- Molina Healthcare (Orlando, FL)
- **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr. Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by translating ... queries to extract, validate, and analyze healthcare data, including claims , pharmacy, and lab datasets. + Build and maintain...and cost drivers across the organization. + Ensure data quality , governance, and documentation standards are met in all… more
- LogixHealth (Dania, FL)
- Location: On-Site in Dania, FL $500 Signing Bonus This Role: As a Reimbursement Analyst at LogixHealth, you will work with the department management teams to provide ... services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting dashboards for clients… more
- The Cigna Group (Sunrise, FL)
- …the office or visit Providers 3 days per week The **Provider Contracting Lead Analyst ** serves as an integral member of the Provider Contracting Team and reports to ... of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales… more
- Evolent (Tallahassee, FL)
- …cost and use trends, and estimate Evolent's ability to reduce costs and improve quality . + Develop models to quantify and articulate value of new and existing ... fostering trust, expertise and cooperation. + Extract, manage, and analyze claims and operational data using industry-standard metrics. + Process and validate… more
- Molina Healthcare (Tampa, FL)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... and credentialing. **KNOWLEDGE/SKILLS/ABILITIES** + Audits loaded provider records for quality and financial accuracy and provides documented feedback. + Assists… more
- MUFG (Tampa, FL)
- …(d) Reporting and Invoicing; (e) Special Projects and UAT testing; (f) Quality Control and Customer Service; (g) US compliance regulation checks/screening/data entry; ... and (h) acceptances/payments, Reimbursement claims . To assist the Section in achieving its planned objectives, the incumbent is assigned to the following Functions:… more
- Highmark Health (Tallahassee, FL)
- …of Healthcare: lower per capita health care costs, improved outcomes from and quality of care received, and optimal member/patient and provider experiences with care ... actionable opportunities for improving health and healthcare outcomes and clinical quality and costs of care, efficiently and effectively managing projects to… more
- Prestige Employee Administrators (Tampa, FL)
- …provided cost-effective employee benefits and HR services, transparent pricing, and personalized, quality service to every client. We go the extra mile to develop ... carriers and clients + Collect and maintain plan documentation + Audit plans + Claims assistance + Partner with Accounting to reconcile bill + Benefit system set up… more
- Acosta Group (Jacksonville, FL)
- …high-severity Workers' Compensation and liability claims . Supervise the Sr. Risk Claims Analyst and ensure alignment with best practices. + Vendor and ... The Director will manage a team including the Sr. Risk Claims Analysts and collaborate closely with internal stakeholders, third-party administrators, brokers,… more
- Molina Healthcare (St. Petersburg, FL)
- …monitors Health Plan Scorable Action Items (SAIs) to ensure performance and quality levels exist in PI Business products and processes. Establishes procedures and ... a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +...At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization… more