- Marriott (Lake Buena Vista, FL)
- …school diploma or GED; 3 years experience in the human resources, management operations , or related professional area. OR * 2-year degree from an accredited ... or related major; 1 year experience in the human resources, management operations , or related professional area. **CORE WORK ACTIVITIES** **Managing Recruitment and… more
- AdventHealth (Maitland, FL)
- …and contractual requirements and apply identified requirements to business operations . + Facilitate resolution to contract violations by leveraging knowledge ... understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10, CPT, HCPCS II, DRG and...+ 3 years Healthcare, Managed Care, Hospital or Ancillary claims analysis, Hospital or Ancillary claims payment,… more
- Sedgwick (Tallahassee, FL)
- …you have just started your career, you are a leader in the industry, or a claims management expert looking for a new challenge, this is your chance to showcase your ... and Special Risks and Marine. As we expand our operations , we are seeking individuals who are passionate about...of clients across the globe, handling complex cases and claims + Collaborate with a talented and supportive team… more
- MyFlorida (Tallahassee, FL)
- …gathered from these individuals to apply the law in making initial determinations on claims . The individual in this position must be able to coordinate a workload of ... are maintained in making timely determinations and issuing first payments on claims when appropriate. This requires sound judgment in applying the law while… more
- Chewy (Plantation, FL)
- …the team to effectively manage its complex insurance portfolio, oversee claims , maintain regulatory insurance compliance, and scale risk management processes in ... insurance policy schedule and support accurate renewal data collection for renewal cycles. ** Claims & Reporting** + Collect, review, and report claims from… more
- Actalent (Orlando, FL)
- …Essential Skills + Certified Pharmacy Technician (CPhT). + Experience in pharmacy operations , appeals, managed care, claims processing, and handling denials. + ... Strong data entry and customer service capabilities. + Proficient in computer systems and applications. + Ability to work independently in a remote environment. Additional Skills & Qualifications + National Pharmacy Technician Certification (CPhT) preferred;… 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...of the disaster on the applicant's assets, inventory, and operations . * Expert Testimony and Litigation Support: In cases… more
- Evolent (Tallahassee, FL)
- …into succinct presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based on relevant ... findings. + Extract, manage, and analyze claims and operational data using industry-standard metrics. + Process and validate raw unadjudicated claims data.… more
- MyFlorida (Tampa, FL)
- …conveyance documents. Responsible for representation in defense of the Department in claims of inverse condemnation, as assigned. As well as being responsible for ... providing legal counsel and advice to District staff concerning the day-to-day operations and business of the Department, including the negotiation, drafting, and… more
- Molina Healthcare (St. Petersburg, FL)
- …CMS timelines. 2. Workflow Integration - Embed CTM insights into downstream operations -Stars, appeals & grievances, enrollment, claims -so each team addresses ... you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer partners… more