- Centene Corporation (Spring Hill, FL)
- …Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations ( claims and encounters). + Assists in delivering provider specific ... metrics and coaches providers on gap closing opportunities. + Assists in identifying specific practice needs where WellCare can provide support. + Partners with physicians/physician staff to find ways to encourage member clinical participation in wellness and… more
- Molina Healthcare (FL)
- …clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains ... unresolved errors issued on daily transactional audits and communicates with Core Operations Functional Business Partners to ensure resolution within 30 days of… more
- Sysco (Pompano Beach, FL)
- …delivery impacts. + Communicate daily with Director of Transportation, Claims Coordinator, and Transportation Supervisors, Transportation Leads, and Transportation ... Operations Associates (TOAs) concerning shipping activities. + Communicate daily...policies (ie attendance, Code of Business Conduct and Ethics, Associate Handbook, etc.). + Accept additional responsibilities or special… more
- Molina Healthcare (Orlando, FL)
- …managed care experience + Experience in one or more of the following: Claims , Provider Services, Provider Network Operations , Hospital or Physician Billing, or ... and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system… more
- Highmark Health (Tallahassee, FL)
- …efficient working relationships with key internal areas, such as Customer Service Operations ( Claims , Dental Benefits, Customer Service, Membership & Billing), ... resolution of issues related to benefit interpretations, customer service inquiries, claims adjudication, benefits issues, membership and billing activity, etc. This… more
- Evolent (Tallahassee, FL)
- …offers candidates the opportunity to positively impact member's care daily. Our clinical operations team possess a can-do spirit, as they will wear multiple hats ... and serves in a supporting role to the Director, Intake and Utilization Management Operations . + This individual will not only lead a production team but will also… more
- L3Harris (Melbourne, FL)
- …L3Harris is seeking an experienced, proactive, and solutions-focused Director & Associate General Counsel - Litigation to manage a broad range of ... in global company environment. This role reports to the Vice President & Associate General Counsel - Litigation. The successful candidate will be responsible for… more
- Humana (Tallahassee, FL)
- …to assignments. The Senior Encounter Data Management professional ensures data integrity for claims errors that result from the data exchange between Humana and its ... to make an impact** **Required Qualifications** **5+ years of medical claims processing/auditing or encounter data management experience** **Demonstrated deep dive… more
- Sarasota County Government (Sarasota, FL)
- …in emergency response activities related to disaster management. Serves as Safety Claims /Risk Unit in the Emergency Operations Center, when activated. + ... Responsible for the management of in-house adjusting staff for property and liability claims and TPA oversight for auto and Workers Compensation programs on behalf… more
- Humana (Tallahassee, FL)
- …They will work closely with IT, the pricing software vendor, CIS BSS, Medicaid operations , claims operations , and other business teams involved in the ... responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and expansion into new… more