• Medical Claims Adjudication - remote

    Cognizant (Tallahassee, FL)
    …collaborate with stakeholders and other teams. **Primary Responsibilities** : + Review claim system data and verify against UB or HCFA paper or EDI information. + ... and external SLAs. + Other duties as assigned by management . **Qualifications:** + A minimum of 2 years' claims...CPT, HCPCA, ICD-10 + Experience making payments with UB/institutional ( CMS -1450) and/or professional ( CMS 1500) claims. +… more
    Cognizant (08/01/25)
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  • Principal Technical Architect - IDP,…

    Iron Mountain (Tallahassee, FL)
    …document processing (IDP), content management , and business process management (BPM) including enterprise system integration. This role requires strong ... ** Content Management & Information Governance:** Hands-on experience with Content Management Systems ( CMS ) and Information Governance frameworks,… more
    Iron Mountain (08/01/25)
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  • Clinical Liaison LPN

    HCA Healthcare (Fort Myers, FL)
    …are met. 2. Creates and maintains a positive relationship with the hospital Case Management team. 3. After a referral from the hospital CM, meets with patients to ... acceptance including support of electronic platform referrals. Ensures the patient meets CMS criteria for home health services. 5. Ensures required documentation is… more
    HCA Healthcare (08/01/25)
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  • Risk & Quality Performance Manager (Remote)

    Molina Healthcare (FL)
    …EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** * 2+ years of program and/or project management experience in risk adjustment and/or quality * 2+ years of experience ... and experience **PREFERRED EXPERIENCE:** * Knowledge of, and familiarity with, NCQA, CMS , and State regulatory submission requirements * Experience working in a… more
    Molina Healthcare (07/31/25)
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  • Senior Training Consultant

    Fiserv (Jacksonville, FL)
    …experience with RESTful application programming interfaces (API). + 6+ years of experience with content management systems ( CMS ) or learning management ... programs using your Finxact subject matter expertise. This includes content development, technical documentation, curriculum design, and delivery. By working… more
    Fiserv (07/31/25)
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  • HubSpot Consultant

    Robert Half Technology (Jacksonville, FL)
    …of HubSpot modules, including Marketing Hub, Sales Hub, Service Hub, and CMS Hub. + Integration: Ensure seamless integration of HubSpot with other systems ... Technical Skills: Proficiency in HubSpot modules, API integrations, and data management . + Analytical Skills: Strong analytical and problem-solving skills. +… more
    Robert Half Technology (07/31/25)
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  • Lead Software Engineer, Mobile

    NBC Universal (Orlando, FL)
    …coding, testing, analyzing, and supporting complex codebases along with configuration management of new Flutter applications. The Lead Software Engineer will also ... + Technical Collaboration - Confer with delivery teams, product team, or management to refine business requirements and collaborate on technical designs and resolve… more
    NBC Universal (07/30/25)
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  • Profee Medical Coder Complex Surgical Pediatric

    Banner Health (FL)
    …according to regulatory agencies for state Medicaid plans, Center for Medicare Services ( CMS ), Office of the Inspector General (OIG) and the Health Care Financing ... (RHIT), in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Certification… more
    Banner Health (07/30/25)
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  • Manager Enrollment and Billing

    Healthfirst (FL)
    …with internal teams (eg, sales, customer service, compliance) to ensure seamless management of members. + Monitor ,report, and deliver updates on memberships, data ... Billing activities are managed in compliance with State and CMS guidelines and to ensure member satisfaction + Lead...Working knowledge of how data processes through systems and system integrations work to understand and plan for addressing… more
    Healthfirst (07/30/25)
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  • Director Reimbursement Design & Market Evaluation

    Highmark Health (Tallahassee, FL)
    …Highmark Health Solutions, Health Plan Operations. **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities to include, but are not limited to: involved ... termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control… more
    Highmark Health (07/30/25)
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