- CVS Health (Tallahassee, FL)
- …evaluating and responding to provider participation and pricing inquiries. + Analyze post-paid healthcare claims as it relates to pricing needs. + Apply in-depth ... with heart, each and every day. **Position Summary** The Dispute Repricing Analyst will be responsible for the accurate analysis and resolution of provider… more
- Humana (Tallahassee, FL)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
- Highmark Health (Tallahassee, FL)
- …+ 2 years of Coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + 1 year of Project ... :** Highmark Health **Job Description :** **JOB SUMMARY** This job creates data -driven insights which identify actionable opportunities aligned to the Quadruple Aim… more
- Bristol Myers Squibb (Tampa, FL)
- …intake and loading requirements. Act as subject matter expert related to Model N claims & payment processing and reporting functionality and has a high level of ... requirements + Acting as a Subject Matter Expert regarding Model N claims & payment processing and reporting functionality including: + Providing internal staff… more
- Centene Corporation (Tallahassee, FL)
- …performance trends, or regulatory reporting with external agencies preferred; Familiarity with claims data , utilization, rate setting, risk adjustment, or member ... field or equivalent experience. 0-2 years of experience in business process, data analysis, or requirements analysis. Healthcare , analytics delivery, project… more
- AdventHealth (Maitland, FL)
- …from the payers in Athena/Epic and MSOW Network Management thus releasing held claims and updating the status report for the practices. + Reviews and resolves ... update current provider load, variance projects and specific payer issues. + Analyzes data to provide payer reimbursement trends, payer load times and load accuracy… more
- Molina Healthcare (FL)
- …cross-functional coordination, and ownership of high-value deliverables-distinct from a pure data analyst role. **Job Duties** **Business Leadership & ... integrity issues, and process gaps. + Apply understanding of healthcare regulations, managed care claims workflows, and...the role. + Validate findings and test assumptions through data , but lead with contextual knowledge of claims… more
- Molina Healthcare (St. Petersburg, FL)
- …trends, payment integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement ... the role. + Validates findings and test assumptions through data , but lead with contextual knowledge of claims...At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization… more
- Evolent (Tallahassee, FL)
- …research skills + Microsoft Office experience (Excel, Visio) + Understanding of healthcare data formats (eg, eligibility, claims , configuration, ... key member of the Product team, focused on client data integrations. This individual will play a critical role...(Required):** + Bachelor's Degree + 2+ years' experience in healthcare , IT business analyst , and/or product management… more