- Molina Healthcare (St. Petersburg, FL)
- …and financial outcomes for all PI solutions. + Leads efforts to improve claim payment accuracy, claim referrals, adjustment analysis and financial performance ... a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +...years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health… more
- Molina Healthcare (St. Petersburg, FL)
- …Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of Coordination ... of Benefits (COB) claim pricing and processing. This role will focus on...guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen.… more
- Marriott (Lake Buena Vista, FL)
- …* Works with the unemployment services provider to respond to unemployment claims ; reviews provider reports for accuracy and corrects errors. * Prepares, audits ... and distributes unemployment claim activity reports to property management. * Attends unemployment...* Ensures employee issues are referred to the Department Manager for resolution or escalated to the Director of… more
- Travelers Insurance Company (Tallahassee, FL)
- …key decisions. You will be working with the Pricing, Product, Underwriting, and Claims teams to both learn the business and communicate your findings and ... B&SI reserving team embraces innovative methods, such as advanced claim level models, you'll play a key role in...the Financial Institutions business unit. + Work with the Claims department to ensure best estimates are appropriately reserved… more
- MyFlorida (Tallahassee, FL)
- …and preparation of bank deposits. + Assists with daily and weekly Fortune claim processes including review of problem claims submitted, contacting PAS for ... SALES OPERATIONS MANAGER - 36000700 Date: Aug 26, 2025 The...assistance, assisting customers with completion of claims , voiding DCW checks, mailing prize payment checks to… more
- CDM Smith (Fort Myers, FL)
- …Assist the project team in developing and maintaining a project risk register. Claim management: Early support for claims and disputes on the project. ... Ensure that proper documentation is developed and maintained for claims . **Job Title:** Commercial Manager - Pacific...and maintained for claims . **Job Title:** Commercial Manager - Pacific **Group:** CCI ESS **Employment Type:** Regular… more
- Sedgwick (Tallahassee, FL)
- …Work(R) Fortune Best Workplaces in Financial Services & Insurance Telephonic Case Manager **PRIMARY PURPOSE OF THE ROLE:** While partnering with the injured worker, ... support systems. + Effectively communicates and builds relationships with the claims ' examiner, client, injured worker, attorney and supervisor. + Identifies issues… more
- Adecco US, Inc. (Orlando, FL)
- …currently assisting one of its clients in their search for a Field Reimbursement Manager to work remotely from Florida! **Pay rate** : $51.95 - 60.10 **Shift ... on Apply Now and don't forget to upload your resume!** The Field Reimbursement Manager (FRM) plays a critical role in facilitating patient access to therapy by… more
- Zelis (St. Petersburg, FL)
- …gained, and the personal interests that shape who you are. Position Overview The Manager , DRG Validation of the Expert Claims Review (ECR) department is ... operations and team management of the DRG product. The Manager , DRG Validation will be primarily responsible for the...+ Oversee the DRG validation process including management of claim assignment and queues, adherence to client turnaround time… more
- AdventHealth (Maitland, FL)
- …Location** : Maitland, FL **The role you will contribute:** A Medical Economics Manager is responsible for overseeing the analysis and evaluation of financial and ... proposals, analyze fee schedules, and determine contract compliance. The Medical Economics Manager must have attention to detail and competencies in decision support… more