- Molina Healthcare (St. Petersburg, FL)
- …methodologies. Works closely with IT, the pricing software vendor, operations, health plan representatives, and other business teams involved in claim processing. ... release notes to accurately request and analyze impact reports of affected claims . + Analyzes, interprets, and maintains configurable tables and files that support… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** This role supports Medicaid state reporting initiatives for its managed care operations across ... accurate submission of mandated reports, leveraging their understanding of claims data and Medicaid program requirements to drive accurate...us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and… more
- Travelers Insurance Company (Orlando, FL)
- …professionals in multiple departments to assist with the timely resolution of claims , which may include: Properly documents claim files, including notes and diaries, ... documents for legal and medical reviews. Reports and assigns claims , and transitions closed files to and from off-site...Bachelor's Degree. **What Is in It for You?** + ** Health Insurance** : Employees and their eligible family members… more
- Sunrise Senior Living (Boca Raton, FL)
- …with the department coordinators in the processing of light duty and worker's compensation claims in order to expedite return to full duty, close the claims , ... community is in compliance with national/provincial regulations pertaining to occupational health and safety requirements and promotion of Risk Management programs… more
- University of Miami (Miami, FL)
- …(https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The UHealth-University of Miami Health System IT Department has an opportunity ... + Minimum 3 years of relevant experience + Resolute Professional Billing Claims and Electronic Remittance Administration required + Additional Resolute Hospital… more
- Meta (Tallahassee, FL)
- …and issues on the project, enable commercial accountability, manage schedule health reporting/escalation, and ensure that schedule change management is effective and ... and communicates schedule risks through defined processes, including Risk Registers, health reviews, and New Build Program management meetings 3. Accountable for… more
- ChenMed (Miami, FL)
- …business to enhance the data models and analytics within the Actuarial and Health Economics teams. + Under limited supervision, updates and enhances models for ... improvement, solution assessment, etc. + Analyzes and validates payer claims data. Assists markets to identify factors driving ...physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're… more
- University of Miami (Miami, FL)
- …potentially compensable events to Chief Medical Risk Officer, Director of Medical Claims and Assistant General Counsel. + Conduct additional investigation and assist ... and physicians in sensitive situations involving actual or potential claims . + Analyze and trend data as captured through...and licensure is a plus + Certified Professional in Health Care Risk Management (CPHRM), Certified Professional in Patient… more
- Walgreens (Melbourne, FL)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Walgreens (Miami, FL)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more