• Pharmacy Contracting Professional 2

    Humana (Tallahassee, FL)
    …2 ensures contract compliance and performs analysis regarding pharmacy claims . Understands department, segment, and organizational strategy and operating objectives, ... 2 ensures contract compliance and performs analysis regarding pharmacy claims . Understands department, segment, and organizational strategy and operating objectives,… more
    Humana (11/21/25)
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  • Project Delivery Administrator

    MyFlorida (Kissimmee, FL)
    …including: + Health insurance (over 90% employer paid) + $25,000 life insurance policy (100% employer paid) + Dental , vision and supplemental insurances + ... General Engineering (GEC) contracts, management of the Plans and Claims Review contract, Disadvantaged Business Enterprise (DBE) program, Affirmative Action/Equal… more
    MyFlorida (11/21/25)
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  • Senior Decision Support Consultant

    Highmark Health (Tallahassee, FL)
    claims and encounters, clinical data, prescription drug data, membership data, dental and vision claims , provider data, financial data (ie, revenue, premium, ... understanding of data flows from various corporate systems (eg, claims , billing, lab, and Rx), to solve complex issues...and projects may involve all aspects of the health insurance business and care management processes and may be… more
    Highmark Health (11/14/25)
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  • VP Client Services | Carrier, Captive, MGA…

    Sedgwick (Tallahassee, FL)
    …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance VP Client Services | Carrier, Captive, MGA | Remote We are seeking candidates ... Account Executive experience on national accounts and five (5) years claims /supervisory experience. **Skills & Knowledge** + In-depth understanding of workers… more
    Sedgwick (11/13/25)
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  • Manager Patient Safety

    HCA Healthcare (Kissimmee, FL)
    …services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, ... plans (accident, critical illness, hospital indemnity), auto and home insurance , identity theft protection, legal counseling, long-term care coverage, moving… more
    HCA Healthcare (11/10/25)
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  • System Director of Risk Management - RN

    Community Health Systems (Naples, FL)
    …performance. **What We Offer** + Competitive Compensation + Comprehensive Benefits: Medical, Dental , Vision, Life Insurance + Generous PTO & Extended Illness ... inappropriate care. + Serve as the primary liaison with CHS Corporate for insurance and legal program coordination. **Patient Safety & Incident Oversight** + Lead… more
    Community Health Systems (09/27/25)
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  • Inpatient DRG Reviewer

    Zelis (FL)
    …match, flexible paid time off, holidays, parental leaves, life and disability insurance , and health benefits including medical, dental , vision, and prescription ... clinical criteria plan, and policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA… more
    Zelis (09/27/25)
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  • Medical Bill Navigator

    Zelis (St. Petersburg, FL)
    …match, flexible paid time off, holidays, parental leaves, life and disability insurance , and health benefits including medical, dental , vision, and prescription ... financial outcomes. What you will do: + Analyze medical claims submitted by members along with their Explanation of...application with the ability to explain medical billing and insurance concepts in a clear and empathetic manner +… more
    Zelis (09/22/25)
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  • Manager, Risk & Compliance

    LCEC (North Fort Myers, FL)
    …to 5:00pm Our benefits include: + Company-wide annual incentive plan + Medical, vision and dental insurance + 401(k) plan with a generous 6% company match + ... including property, liability, workers' compensation, cyber, and auto coverage. Oversee insurance renewals, claims processing, broker relationships, and cost… more
    LCEC (11/02/25)
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  • Sr. Patient Accounts Representative (H)

    University of Miami (Miami, FL)
    …and in assuring compliance with protocols and regulations. CORE JOB FUNCTIONS + Submits claims to insurance companies and follows up on outstanding claims . ... identifies any errors, and researches coverage policies. + Assists patients with insurance and billing questions. + Sets up budget plans on outstanding accounts,… more
    University of Miami (09/13/25)
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