- Highmark Health (Tallahassee, FL)
- …achieve successful and measurable outcomes. Will monitor and analyze the delivery of health care services in accordance with claims submitted, and analyzes ... the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code submission, analysis of the… more
- Centene Corporation (Tallahassee, FL)
- …medical provider office, customer service within a healthcare organization, and medical claims . Knowledge of health care, managed care, Medicare or Medicaid.Pay ... one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national… more
- Centene Corporation (Tallahassee, FL)
- …implementation of recommendations to providers that would improve utilization and health care quality. + Reviews claims involving complex, controversial, ... 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a diversified, national organization offering competitive… more
- Molina Healthcare (FL)
- …higher) **Preferred Experience** + 2+ years of experience working in the group health business preferred, particularly within claims processing or operations. + ... enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of claims… more
- NBC Universal (Orlando, FL)
- …all departments - including Guest Experience, Guest Communications, Merchandise, Security, Legal/ Claims , Environmental Health & Safety, Digital & Technology, and ... operational teams to ensure timely processing and compliance. Partners with Environmental Health and Safety on audit readiness and quality assurance. + Provides… more
- NBC Universal (Orlando, FL)
- …limited to Operations, Revenue Operations, third-party vendors, Digital and Technology, Legal/ Claims , Environmental, Health , and Safety. Supports the Managers in ... Technical Services leadership in maintaining all regulatory training tracking, Environmental, Health & Safety training and compliance efforts, and updating standard… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, ... data transformations, automation, and enhancements. Conduct in-depth analysis of healthcare claims to identify data issues and optimization opportunities. Work with… more
- Elevance Health (FL)
- **Senior Health Economist - Managed Care** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, ... not eligible for current or future visa sponsorship._ Carelon Health is a proud member of the Elevance ...Senior) measures financial performance of core Carelon products leveraging claims , authorization, and membership data to tell a detailed… more
- CHS (Clearwater, FL)
- …+ High school graduate or equivalent. + Knowledge of medical terminology, billing, claims and the health insurance industry is strongly preferred but not ... + **Monday - Friday, Day Shift** + **Paid Training, Health , Dental, Vision, and Life Insurance as well as...vary by state.) Full Time employees can enjoy: * Health Coverage: Two flexible medical plans. * Dental &… more
- Cardinal Health (Doral, FL)
- …done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as ... and support from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves by follow-up &… more