- Humana (Tallahassee, FL)
- …closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid ... APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg performing basic… more
- UIC Government Services and the Bowhead Family of Companies (Jacksonville, FL)
- …and other protected characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual ... based on the provisions contained within The Alaska Native Claims Settlement Act. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities. All… more
- Sedgwick (Orlando, FL)
- …at any time. As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job ... postings. Actual compensation is influenced by a wide range of factors...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- Molina Healthcare (Miami, FL)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... not limited to, Configuration, Business Systems, Encounters (inbound and outbound), Claims , Provider Services and Contracting. * Identifies issues, resolves problems… more
- Evolent (Tallahassee, FL)
- …- Payer side, Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1 years of experience in ... assurance and database testing, medical benefits, provider, enrollment, and / or claims data. + Demonstrable experience with Testing, Writing Test cases, Test Plans,… more
- Devereux Advanced Behavioral Health (Orlando, FL)
- …charts, graphs and tables for data analysis. + Ensure accurate billing and claims submission for Medicaid, Managed Care, and other third-party payors + Hiring and ... outstanding receivables and pursue timely collections. + Resolve denied or rejected claims , working closely with payors to ensure proper adjudication + Validate rate… more
- MyFlorida (Bartow, FL)
- …$77,526.08 - $100,327.87 Posting Closing Date: 08/26/2025 Total Compensation Estimator Tool (https://compcalculator.myflorida.com/) STATE OF FLORIDA DEPARTMENT OF ... related activities. Reviews and makes recommendations on construction related claims . Provides technical assistance and related coordination activities to utility… more
- LCEC (North Fort Myers, FL)
- …workers' compensation , cyber, and auto coverage. Oversee insurance renewals, claims processing, broker relationships, and cost analysis + Manage the records ... management skills (Required) + Experience working with insurance markets and claims processes. (Required) + Knowledge of risk assessment methodologies, internal… more
- NextEra Energy (Miami, FL)
- …FPLES team, you will be responsible for assisting customer with filing claims , providing detailed explanations of services or products, listening to customers ... * Receives inbound calls and responds to customer requests, inquiries, claims processing inquires, billing or claim disputes. * Handle situations which… more
- Evolent (Tallahassee, FL)
- …You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, and population ... with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including prior authorization data… more