- 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 ... regulations across all jurisdictions where Wesco operates. + Maintain accurate and up-to-date claim records in the risk management information system (RMIS). +… 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)
- …+ Searches for and links invoices, contracts, and Proof of Performance to claims as needed. + Uses systems , reports, and Standard Operating Procedures ... to work assigned claim steps and gather supporting claims information. + Processes invalid claims in accordance with set policies and guidelines. + Corrects… more
- Molina Healthcare (Jacksonville, FL)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations,… more
- Molina Healthcare (St. Petersburg, FL)
- …and regulatory guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience ... **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims … more
- Highmark Health (Tallahassee, FL)
- …BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, proactively ... identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their impact on operational processes, and implement… 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
- Chewy (Plantation, FL)
- **Our Opportunity:** Chewy's Corporate Risk & Insurance team is seeking a **Risk Analyst - Corporate Risk & Insurance** to support its growing portfolio of insurance ... the team to effectively manage its complex insurance portfolio, oversee claims , maintain regulatory insurance compliance, and scale risk management processes in… more
- Strategic Systems Programs Office (Cape Canaveral, FL)
- …respond to this flyer. Responsibilities You will serve as a FINANCIAL MANAGEMENT ANALYST in the Comptroller Branch (SPP13), within the Support Services and Planning ... of NAVAL ORDNANCE TEST UNIT FIELD ACTIVITY OF STRATEGIC SYSTEMS PROGRAMS. You will be responsible for providing valuable...individuals under this specific hiring authority. However, if you claim veteran's preference, you will be required to submit… more
- AdventHealth (Maitland, FL)
- …relates to reimbursement methodologies + Applies significant understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10, ... : Maitland, FL **The role you will contribute:** The Senior Compliance Analyst applies technical, analytical, and problem-solving skills to identify, quantify, and… more
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