- WTW (Miami, FL)
- …+ Maintain strong professional relationships with key parties to facilitate efficient claims resolution. **Compliance & Quality Assurance ** + Ensure ... We are seeking a highly motivated individual to join our Company as a Claims Analyst based in Miami. The candidate will have multiple claims responsibilities… more
- Prime Therapeutics (Tallahassee, FL)
- …requestors to resolve questions regarding requested software changes, and participate with Quality Assurance and UAT resources to review related test cases ... career? Come build the future of pharmacy with us. **Job Posting Title** IT Analyst **Job Description** The IT Business Systems Analyst is responsible for… more
- MyFlorida (Tallahassee, FL)
- …under this position's managerial authority. + Using information gathered from the quality assurance review to assist supervisors in developing training catalogs ... SENIOR MANAGEMENT ANALYST SUPV - SES - 79010439 Date: Jan...and implementing motivational training to improve the quality and quantity of work performed by staff. +… more
- Humana (Tallahassee, FL)
- …+ Creating and executing comprehensive test plans + Ongoing Medicare Pricer maintenance, quality assurance , and compliance + Determine root causes driving issues ... health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer...closely with IT, the pricing software vendor, CIS BSS, claims operations, and other business teams involved in the… more
- Point32Health (FL)
- …is compliant with the regulatory requirements set-forth by NCQA (National Committee for Quality Assurance ), DOI (Dept of Insurance), CMS, DOL and any state ... leading not-for-profit health and well-being organization dedicated to delivering high- quality , affordable healthcare. Serving nearly 2 million members, Point32Health… more
- Humana (Tallahassee, FL)
- …Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance , and compliance + Determining root causes driving issues ... and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral… more
- Highmark Health (Tallahassee, FL)
- …coding principles are incorporated into policy criteria. + **Policy Publication & Quality Assurance :** Manage the full publication process for assigned policies. ... Conduct peer reviews of other policies as part of the quality assurance process to ensure accuracy, clarity, and consistency. + **Consultative & Expert Role:**… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …rules and regulations affecting Company. + Responsible for participating in quality assurance , compliance and in-service and continuing education activities ... Job Description Job Title: OTC Grievance Analyst Position Summary: Grievance Analysts are empowered to...products in accordance with regulatory requirements, internal policies and claims events + Identify correct resource and reroute inappropriate… more
- Public Consulting Group (Tallahassee, FL)
- …effectiveness. **Duties and Responsibilities** + Provides leadership, management, and direction to the Quality Assurance Analyst team. + Leads and manages ... Third Party Administrator Services + Enhance Health and Public Safety Services + Claims Processing Services and Solutions + Consulting and Advisory Services + Cost… more