- CVS Health (Tallahassee, FL)
- …but not limited to termination requests, tax id changes, hold requests, claim reimbursement, system , directory accuracy and various contractual issues. ... all parties. Presentation of DHMO and PPO plan design, compensation process, claim / encounter submission, and referral policies during new office orientations and… more
- Molina Healthcare (Tampa, FL)
- …for vendor invoices and tracks ongoing invoice activity + Facilitates onshore/offshore vendor system access for technology platforms and HR systems + Submits ... **Job Description** **Job Summary** Supports ongoing Claims and Enrollment operations in the management of smaller scale, less complex vendor activities. Provides… more
- Molina Healthcare (FL)
- …developing requirements for major projects of considerable complexity, prepares system design specifications, conducts research to resolve customer initiated issues ... related to core systems processing, and coordinates and manages project teams in...and manages project teams in the development of large multi- system , multi-platform projects. This position is responsible for implementing… more
- MUFG (Tampa, FL)
- …/Money Market inquiries as well as cases requiring compensation payments and/or claims in accordance with established regulations. Ensuring all cases are verified in ... cases, including recommendations and follow-up. Responsible for cases studies and upgrades system testing, enhancements, and various projects relating to system .… more
- Robert Half Finance & Accounting (Opa Locka, FL)
- …and service technicians with parts compatibility and availability . Support warranty claims and product issues . Maintain and update product/parts information in ERP ... system . Process payments for non-warranty items or non-term...equipment or similar mechanical industries . Familiarity with ERP/accounting systems such as Sage, SAP, QuickBooks, Peachtree, etc. .… more
- Centene Corporation (Tallahassee, FL)
- …support for business operations in all or some of the following areas: claims , provider data, member data, clinical data, HEDIS, pharmacy, external reporting + ... Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources + Review data to determine operational impacts and needed… more
- Highmark Health (Tallahassee, FL)
- …progressive scope and complexity + 2 years of Coding languages, analytical software, systems , tools and processes using claims , clinical, enrollment and provider ... data + 1 year of Project leadership in a complex, matrixed environment (payer and/or provider preferred) + 1 year of Providing analytical consultation to clinical, administrative, operational and financial stakeholders **Preferred** + None **SKILLS** +… more
- Centene Corporation (Tallahassee, FL)
- …analysis, identification of implementation barriers and user acceptance testing of new systems + Identify and analyze user requirements, procedures, and problems to ... trends, or regulatory reporting with external agencies preferred; Familiarity with claims data, utilization, rate setting, risk adjustment, or member eligibility and… more
- NextEra Energy (North Palm Beach, FL)
- …subsidiary and provides coverage to both affiliated and non-affiliated risks. As the Operations Analyst for Claims & Finance, you will be assisting the Claims ... Loss), following up with TPAs (Third Party Administrators), manage claims BDXs (Bordereau), processing invoices, generate loss runs &...day/week * Reviews incoming BDXs for accuracy into the system * Utilizes ingestion system to import… more
- Molina Healthcare (FL)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... coordination, and ownership of high-value deliverables-distinct from a pure data analyst role. **Job Duties** **Business Leadership & Operational Ownership** +… more