- 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
- CVS Health (Miami, FL)
- …in-person support across multiple worksites, handling complex benefit and claims inquiries, and providing education during open enrollment and health-related ... This role is ideal for someone with excellent communication skills, knowledge of healthcare benefits, and a passion for serving their community. **Primary Job Duties… more
- Healthfirst (FL)
- …peers to establish goals, priorities and deliverables of Business/ Project Analyst team. Ensurelong-term strategic and short-term tactical Operational needs for ... ensure their own optimal performance as well as performance of the Business/Project Analyst team. + Regularly meet with supervisor, peers, and stakeholders to drive… more
- Highmark Health (Tallahassee, FL)
- …scope and complexity + 5 years with coding languages, analytical software, systems , tools and processes using claims , clinical, enrollment and provider ... and/or create analytics and reporting solutions aligned to the Quadruple Aim of Healthcare : lower per capita health care costs, improved outcomes from and quality of… more
- CVS Health (Tallahassee, FL)
- …conducts investigations to effectively pursue the prevention, investigation and prosecution of healthcare fraud and abuse, to recover lost funds, and to comply with ... in a prepayment environment - Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc. - Researches and prepares cases… more
- HCA Healthcare (Pensacola, FL)
- **Description** **Introduction** Are you passionate about the patient experience? At HCA Healthcare , we are committed to caring for patients with purpose and ... on years of service) + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family building benefits with Progyny… more
- Molina Healthcare (FL)
- …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of ... staff for mentoring, coaching, and analysis questions. + Reviews Medical Economics analyst work products to ensure accuracy and clarity. + Reviews regulatory… more
- Public Consulting Group (Tallahassee, FL)
- …Third Party Administrator Services + Enhance Health and Public Safety Services + Claims Processing Services and Solutions + Consulting and Advisory Services + Cost ... Studies + Cost Settlement and Supplemental Payment Strategies + Healthcare Access and Markets A Test Leader oversees the...Management: Document, track, and report defects using bug tracking systems , and work with developers to ensure issues are… more