- Molina Healthcare (Tampa, FL)
- …+ Perform research and analysis of complex healthcare utilization and performance date, claims data , pharmacy data , and lab data ... on relevant findings. + Oversee development, organization, and ongoing maintenance of data representing a wide range of healthcare information. + Develop and direct… more
- AdventHealth (Altamonte Springs, FL)
- …from the payers in Athena/Epic and MSOW Network Management thus releasing held claims and updating the status report for the practices. + Reviews and resolves ... update current provider load, variance projects and specific payer issues. + Analyzes data to provide payer reimbursement trends, payer load times and load accuracy… 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 ... to ensure effective and consistent support and execution The Analyst should possess the following: * Ability to work...across the group's teams. This role will ensure accurate data and shared services for underwriting support, claims… more
- Zelis (St. Petersburg, FL)
- …that shape who you are. Position Overview At Zelis, the Clinical Dispute Analyst role is responsible for the resolution of facility and provider disputes as ... will be responsible for reviewing facility inpatient and outpatient claims for Health Plans and TPA's to ensure adherence...Team on day-to-day activities including troubleshooting and review for data accuracy. + Serve as a subject matter expert… more
- Prime Therapeutics (Tallahassee, FL)
- …2+ years of work experience. + Prior experience as a Business Intelligence Developer/ Analyst or Data Analyst supporting business intelligence, reporting, ... creating and contributing to various facets of information delivery and data analytics projects. Expectations include analyzing, designing, and developing business… more
- Kemper (Doral, FL)
- …of the NICB Basic and/or Analytics Academies are desirable. + Certified Insurance Fraud Analyst (CIFA), Fraud Claims Law Specialist (FCLS) or Fraud Claims ... College Degree or equivalent work experience * Three years of insurance claims experience or related fraud analytics background. **Position Requirements:** + Strong… more
- Kemper (Jacksonville, FL)
- …ensure solutions drive business value. **Qualifications:** * 5+ years in data -centric roles ( analyst , developer, architect, consultant). * Experience functioning ... of data and business architecture, with P&C Insurance and Claims experience preferred. * Excellent communication skills across disciplines and comfortable… more
- Highmark Health (Tallahassee, FL)
- …work closely with the section's Accountant, Accounting Coordinators, Associate Analyst , providing, guidance, feedback, training, motivation, and support. This team ... for non-payment, Completing write-offs as appropriate, Coordinating AR issues affecting claims or inquiry processing with Membership and Billing personnel.Lead or… more
- Evolent (Tallahassee, FL)
- …skills + Microsoft Office experience (Excel, Visio) + Understanding of healthcare data formats (eg, eligibility, claims , configuration, authorizations, clinical ... key member of the Product team, focused on client data integrations. This individual will play a critical role...Degree + 2+ years' experience in healthcare, IT business analyst , and/or product management + Experience working with FHIR… more
- Cognizant (Tallahassee, FL)
- …hands-on experience with Duck Creek Technologies' platforms (Reinsurance, Policy, Billing, Claims , and/or Rating) in transformation programs. . Proven success in ... role. . Familiarity with IT consulting and transformation projects, including data migration and system integration. . Technical Skills: o Proficiency in… more