- MyFlorida (Orlando, FL)
- …with DCF salary policy Posting Closing Date: 09/02/2025 Total Compensation Estimator Tool (https://compcalculator.myflorida.com/) This is an Internal Agency ... that is responsible for investigation, calculation and recovery of overpayment claims for public assistance programs (Temporary Cash Assistance, Food Assistance,… more
- Prime Therapeutics (Tallahassee, FL)
- …Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of ... data + Develop financial pricing models to monitor performance against pharmacy claims data and identify financial pricing opportunities to drive savings and/or meet… more
- MyFlorida (Tampa, FL)
- …Salary: $17.00 per hour Posting Closing Date: 09/03/2025 Total Compensation Estimator Tool (https://compcalculator.myflorida.com/) OPS - SENIOR CLERK FLORIDA ... service, sales of Lottery products, validation and payment of winning claims , preparation of promotional book inventory, and various administrative tasks. This… more
- AdventHealth (Altamonte Springs, FL)
- …Physician Advisor is responsible for providing clinical review of utilization, claims management, and quality assurance related to inpatient care, outpatient ... denial management by reviewing and making recommendations on appealed provider claims and makes determinations for appeals and grievances from patients; assists… more
- Prime Therapeutics (Tallahassee, FL)
- …Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of ... data + Develop financial pricing models to monitor performance against pharmacy claims data and identify financial pricing opportunities to drive savings and/or meet… more
- Prime Therapeutics (Tallahassee, FL)
- …assurance of Service Level Agreement performance, assurance of accuracy of claims payment and administrative policies, rate maximization through ongoing benefit ... + Provides clinical operations input and support of client specific claims processing programs, coordinates implementations of clinical projects and programs and… more
- ChenMed (Miami, FL)
- …**ESSENTIAL JOB DUTIES/RESPONSIBILITIES:** + Analyzes and interpret enrollment, revenue, and claims (utilization and unit cost) data to identify and solve business ... and execution of actions to improve those results). + Prepares ad-hoc analysis for claims and KPIs of medical costs for executive leadership + Develops a deep… more
- Prime Therapeutics (Tallahassee, FL)
- …Education Level Bachelors + Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the United States without the ... or residency sponsorship. **Additional Qualifications** + 3+ years' fraud investigations/ claims experience. + Ability to manage workload while simultaneously working… more
- Mass Markets (FL)
- …site and project. This is an entry-level position with competitive compensation commensurate with experience. While prior contact center experience isn't required, ... to complete account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts, policies, and procedures… more
- Elevance Health (Tampa, FL)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new...in good faith believes is the range of possible compensation for this role at the time of this… more