- AdventHealth (Maitland, FL)
- …shared savings, bundled payments, pay-for-performance, and capitation Working knowledge of healthcare claims for all provider types Managed Care, Patient ... using knowledge of healthcare managed care contracts and healthcare administrative claims data Reviews existing complex models and implements them on new… more
- Evolent (Tallahassee, FL)
- …analyses into succinct presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based ... RVUs, bundled payments, etc. is preferred + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing… more
- Cognizant (Tallahassee, FL)
- …claim processing is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist, you will be responsible for timely and accurate ... adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support...* Good skills at problem resolution specifically related to healthcare claim adjudication. * Possess ability to work at… more
- Molina Healthcare (Tampa, FL)
- …trends, payment integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Molina Healthcare (FL)
- …trends, payment integrity issues, and process gaps. + Apply understanding of healthcare regulations, managed care claims workflows, and provider reimbursement ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- CVS Health (Tallahassee, FL)
- …. 3+ years of experience handling complex druggist and professional medical malpractice claims with either a healthcare company, insurance carrier, third party ... . 5+ years of experience handling complex druggist and professional medical malpractice claims with either a healthcare company, insurance carrier, third party … more
- Robert Half Accountemps (Orlando, FL)
- …records. Requirements * Proven experience in medical billing, including familiarity with healthcare claims processes. * Strong background in medical collections, ... will play a vital part in managing medical billing, claims , and collections processes for healthcare services. This is a long-term contract position that offers… more
- Evolent (Tallahassee, FL)
- …or related healthcare consulting entity + Extensive knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... public health, biology) + At least 5 years of professional experience in claims -based healthcare analytics with a payer, provider, vendor, managed care,… more
- Evolent (Tallahassee, FL)
- …Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... to our culture. **What You'll Be Doing:** + Lead in-depth analyses of healthcare data - including authorizations, claims , membership, and clinical outcomes to… more
- AdventHealth (Altamonte Springs, FL)
- …close the most critical gaps in lowering the cost of care. The Analyst uses healthcare data ( claims , labs, EHR data) analytics to gain insights into provider ... + analytics interfaces such as Tableau, Business Objects + working with healthcare , insurance or claims data + Six Sigma certified This facility is an equal… more