- Molina Healthcare (Miami, FL)
- …and test assumptions through data, but lead with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... trends, payment integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement… more
- Molina Healthcare (FL)
- …concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system ... + Min. 2 years operational managed care experience (call center, appeals or claims environment). + Health claims processing background, including… more
- Molina Healthcare (FL)
- …concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system ... + Min. 3 years operational managed care experience (call center, appeals or claims environment). + Health claims processing background, including… more
- Molina Healthcare (Miami, FL)
- …Provides leadership and direction to MMS Operational Units management staff (eg, Claims Processing , Provider Services, Provider Enrollment, Finance, Managed Care ... or equivalent experience **Required Experience** 3 years supervision/management experience in Claims Processing or Provider Services environment and/or any high… more
- Molina Healthcare (Tampa, FL)
- …and tests assumptions through data, but leads with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... trends, payment integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement… more
- Molina Healthcare (FL)
- …and test assumptions through data, but lead with contextual knowledge of claims processing , provider contracts, and operational realities. + Create succinct ... trends, payment integrity issues, and process gaps. + Apply understanding of healthcare regulations, managed care claims workflows, and provider reimbursement… more
- Molina Healthcare (St. Petersburg, FL)
- …and test assumptions through data, but lead with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... trends, payment integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement… more
- Molina Healthcare (Jacksonville, FL)
- …operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms (eg, PMPM, ... related to cost, utilization and revenue for multiple Molina Healthcare products. Designs and develops reports to monitor health...and manage information from large data sources. + Analyze claims and other data sources to identify early signs… more
- Molina Healthcare (Orlando, FL)
- …Provider Network Operations, Hospital or Physician Billing, or similar. + Claims processing background including coordination of benefits, subrogation, and/or ... and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …and credentialing documents are entered and/or scanned into the Doctors HealthCare Plans, Inc, ("DHCP") credentialing CACTUS database, provide data entry and ... Department. This position will assist the Credentialing Department in the timely processing of Initial Credentialing / Recredentialing of application, processing … more