- WESCO (Orlando, FL)
- As an Analyst - Risk Management ( Claims ), you will be responsible for the daily management of claims that fall within and outside the insurance program. You ... internal and external teams (brokers/carriers/counsel) and contributes to favorable claim outcomes through data analysis and strategic support. **Responsibilities:**… more
- CVS Health (Tallahassee, FL)
- …with heart, each and every day. **Position Summary** Inspects and provides accurate claim information to support savings optimization for claims . Responds to ... procedures for medical cost management. Coordinates support functions for claim adjudication. **Required Qualifications** Effective communication, telephonic and organization… more
- Acosta Group (Jacksonville, FL)
- …as needed. + Uses systems, reports, and Standard Operating Procedures to work assigned claim steps and gather supporting claims information. + Processes invalid ... + High School Diploma/GED Work Experience + Four years of claims experience preferred + Food brokerage experience and/or client experience in sales… more
- Molina Healthcare (Jacksonville, FL)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... Marketplace is required. + Medical coding experience is highly preferred . **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent combination… more
- Molina Healthcare (Miami, FL)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex claims business problems and issues using data from internal and external sources to provide insight to ... task and workflow analysis. + Interpret customer business needs in the claims space and translate them into application and operational requirements + Communicate… more
- Molina Healthcare (St. Petersburg, FL)
- …background in payment integrity-either at a health plan or vendor-is strongly preferred . **Knowledge/Skills/Abilities** + Review Medicaid COB claims for correct ... **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims … more
- Molina Healthcare (Tampa, FL)
- …Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- AdventHealth (Maitland, FL)
- …: Maitland, FL **The role you will contribute:** The Senior Compliance Analyst applies technical, analytical, and problem-solving skills to identify, quantify, and ... support executive decision-making regarding contract violations. The Senior Compliance Analyst will have expertise in Commercial and Governmental (Medicare,… more
- CVS Health (Tallahassee, FL)
- …Strong basic math, communication, analytical, critical-thinking, and problem-solving skills. ** Preferred Qualifications** + Claims processing experience. + ... with heart, each and every day. **Position Summary** The Dispute Repricing Analyst will be responsible for the accurate analysis and resolution of provider… more
- Highmark Health (Tallahassee, FL)
- …resolution of issues related to benefit interpretations, customer service inquiries, claims adjudication, benefits issues, membership and billing activity, etc. This ... relationships with key internal areas, such as Customer Service Operations ( Claims , Dental Benefits, Customer Service, Membership & Billing), Provider Data… more