- Elevance Health (Tampa, FL)
- …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development… more
- Syms Strategic Group, LLC (SSG) (Tallahassee, FL)
- Syms Strategic Group (SSG) is seeking a talented Senior Functional Analyst Location: Remote Department: Veterans Affairs Type: Full Time Min. Experience: Experienced ... JIRA tools + Experience in large, Agile software development or data integration projects Professional Certifications None required Years of Professional Experience… more
- CVS Health (Tallahassee, FL)
- …day. **Position Summary** CVS Health is looking for an experienced Business Analyst , QA and Technical SME with focus on balancing high-impact business management ... Qualifications** - Healthcare Insurance and PBM knowledge including Prior Authorizations, Claims , Rebates, Network contracting, Sales, Call Center Ops and Pharmacy… more
- JPMorgan Chase (Tampa, FL)
- …corporate events, ensuring timely settlement of trades and cash, management of claims and overdrafts, client / regulatory reporting and input into the production ... delivery (IBOR). As a Investment Book of Record (IBOR) Analyst in the Investment Middle Office Services (IMOS) team,...positions for front-office functions. IBOR is not simply a data repository supporting the investment function though, it is… more
- Raymond James Financial, Inc. (St. Petersburg, FL)
- …areas, its products, and general functions. + Assists with the monitoring of claims . + Supports colleagues with gathering the data collection and analysis ... Standard Office skills. . Fundamental concepts of insurance policy renewals and claims handling. + Insurance industry and terminology. . Fundamental concepts of… more
- Prestige Employee Administrators (Tampa, FL)
- …focus on running-and growing-their businesses. Bonded by shared goals, we're a data -driven and results-focused company committed to solving any HR issue, big or ... carriers and clients + Collect and maintain plan documentation + Audit plans + Claims assistance + Partner with Accounting to reconcile bill + Benefit system set up… more
- Molina Healthcare (FL)
- …care or payer environment. + In-depth knowledge of medical and hospital claims processing, including CPT/HCPCS, ICD, and modifier usage. + Strong understanding of ... large and complex requirements. + Ability to organize and maintain regulatory data including real-time policy changes. + Self-motivated and ability to take… more
- Highmark Health (Tallahassee, FL)
- …bachelor's degree + 10-15 years experience in support of a Marketing function or Data Analyst role or in a business environment with responsibility for ... sources across Highmark's business units, coupled with a general understanding of data flows from various corporate systems (eg, claims , billing, lab, and… more
- ChenMed (Miami, FL)
- …in this role assists with the strategic alignment and oversight of claims assembly and submission processes. In close collaboration with Billing, Coding, IT, ... with all relevant healthcare regulations and standards. + Manages payer data to determine denial and underpayment trends to accomplish business objectives.… more
- Public Consulting Group (Tallahassee, FL)
- …Third Party Administrator Services + Enhance Health and Public Safety Services + Claims Processing Services and Solutions + Consulting and Advisory Services + Cost ... + Provides leadership, management, and direction to the Quality Assurance Analyst team. + Leads and manages department providing oversight on operations,… more