- Molina Healthcare (Miami, FL)
- …expertise and responsibility for oversight, production, and resolution of Health Plan Payment Integrity (PI) recovery concepts. This role executes and monitors ... **Business Leadership & Operational Ownership** + Develop and execute effective Payment Integrity strategies through both pre- payment and post payment… more
- Molina Healthcare (FL)
- **Job Description** **Job Summary** The Health Plan Operations, Payment Integrity Program Manager is an individual contributor role designed for a highly ... on identifying, leading, and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy....years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health… more
- Molina Healthcare (St. Petersburg, FL)
- …expertise and responsibility for oversight, production, and resolution of Health Plan Payment Integrity (PI) recovery concepts. This role executes and monitors ... lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +...years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health… more
- Molina Healthcare (St. Petersburg, FL)
- **Job Summary:** The Subrogation Manager is responsible for overseeing all aspects of healthcare subrogation operations across Medicaid, Medicare, and Marketplace ... lines of business. This includes direct management of internal teams and external vendors handling both first-pass and second-pass recovery efforts. The role requires experience across a wide range of subrogation case types-including automobile-related claims… more
- Molina Healthcare (Tampa, FL)
- …This role focuses on identifying and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will ... lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +...years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health… more
- Molina Healthcare (St. Petersburg, FL)
- …are seeking a highly experienced Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and ... acumen. Experience in Medicaid managed care is required, and a background in payment integrity -either at a health plan or vendor-is strongly preferred.… more
- Elevance Health (Tampa, FL)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 ... an accommodation is granted as required by law._ **Carelon Payment Integrity ** is a proud member of...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Trinity Health (Fort Lauderdale, FL)
- …to, appending modifiers and checking clinical documentation. Works closely with Revenue Integrity staff and providers to educate on improved documentation to support ... need for accurate and complete documentation to ensure revenue optimization and integrity . Educate clinical staff on need for accurate and complete documentation to… more
- Intermountain Health (Tallahassee, FL)
- …responsible for billing, follow-up, and resolving issues that delay or prevent payment of the patient's account within Intermountain's policies and procedures. Scope ... management, and designated areas in the response process. 5. Assists manager with interviews, onboarding, monitoring and measuring goals, annual reviews and… more
- Vontier (Tallahassee, FL)
- …inspire others, helping lead them to greatness, all with uncompromising personal integrity ? If you possess these personal qualities, then consider being an ... Automotive Sales Manager (District Manager .) You'll introduce qualified individuals...self-starter. + Humble, tenacious, professional, leader with uncompromising personal integrity . + Basic MS Office knowledge is required; intermediate… more
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