- Healthfirst (FL)
- …within any area of operations (Member Services, Enrollment & Billing, Claims , Provider Services, etc.). + Experience with database reporting and automation, ... work experience. **Preferred Qualifications:** + Experience working within a Healthcare industry (such as commercial insurance plans, hospital, managed long-term… more
- Prime Therapeutics (Tallahassee, FL)
- …analysis to include 3 years of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare , and/or related field + Previous experience using ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- Prime Therapeutics (Tallahassee, FL)
- …analysis to include 3 years of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare , and/or related field. + Previous experience using ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- AdventHealth (Maitland, FL)
- …timely. **The expertise and experiences you'll need to succeed:** + 3 years Healthcare , Managed Care, Hospital or Ancillary claims analysis, Hospital or ... or related field with bachelors degree + 5 years Healthcare , Managed Care, Hospital or Ancillary claims analysis, Hospital or Ancillary claims payment or… more
- VetsEZ (FL)
- …a related field. + 7+ years of experience with Pega PRPC v7.x+ (including Smart Claims & Healthcare Foundation). + 3+ years of Java development experience. + ... Certified Senior System Architect (CSSA) certification required; Lead System Architect (LSA) preferred. + Strong knowledge of Pega architecture and PRPC implementation, including Direct Capture of Objectives (DCO), enterprise class structure, Ruleset design,… more
- Humana (Tallahassee, FL)
- …operations, technology, communications, and processes + Solid understanding of healthcare operations, particularly around claims processing, enrollment, provider ... make an impact** **Required Qualifications** + Bachelor's degree in healthcare administration, public health, information systems, business, policy administration or… more
- Molina Healthcare (FL)
- …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more
- BrightSpring Health Services (Fort Lauderdale, FL)
- …all regulatory requirements + Provide exceptional customer service to patients and healthcare providers + Process insurance claims and handle medication ... + Collects information needed to fill prescriptions from customers or healthcare professionals + Measures, mixes, and labels medications under the supervision… more
- Molina Healthcare (St. Petersburg, FL)
- …Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of Coordination ... and regulatory guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in… more
- LogixHealth (Dania Beach, FL)
- …Required: + Minimum 1-2 years of A/R follow-up experience in professional healthcare billing + Familiarity with payer regulations, claims appeals processes, ... coders to provide cutting edge solutions that will directly improve the healthcare industry. You'll contribute to our fast-paced, collaborative environment and will… more