- Molina Healthcare (Orlando, FL)
- …updates/changes within claims processing system . + Experience using claims processing system (QNXT). ** PREFERRED EDUCATION:** Bachelor's Degree or ... equivalent combination of education and experience ** PREFERRED EXPERIENCE:** 3+ years Healthcare Claims Adjudication **PHYSICAL DEMANDS:** Working environment is… more
- CHS (Clearwater, FL)
- **Overview** ** Claims Manager** **Servicing** **Health Insurance Policies or Benefits** **Summary:** Premier Administrative Solutions (PAS) is a Third-Party ... organizations, insurance marketing organizations, and employers. One core service, claims administration, is where submissions for payment/reimbursement/sharing from medical… more
- CDM Smith (Orlando, FL)
- …Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial data related ... to disaster-related claims , including property damage, business interruption, and other loss...potential fraud, and ensure the integrity and fairness of claim settlements. By applying advanced accounting, auditing, and investigative… more
- Veterans Affairs, Veterans Health Administration (Cape Coral, FL)
- …background. Preferred experience as Medical Review Officer, Certified medical examiner for commercial motor vehicle drivers, and certification as an independent ... and written English in accordance with 38 USC 7402(d). Preferred Experience: Board certified in Occupational Health / Preventative...medical examiner for disability exams Reference: For more information on… more
- MyFlorida (Tallahassee, FL)
- …* Experience with SQL, SAS Enterprise Guide (EG), R, and Excel. Preferred Qualifications: Industry certifications, eg, Certified Fraud Examiner ; Accredited ... design and implement algorithms to effectively data-mine within various types of claims data utilizing a variety of software applications; compile research, data… more
- Highmark Health (Tallahassee, FL)
- …+ None ** Preferred ** (any of the following) + Certified Fraud Examiner (CFE) + Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) + ... 6 years of related and progressive experience in lieu of Bachelor's degree ** Preferred ** + Master's Degree in Fraud, Forensics Accounting, Business or related field… more