- 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
- Navy Federal Credit Union (Pensacola, FL)
- …Union is seeking a highly analytical and detail-oriented Senior Technical Analyst to support the management of enterprise-wide commercial insurance programs and ... in evaluating insurable exposures, optimizing insurance program structures, and leveraging data to inform risk financing strategies. The ideal candidate will bring… more
- Evolent (Tallahassee, FL)
- …data using industry-standard metrics. + Process and validate raw unadjudicated claims data . **Qualifications Required and Preferred:** + Bachelor's degree, ... presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make...of complex healthcare claims , eligibility, and pharmacy data to make recommendations based on relevant findings. +… more
- Highmark Health (Tallahassee, FL)
- …business unit needs. May troubleshoot errors, conduct impact analyses, and/or solve data rejection. Performs business analyses in one or more operational areas. ... 3 - 5 years of experience in a Business Analyst or Business Process Analyst role or...role or experience in a related operational area (eg claims , billing, customer service, etc.) **Preferred** + 1 -… more
- Molina Healthcare (Orlando, FL)
- …solutions. + Write advanced SQL queries to extract, validate, and analyze healthcare data , including claims , pharmacy, and lab datasets. + Build and maintain ... **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr. Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by translating… more
- Bank of America (Miami, FL)
- Treasury - Senior Quality Analyst (Bilingual - English / Spanish (Portuguese a plus) Miami, Florida **To proceed with your application, you must be at least 18 years ... be at least 18 years of age.** Acknowledge (https://ghr.wd1.myworkdayjobs.com/Lateral-US/job/Miami/Treasury Senior-Quality- Analyst --Bilingual English Spanish--Portuguese-a-plus-\_25030676-2) **Job Description:** At Bank of America,… more
- University of Miami (Miami, FL)
- …and tests the revised treatment matrix to identify possible cancers from claims data . CORE JOB FUNCTIONS Analyzes regulatory requirements, identifies potential ... has an exciting opportunity for a Full Time Regulatory Analyst 1 to work remotely. CORE JOB SUMMARY The...1 to work remotely. CORE JOB SUMMARY The Regulatory Analyst 1 - UHealth conducts on-site audits and reviews… more
- CVS Health (Tallahassee, FL)
- …with heart, each and every day. **Position Summary** The Dispute Repricing Analyst will be responsible for the accurate analysis and resolution of provider ... and responding to provider participation and pricing inquiries. + Analyze post-paid healthcare claims as it relates to pricing needs. + Apply in-depth research to… more
- Mass Markets (FL)
- …partner in the industry. We are looking for a proactive and detail-oriented Real-Time Analyst to join our workforce management team. This role is crucial in ensuring ... monitoring real-time call volumes, managing agent availability, analyzing performance data , and making real-time scheduling adjustments. This position requires… more
- Molina Healthcare (Tampa, FL)
- …all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims ... systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and… more