• Claims Investigator - Experienced

    Command Investigations (Orlando, FL)
    …all assignments. If you have the desire to operate at your highest professional level within an organization that values and rewards excellence, please submit your ... hire. Visit our website and find out why at www.GoCommand.com . The Claims Investigator should demonstrate proficiency in the following areas: + AOE/COE, Auto, or… more
    Command Investigations (09/01/25)
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  • Director, Business Process Ownership…

    USAA (Tampa, FL)
    …our career path planning and continuing education assists employees with their professional goals. For more details on our outstanding benefits, visit our benefits ... page on USAAjobs.com. _Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting._ _USAA is an Equal… more
    USAA (08/22/25)
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  • Medical Economics Manager

    AdventHealth (Maitland, FL)
    … processing, contract management, or medical economics experience Proficiency in understanding professional and facility claims and managed care concepts such as ... sources using knowledge of healthcare managed care contracts and healthcare administrative claims data Reviews existing complex models and implements them on new… more
    AdventHealth (08/19/25)
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  • Encounter Data Management Professional

    Humana (Tallahassee, FL)
    …caring community and help us put health first** The Encounter Data Management Professional ensures data integrity for claims errors. The Encounter Data ... the appropriate courses of action. The Encounter Data Management Professional develops business processes to ensure successful submission and...Qualifications** + 1 - 5 years or more of claims processing experience + Minimum of 1 year experience… more
    Humana (08/22/25)
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  • Analyst, Performance Suite Analytics

    Evolent (Tallahassee, FL)
    …mining, advanced/ statistical analysis, and data manipulation + 1+ years of professional experience in claims -based healthcare analytics with a payer, provider, ... RVUs, bundled payments, etc. is preferred + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing and… more
    Evolent (06/24/25)
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  • Sr Medical Economics Analyst

    AdventHealth (Maitland, FL)
    claims processing, contract management, or medical economics Proficiency in understanding professional and facility claims and managed care concepts such as ... various sources using knowledge of healthcare managed care contracts and administrative claims data. + Employs existing complex models and implements them on new… more
    AdventHealth (08/28/25)
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  • Investigator Senior

    Elevance Health (Tampa, FL)
    …and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying and ... healthcare fraud in order to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding,… more
    Elevance Health (08/28/25)
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  • Investigator Senior

    Elevance Health (Miami, FL)
    …and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying and ... in order to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health insurance policies,… more
    Elevance Health (08/12/25)
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  • SIU Investigator - Part-Time

    Allied Universal (St. Petersburg, FL)
    …Law Associate (FCLA) + Fraud Claim Law Specialist (FCLS) + Certified Protection Professional (CPP) + Associate in Claims (AIC) + Chartered Property Casualty ... Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services....consulting projects, and other assignments as directed + Produce professional and expert reports, memos, and letters that are… more
    Allied Universal (08/22/25)
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  • Director, Performance Suite Analytics

    Evolent (Tallahassee, FL)
    …administration, epidemiology, public health, biology) + At least 5 years of professional experience in claims -based healthcare analytics with a payer, provider, ... or related healthcare consulting entity + Extensive knowledge of healthcare claims ; specifically, differences between institutional vs professional billing and… more
    Evolent (07/09/25)
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