• Health Plan Operations, Payment Integrity Program…

    Molina Healthcare (FL)
    …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... Analysis** + Use a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. + Apply understanding of… more
    Molina Healthcare (08/14/25)
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  • DRG Coding Auditor

    Elevance Health (Tampa, FL)
    …is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and ... you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines...Health Information Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder. +… more
    Elevance Health (08/13/25)
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  • 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)
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  • 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)
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  • Ops Employment Security Rep II - 1 1 1 1 1 1 1

    MyFlorida (Fort Lauderdale, 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 (07/17/25)
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  • Ops Employment Security Rep II - 1 1 1 1

    MyFlorida (Orlando, FL)
    …This is an OPS Employment Security Representative II- Employment Review Specialist position in the Department of Commerce's Reemployment Assistance Programs ... applying laws and policies to determine the eligibility of reemployment assistance claims using the CONNECT system. This includes gathering claimant and employer… more
    MyFlorida (07/09/25)
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  • Underwriter - Energy

    AIG (Miami, FL)
    …are established and maintained for the Energy division. + Work with Claims , Finance, Operational, Accounting, Legal, and Actuarial support teams to support portfolio ... to monitoring of submission flow by distribution channels and analysis of losses/ claims behaviors, among others. + Support in the preparation of presentations to… more
    AIG (08/08/25)
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  • Eligibility Supervisor - SES

    MyFlorida (Tampa, FL)
    …recruiting, billing, or collecting accounts, checking credit, processing insurance policies or claims or providing customer service. + OR an Associate degree or ... experience in the Economic Self-Sufficiency Program as an Economic Self-Sufficiency Specialist I or an Economic Self-Sufficiency Specialist II (Eligibility… more
    MyFlorida (08/26/25)
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  • Admissions Representative Registrar

    HCA Healthcare (Brandon, FL)
    …to join an organization that invests in you as a Medical Business Office Specialist ? At Brandon Surgery Center, you come first. HCA Healthcare has committed up to ... We are looking for a dedicated Medical Business Office Specialist like you to be a part of our...and insurance information to ensure accurate coding, billing and claims submission. What you will do: + You will… more
    HCA Healthcare (08/16/25)
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  • Construction Manager

    MyFlorida (Fort Pierce, FL)
    …Labor and On Job training compliance programs with the Resident Compliance Specialist . Oversees coordination and administration of Local Area Program (LAP) projects ... include contract and specification interpretation, changed conditions, supplemental agreements, claims and/or disputes to ensure compliance with Construction Administration… more
    MyFlorida (09/03/25)
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