- Molina Healthcare (Orlando, FL)
- …equivalent combination of education and experience **PREFERRED EXPERIENCE:** 3+ years Healthcare Claims Adjudication **PHYSICAL DEMANDS:** Working environment is ... clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains… more
- NTT DATA North America (Orlando, FL)
- …using applicable methodology/ fee schedule **Requirements:** + 1-3 year(s) hands-on experience in Healthcare Claims Processing + 2+ year(s) using a computer with ... NTT DATA is seeking to hire a **Remote Claims Processing Associate** to work for our end...Work independently to research, review and act on the claims + Prioritize work and adjudicate claims … more
- Humana (Tallahassee, FL)
- …This is your opportunity to lead cross-functional initiatives, apply your expertise in healthcare claims , and shape the future of operational excellence in a ... healthcare industry + 2+ years of demonstrated expertise in end-to-end healthcare claims operations, including claim ingestion, processing, system navigation,… more
- Cognizant (Tallahassee, FL)
- …for payments, utilization review/quality assurance procedures. + Excellent problem-solving skill in healthcare claims adjudication. + Ability to work at a ... and able to multi-task successfully? If so, please apply today! The Claims Processor, you will ensure accurate and timely adjudication of professional and… more
- Molina Healthcare (St. Petersburg, FL)
- …advanced skills in data analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue, and ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst, Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities… more
- Molina Healthcare (St. Petersburg, FL)
- …Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst, Healthcare Analytics role will be responsible for work...Adjustment submissions data to evaluate healthcare intervention program performance. Develops and presents Risk Adjustment… more
- Evolent (Tallahassee, FL)
- …**What You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... working seamlessly with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including… more
- Molina Healthcare (Tampa, FL)
- …solutions. * Write advanced SQL queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. * ... **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Healthcare plays a critical role in supporting clinical and operational initiatives by… more
- Molina Healthcare (Orlando, FL)
- …technical solutions. + Write advanced SQL queries to extract, validate, and analyze healthcare data, including claims , pharmacy, and lab datasets. + Build and ... **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr. Analyst, Healthcare plays a critical role in supporting clinical and operational initiatives by translating … more
- Molina Healthcare (Jacksonville, FL)
- …optimize data models to support analytical and operational use cases, including healthcare claims and utilization data. * Collaborate with cross-functional ... and outcomes Research) * Prior experience working in the healthcare industry with familiarity in clinical, claims ,...the healthcare industry with familiarity in clinical, claims , or care management data. * Experience with cloud… more