• Health Insurance Fraud Analyst II

    MyFlorida (Tallahassee, FL)
    …design and implement algorithms to effectively data-mine within various types of claims data utilizing a variety of software applications; compile research, data ... include, but not be limited to, the following: * Identify suspicious patterns in claims data and other sources by applying your knowledge of heath care coding… more
    MyFlorida (08/20/25)
    - Related Jobs
  • Leave of Absence Coordinator

    Sedgwick (Orlando, FL)
    …you looking for an impactful job that offers the opportunity to develop a professional career? Bring your 1-2 years' experience in an office setting and grow with ... comprehensive benefits package to take care of your mental, physical, financial and professional needs. **PRIMARY PURPOSE OF THE ROLE** : To analyze reported leave… more
    Sedgwick (06/29/25)
    - Related Jobs
  • Diagnosis Related Group Clinical Validation…

    Elevance Health (FL)
    …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
    Elevance Health (08/23/25)
    - Related Jobs
  • Assistant Attorney General-DLA

    MyFlorida (Tallahassee, FL)
    …Annually Qualifications: Admission to the Florida Bar and two years of professional experience in the practice of law, legal research, teaching law or ... Antitrust litigation + Experience in Complex litigation + Experience in False Claims Act litigation + Experience with E-discovery + Undergraduate degree in Economics… more
    MyFlorida (08/20/25)
    - Related Jobs
  • Associate Director, Commercial Data Management

    Otsuka America Pharmaceutical Inc. (Tallahassee, FL)
    …third-party data assets, including Xponent Plantrak, DDD, HCOS, Claims Data, Specialty pharma, omnichannel data, SalesForce/Veeva (Call/Sample/Detail), etc. ... through influence, persuasion and relationships. + Highest personal and professional integrity and strong work ethics. + Results orientation,...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
    Otsuka America Pharmaceutical Inc. (08/13/25)
    - Related Jobs
  • EHS Leader - US

    Sysco (Auburndale, FL)
    …on injury trends, KPIs, and risk assessments. + Support the workers' compensation claims process by completing OSHA determinations, identifying gaps in claims ... other requirements related to general liability, motor vehicle, and property damage claims . + Partner and collaborate with all functional leaders to influence and… more
    Sysco (08/08/25)
    - Related Jobs
  • Ops Employment Security Rep II - 1 1 1 1 1 1

    MyFlorida (Tallahassee, FL)
    …issues and the chargeability of employer accounts for benefit payments on claims . This may be accomplished telephonically, through written correspondence, or through ... of first payments when potential issues are detected on initial or additional claims . This is accomplished through tracking the assigned claim load and utilizing the… more
    MyFlorida (07/23/25)
    - Related Jobs
  • Ops Employment Security Rep II - 1 1 1 1

    MyFlorida (Orlando, FL)
    …applying laws and policies to determine the eligibility of reemployment assistance claims using the CONNECT system. This includes gathering claimant and employer ... information, reviewing documentation, assessing claims , knowledge and application of Florida Reemployment Assistance Program Rules and State/Federal Laws, and… more
    MyFlorida (07/09/25)
    - Related Jobs
  • Care Team Representative

    Sedgwick (Orlando, FL)
    …job requiring no prior experience that offers an opportunity to develop a professional career? + A stable and consistent work environment in an office and/or ... to take care of your mental, physical, financial and professional needs. See what a day in the life...To provide excellent service displaying empathy to callers regarding claims for multiple lines of business, including but not… more
    Sedgwick (06/29/25)
    - Related Jobs
  • Manager, Case Management, MD

    Carnival Cruise Line (Miami, FL)
    …reviewing care plans, coordinating with internal stakeholders, supporting disability claims , and facilitating return-to-work planning. The Manager also escalates ... planning in compliance with regulations and employment obligations. + Support disability claims and benefits review for crew unable to return to duty. +… more
    Carnival Cruise Line (08/29/25)
    - Related Jobs