahassee, FL)
- …laws including, Antitrust; healthcare laws and regulations, (eg, Anti-Kickback, False Claims Act, and HIPAA); and Marketing and Advertising + Demonstrate excellent ... communication skills and ability to provide business clients with clear and precise guidance on business, compliance, and legal risks + Develop and conduct legal training for business clients + Understand complex legal, compliance and business situations and… more
- Molina Healthcare (St. Petersburg, FL)
- …rejections. Address a variety of enrollment questions or concerns received via claims , call tracking, or e-mail. Maintain records in the enrollment database. ... **Knowledge/Skills/Abilities** + Has direct oversight of enrollment, premium billing and reconciliation processes and all related staff + Coaches and mentors direct staff, including goal setting and score card development + Monitors and enforces compliance… more
- Meta (Tallahassee, FL)
- …on prescription wearer and channel needs and mindsets 8. Manage prescription product claims , content, and pricing in B2C and B2B contexts, and for wearers with ... and without insurance **Minimum Qualifications:** Minimum Qualifications: 9. 7+ years of experience in product marketing, product management, management consulting, business strategy in vision correction and/or eye health fields 10. In-depth knowledge of… more
- Mass Markets (FL)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service, ... Digital Experience Provider (DXP), Account Receivables Management (ARM), Application Software Development, Managed Services, and Technology Services, to mid-market, Federal & enterprise partners. MCI now employs 10,000+ talented individuals with 150+ diverse… more
- Three Saints Bay (Panama City, FL)
- …of one of the following disciplines: Military Pay, Military Personnel, Travel Claims , or Navy Transportation. Substitutions for HR background can be from similar ... experience gained in either the private sector or other Federal Agencies. . Ability to obtain and maintain qualifications to access and manage information up to and including the Controlled Unclassified Information (CUI) level. VEVRAA Federal Contractor Three… more
- Suddath (Jacksonville, FL)
- …be available as needed. + Coordinate with the Quality Assurance Manager and Claims Manager in the areas of training, continuous improvement, and corrective action + ... Maintain adequate inventories of material and supplies to avoid service failures due to out of stock items. + Maintain rolling stock, material handling equipment, and moving equipment to eliminate service failures whether from breakdown or unavailability +… more
- Ascension Health (Jacksonville, FL)
- …reimbursement from public/private payers. + Perform error analysis for disputed/denied claims and provides recommendations for process improvements. + Assist with ... third party audits when necessary. + Investigate, evaluate, recommend, and implement fee updates and new fees. + Act as a resource for information on public/private payer assistance and guidelines. + Research reimbursement issues as necessary. + Train and… more
- Molina Healthcare (Orlando, FL)
- …advanced SQL queries to extract, validate, and analyze healthcare data, including claims , pharmacy, and lab datasets. + Build and maintain efficient ETL pipelines ... to support ongoing reporting and analytics workflows. + Utilize Databricks and Snowflake to develop scalable data pipelines and analytical datasets. + Create and maintain Power BI dashboards to deliver insights on utilization, outcomes, and cost drivers across… more
- Cleveland Clinic (Weston, FL)
- …data and efficiently leads meetings. + Identify cases that may be potential claims and provide an early notification to other departments (Law, ERI) once identified. ... + Present cases to Medical Legal, Huddle I and Huddle II in a timely manner. + Participate in Institute/Hospital Committees representing Clinical Risk Management. + Drive continuous improvement activity around clinical risk management priorities and… more
- Kyndryl (Tallahassee, FL)
- …Partner with CCaaS architects to build future-proof architectures with EHR, CRM, and claims system integrations. The compensation range for the position in the US is ... $159,240 to $286,560 based on a full-time schedule. Your actual compensation may vary depending on your geography, job-related skills and experience. For part time roles, the compensation will be adjusted appropriately. The pay or salary range will not be… more