• Payment Administration & Review Subject…

    Abbott (Orlando, FL)
    …failure, allowing people to restore their health and get on with their lives. The Payment Review & Administration SME is responsible for leading the review and ... This role coordinates with insurance payers and internal departments to resolve payment discrepancies, patient refunds, and prepares documentation for internal,… more
    Abbott (07/22/25)
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  • Payment Innovation Director

    Elevance Health (FL)
    …required by law. The ** Payment Innovation Director** is responsible for Payment Innovation business solution research, design, development, and ... candidates not within a reasonable commuting distance from the posting location(s) will not be considered for ...conceptualizing innovative payment solutions for healthcare providers thru provider… more
    Elevance Health (08/21/25)
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  • Health Plan Operations, Payment Integrity…

    Molina Healthcare (FL)
    …projects and tasks to ensure CMS and State regulatory requirements are met for pre-pay edits, post payment datamining, and overpayment recovery which improves ... **Job Description** **Job Summary** The Health Plan Operations, Payment Integrity Program Manager is an individual contributor...Integrity Program Manager is an individual contributor role designed for a highly capable individual who serves as a… more
    Molina Healthcare (08/14/25)
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  • Provider Payment Appeal Analyst I

    Elevance Health (Miami, FL)
    …on hybrid/virtual/ work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an ... between 8 am - 9 pm EST The **Provider Payment Appeal Analyst I** is responsible for ...for this role at the time of this posting . This range may be modified in the future… more
    Elevance Health (08/27/25)
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  • Clinical Fraud Investigator II - Registered Nurse…

    Elevance Health (Tampa, FL)
    …on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an ... Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to...for this role at the time of this posting . This range may be modified in the future… more
    Elevance Health (08/16/25)
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  • Lead Analyst, Payment Integrity

    Molina Healthcare (Tampa, FL)
    …This role focuses on identifying and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied ... Operational Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met … more
    Molina Healthcare (08/20/25)
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  • Lead Analyst, Configuration Oversight…

    Molina Healthcare (St. Petersburg, FL)
    …seeking a highly experienced Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and ... in Medicaid managed care is required, and a background in payment integrity-either at a health plan or vendor-is strongly preferred. **Knowledge/Skills/Abilities**… more
    Molina Healthcare (07/24/25)
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  • Computer Systems Analyst IV (Working Title:…

    MyFlorida (Tallahassee, FL)
    COMPUTER SYSTEMS ANALYST IV (WORKING TITLE: PROCUREMENT TO PAYMENT CO-LEAD) - 43005043 Date: Aug 28, 2025 The State Personnel System is an E-Verify employer. For ... Services Working Title: COMPUTER SYSTEMS ANALYST IV (WORKING TITLE: PROCUREMENT TO PAYMENT CO-LEAD) - 43005043 Pay Plan: SES Position Number: 43005043 Salary:… more
    MyFlorida (08/29/25)
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  • Payment Controls Lead, Vice President

    Citigroup (Tampa, FL)
    Individuals in Cross Disciplinary Controls are responsible for multiple activities within the Controls capabilities such as assessment & design, MCA, QA, Monitoring ... & Testing, Issue Management and/or Governance Reporting & Analysis for effective end to end oversight, design, implementation, and execution of controls. Individuals… more
    Citigroup (06/20/25)
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  • Director, Reporting & Analytics ( Payment

    Molina Healthcare (Tampa, FL)
    …Summary** Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing and ... deploying reports to provider networks and other end users for operational and strategic analysis. **Knowledge/Skills/Abilities** The Director of Reporting &… more
    Molina Healthcare (08/28/25)
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