- Prime Therapeutics (Tallahassee, FL)
- …analysis to include 5 years of experience in Pharmacy Benefit Management (PBM), claims processing , healthcare, and/or related field** **3 years of experience ... using Tableau, SQL, SAS, Alteryx, Teradata, R, or Python technologies** **Must be eligible to work in the United States without the need for work visa or residency sponsorship** **Additional Qualifications** **Extensive PBM industry knowledge and deep… more
- Centene Corporation (Tallahassee, FL)
- …management and provider data management, credentialing or healthcare operations (ie claims processing , billing, provider relations or contracting) experience, ... preferably in a managed care or insurance environment.Pay Range: $55,100.00 - $99,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off… more
- Syms Strategic Group, LLC (SSG) (Tallahassee, FL)
- …for a Federal Health Agency (VA, DHA, HHS, etc.) Healthcare billing and claims processing application knowledge Formal Education Master's degree in Engineering ... or a related scientific or technical discipline Citizenship Requirement US Citizenship required for this specific opportunity Security Clearance Requirements Must possess or qualify for a Public Trust (MBI) CRITICAL NOTES: + SSG will not make assumptions… more
- Humana (Tallahassee, FL)
- …Humana Pharmacy Solutions ensuring compliance with programmatic requirements, such as claims processing , prior authorization, formulary management and clinical ... programming + Represents Humana at all Pharmacy Medicaid meetings including those with the Michigan Department of Health and Human Services (MDHHS) **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree in Pharmacy or Doctor of… more
- Humana (Tallahassee, FL)
- …2 years of Humana Experience + Knowledge of Humana Medical and Pharmacy Claims Processing Systems + Experience with data query/data programming applications (ie ... SQL, Python) + Knowledge of data visualization tools (ie Power BI, QlikView, Tableau) **Additional Information** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and… 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 Allocation Plans and Time Studies + Cost Settlement and Supplemental Payment Strategies + Healthcare Access and Markets A Test Leader oversees the testing process, developing test strategies and plans, guiding a team of testers, and collaborating with… more
- MyFlorida (Largo, FL)
- …System and to other Accounts Receivable billing software systems. + Perform third party claims processing and collection activities for all payors of the State ... Veterans' Homes. + Perform daily account receivables functions to maintain the billing. + Process monthly billing for all Medicare A&B, Medicaid, Medicaid Managed Care, Third Party Insurers, and any other payer for the State Veterans' Homes. + Review and… more
- Oracle (Tallahassee, FL)
- …of AI agents and multi-agent systems that orchestrate complex RCM workflows ( claims processing , charge capture, revenue integrity, denial management, and ... follow-up). Review and contribute to design docs, system diagrams, and critical code paths as needed. + **AI/ML solution delivery** Oversee end-to-end delivery of scalable AI/ML solutions, including data pipelines, model integration, inference services, and… more
- Highmark Health (Tallahassee, FL)
- …within the healthcare industry. + Understanding of health plan operations, including claims processing , enrollment, billing, and customer service. + Proven track ... record of successfully managing complex projects and delivering results on time and within budget. + Strong understanding of the market and competitive landscape. + Excellent communication, interpersonal, and presentation skills. + Demonstrated ability to… more
- Datavant (Tallahassee, FL)
- …following fields would be beneficial: Data Entry, Medical Records, Health Care, Insurance Claims Processing and Proof Reading/Editing of Documents + Ability to ... stay organized while working quickly. Strong attention to detail is also required. + Passing annual Introductory HIPAA examination. (Testing to be given annually in accordance with employee review.) + Required to take and pass a 90-day ROI Certification course… more