- Sedgwick (Tallahassee, FL)
- …modeling challenges, findings, and outcomes to stakeholders **QUALIFICATIONS** + Insurance claims knowledge preferred + Minimum one year of predictive modeling, data ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Elevance Health (FL)
- …for building advanced analytics platforms, AI/ML-driven decision support tools, claims optimization systems, and clinical insights platforms that enable Elevance ... building, scaling, and maintaining platforms for: + Medical Cost Management ( claims review, payment integrity, utilization management, risk adjustment). + Cost of… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive ... legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,...will not be held liable or responsible for any claims , losses, damages or expenses resulting from job recruiting… more
- Sedgwick (Tampa, FL)
- …the justified services. + Monitors, assists, tracks, and provides approval for all claims that are re-inspected by the carrier. + Maintains contact with the client ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
- …fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive ... legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,...will not be held liable or responsible for any claims , losses, damages or expenses resulting from job recruiting… more
- MyFlorida (Miami, FL)
- …conveyance documents. Responsible for representation in defense of the Department in claims of inverse condemnation, as assigned. The Difference You Will Make: ... documents. Responsible for representation in defense of the Department in claims of inverse condemnation, as assigned. Responsible for thoroughly researching all… more
- Sharecare (Tallahassee, FL)
- …eligibility, benefit education, open enrollment / new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, ... resolution with providers, payers or 3rd parties for: + Claims adjustments + Grievances and appeals submissions + Utilization...experience in healthcare, preferably helping members navigate benefits and claims , OR held one or more of the following… more
- MyFlorida (Fort Myers, FL)
- …service, sales of Lottery products, validation and payment of winning claims , preparation of promotional book inventory, and various administrative tasks. This ... office. + Pay/validation operator and assists players in completing claims for prizes greater than $599.00. + Primary or...or secondary ticket sales redemption. + Validates and processes claims and pays prizes. + Performs daily and weekly… more
- Molina Healthcare (St. Petersburg, FL)
- …including accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data within multiple claims systems ... Ensures that provider information is loaded accurately to ensure proper claims processing, outbound reporting and directory processes. **Required Qualifications** *… more
- Molina Healthcare (FL)
- JOB DESCRIPTION Job Summary Provides entry level support for claims activities including reviewing and resolving member and provider complaints, and communicating ... information system and prepares documentation for further review. * Researches claims issues utilizing systems and other available resources. * Assures timeliness… more