- Molina Healthcare (St. Petersburg, FL)
- …highly experienced Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of ... related to over- or underpayment. + Utilize QNXT to research claims history, provider contract setup, and...operations + Must have strong understanding of QNXT claims processes + Must be able to identify and… more
- Estes Express Lines (Tampa, FL)
- …an effective working relationship with other departments such as safety, sales, claims , loss prevention, customer care, and operations + Direct investigations ... **Job Summary:** Accountable for large, complex maintenance shop's operations , equipment, preventive maintenance, safety, and life cycle of all employees, eg talent… more
- Molina Healthcare (St. Petersburg, FL)
- …membership cards and materials. Verify enrollment status, make changes to records, research and resolve enrollment system rejections. Address a variety of enrollment ... questions or concerns received via claims , call tracking, or e-mail. Maintain records in the...needed + Participate in process improvement initiatives to improve operations + Understands the compliance and regulatory guidelines for… more
- Walmart (Lakeland, FL)
- …associates Manage processing of shipload purchase orders inboundoutbound containerstrailers and claims my monitoring all activities conducting problems research ... coaching teaching and evaluation of associates and leaders Facilitate carrier operations by processing and monitoring carrier activity working with carriers and… more
- Truist (Orlando, FL)
- …review the following job description:** Under minimal supervision of the Operations Manager , responsible for handling electronic payment exceptions, escalations, ... to applicable operating rules and regulatory guidelines. 2. Independently analyze, research , and support electronic payment cases/ claims /inquiries escalated by… more
- USAA (Tampa, FL)
- …to collect and analyze data. What sets you apart: + P&C Claims Operations and/or Optimization experience. + 2+ years Manager , Claims Operations ... Actively provide relevant business performance intel to progress the planning, research , analysis, development, and implementation of new and modifications to… more
- MyFlorida (Tallahassee, FL)
- …Waivers. Prepare data and perform analysis necessary to support Medicaid operations and Medicaid expenditures for quarterly CMS 64 Expenditures reporting, CMS ... waivers and ensure timely submission of results to the Unit Manager . Maintain knowledge of Health Information Portability and Accountability (HIPPA) complaint… more
- MyFlorida (St. Petersburg, FL)
- …officials and regulatory agencies as requested or directed by supervisor/ manager . + Coordinate and assist department legal/board staff regarding administrative ... other people are saying and asking questions as appropriate; conduct fact-finding research ; knowledge of the methods of data collection and analysis; organize data… more
- MyFlorida (Tallahassee, FL)
- …issues related to information technology. + Functions in the capacity of a project manager when assigned to do so by the Office of the Director. + Manages ... needed. + Conducts, prepares, and reviews reports, studies, publications, and research relating to operational trends and strategic program objectives. Your Specific… more
- The Cigna Group (Sunrise, FL)
- …of communication with matrix partners including but not limited to, Claims Operations , Medical Management. Credentialing, Legal, Medical Economics, Compliance, ... 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… more