- Humana (Tallahassee, FL)
- … healthcare industry + 2+ years of demonstrated expertise in end-to-end healthcare claims operations , including claim ingestion, processing, system ... This is your opportunity to lead cross-functional initiatives, apply your expertise in healthcare claims , and shape the future of operational excellence in a… more
- 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
- CVS Health (Tallahassee, FL)
- … insurance or a highly regulated industry. + Strong knowledge of healthcare payer operations ( claims , eligibility, enrollment, prior authorization, ... timely release of features. **Stakeholder Engagement** + Collaborate with business units, operations , clinical teams, compliance, and IT to align on priorities and… more
- Elevance Health (Tampa, FL)
- **Business Architect Sr. - Claims Systems** **Location:** This role requires associates to be in-office 1 day per week, fostering collaboration and connectivity, ... as required by law. The **Business Architect Sr. - Claims Systems** will be part of Elevance Health's National... Systems** will be part of Elevance Health's National Operations Command Center (NOCC) which is responsible for E2E… more
- Elevance Health (Tampa, FL)
- …integrity across CareBridge. The ideal candidate has experience working in leading healthcare payer claims / revenue cycle management (RCM) organizations, with ... **Clinical Documentation and Claims Integrity Director** **Location:** Alternate locations may be...and Elevance Health leadership across Product, Analytics, and Clinical Operations teams. + Advises on vendor investments and operational… more
- Cognizant (Tallahassee, FL)
- …variety of business operations . We are seeking **Fully Remote US Based** Claims Processors to join our growing team. The **Medical** ** Claims Processor** is ... responsible for the timely and accurate adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to … more
- AssistRx (Orlando, FL)
- …manufacturer programs. + Familiarity with patient assistance programs, specialty pharmacy operations , and healthcare compliance standards. Benefits + Supportive, ... to claim processing activities. In addition, manager will ensure effective day-to-day operations and provide ongoing Copay program metrics for internal and external… more
- TEKsystems (Orlando, FL)
- …mission-driven team that supports critical disability evaluations. + Gain exposure to healthcare operations and recruitment. + Receive training on specialized ... Role We're looking for a detail-oriented and resourceful disability claims processor to join our team. This role is...School Diploma or equivalent. + 2+ years of administrative healthcare experience + Strong computer literacy and internet research… more
- Healthfirst (FL)
- …problem solving, and analytical skills. + Experience within any area of operations (Member Services, Enrollment & Billing, Claims , Provider Services, etc.). ... value. + Collaborate with Information Technology, Business Transformation and Operations teams to support effective department management including introducing new… more
- Molina Healthcare (FL)
- …trends, payment integrity issues, and process gaps. + Apply understanding of healthcare regulations, managed care claims workflows, and provider reimbursement ... **Job Description** **Job Summary** The Health Plan Operations , Payment Integrity Program Manager is an individual...operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to… more
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