- Molina Healthcare (Jacksonville, FL)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting,… more
- USAA (Tampa, FL)
- …candidate selected for this position will be joining the Service Team within the Claims Actuary and Analytic community, which is part of P&C Data Science. They be ... responsible for delivering insights to the Claims organization related to all things Service to better...The essence of work performed by the Decision Science Analyst involves gathering, manipulating and synthesizing data (eg, attributes,… more
- Molina Healthcare (Tampa, FL)
- …**Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Molina Healthcare (St. Petersburg, FL)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... and regulatory guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in… more
- Molina Healthcare (Tampa, FL)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... life cycle + Gains a deep understanding of Molina claims life cycle and all processes that affect ...Eg, Medicare Exclusion POC + Acts as a team lead , assigning and prioritizing work for other team members… more
- The Cigna Group (Sunrise, FL)
- …work in the office or visit Providers 3 days per week The **Provider Contracting Lead Analyst ** serves as an integral member of the Provider Contracting Team and ... reports to the Contracting Manager or Market Lead . This role assists and supports the day to day contracting and network activities. **DUTIES AND RESPONSIBILITIES**… more
- Prime Therapeutics (Tallahassee, FL)
- …and assumptions to define additional resource needs; collaborate with Business Systems Analyst Resource Lead or Resource Manager to determine work assignments ... Provide work plan and detailed estimate based on scope; lead scope management, prioritization and drive scope trade off...within project + Educate and advance business systems analyst practice within the Claims IT team… more
- NextEra Energy (North Palm Beach, FL)
- …and provides coverage to both affiliated and non-affiliated risks. As the Principal Operations Analyst for Claims & Finance, you will be assisting the Claims ... **Principal Insurance Operations Analyst ** **Date:** Aug 26, 2025 **Location(s):** North Palm...Loss), following up with TPAs (Third Party Administrators), manage claims BDXs (Bordereau), processing invoices, generate loss runs &… more
- Elevance Health (Miami, FL)
- **Provider Payment Appeal Analyst I** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... am - 9 pm EST The **Provider Payment Appeal Analyst I** is responsible for supporting the Payment Dispute...root cause and appropriate resolution. + Must work with Claims Operations to remediate impacted claims . **Minimum… more
- University of Miami (Miami, FL)
- …of Miami Health System IT Department has an opportunity for a full-time Epic Analyst 2. The Epic Analyst 2 assists Associate Epic Analysts on the ... to optimize the application's configuration, function, and access. The Epic Analyst 2 facilitates day-to-day application support and resolving application issues and… more