- 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 ... with Optum WebStrat or PSI applications + Experience reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg performing basic… more
- Sedgwick (Tallahassee, FL)
- …touch. \#NURSE _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
- Cognizant (Tallahassee, FL)
- …firms * Strong background in Healthcare industry, including health plans, claims , and provider operations * Project management and people management experience ... of payer functions and Medicaid plan implementations, including enrollment, billing, claims , care management, member portal, shopper tools, etc. **These will help… more
- Molina Healthcare (St. Petersburg, FL)
- …Experience working in a Medicare environment is highly preferred. + Claims adjudication experience is highly preferred. **Job Qualifications** **Required Education** ... encounter processes, provider and contract configuration, provider information management, claims processing and other related functions. **Preferred Education** Bachelor's… more
- MyFlorida (Miami, FL)
- …- $62,425.00 Annually Posting Closing Date: 12/21/2025 Total Compensation Estimator Tool (https://compcalculator.myflorida.com/) This is a re-advertisement. Prior ... but are not limited to fraud against the Medicaid Program, false claims against the Medicaid program, investigating possible criminal violations of any applicable… more
- UIC Government Services and the Bowhead Family of Companies (Miami, 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. Please… more
- MetLife (Tampa, FL)
- …aspects of people management including interviewing/hiring, promotions, performance and compensation management, training and development * Responsible for working ... drive improvement or increase productivity * Effectively work with cross-functional claims management teams in the planning, enhancement, and implementation of… more
- Sedgwick (Tampa, 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
- Evolent (Tallahassee, FL)
- …+ Lead in-depth analyses of healthcare data - including authorizations, claims , membership, and clinical outcomes to identify cost drivers, utilization patterns, ... Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing and various… more
- CenterWell (Tallahassee, FL)
- …Medical Director, Primary Care relies on medical background and reviews health claims . The Medical Director, Primary Care work assignments involve moderately complex ... factors. The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex… more