- The Cigna Group (Tampa, FL)
- …the requirements of business and reporting teams within areas such as pharmacy claims , medical claims , membership eligibility, etc. Build automated solutions ... for data quality checks, Audit Balance and Controls (ABC), and monitoring processes. Develop...color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual… more
- University of Miami (Miami, FL)
- …and testing the revised treatment matrix which will identify possible cancers from claims data. The RA1 will facilitate the process of preparing required regulatory ... as part of the plan to resolve the deficiencies identified during the audit /monitoring visit. + Assist in the collection and maintenance of credentialing information… more
- Walgreens (Longwood, FL)
- …issues and prevent payment rejections. Follows-up with insurance companies as well as medical providers and participates in 3rd party audit . + Follows-up with ... privacy, generics, less expensive medicines, over-the-counter products, and refers to medical provider as needed to ensure medication is taken correctly, health… more
- Walgreens (Deltona, FL)
- …patient issues and prevent payment rejections. Follows up with insurance companies and medical providers and participates in 3rd-party audit . + Follow-up with ... privacy, generics, less expensive medicines, over-the-counter products, and refers to medical provider as needed to ensure medication is taken correctly, health… more
- Walgreens (Ocala, FL)
- …issues and prevent payment rejections. Follows- up with insurance companies as well as medical providers and participates in 3rd party audit . + Follows-up with ... privacy, generics, less expensive medicines, over-the-counter products, and refers to medical provider as needed to ensure medication is taken correctly, health… more
- Mass Markets (Tampa, FL)
- …such as quality assurance, training, IT, and recruiting. + Develop and audit quality assurance strategies to ensure the delivery of world-class service + ... sometimes even cars! + Health Benefits: Full-time employees are eligible for comprehensive medical , dental, and vision coverage after 90 days of employment, and all… more
- Monte Nido (Miami, FL)
- …legal requirements in administering various leave types, such as Family and Medical Leave Act (FMLA), short-term disability (STD), workers compensation and other ... prioritize your success and well-being, providing: + Competitive compensation + Medical , dental, and vision insurance coverage (Benefits At a Glance… more
- CVS Health (Tallahassee, FL)
- …or audit experience. **Preferred Qualifications** + Medicare experience + Claims experience + Experience in reading or researching benefit language in Summary ... to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and… more
- Datavant (Tallahassee, FL)
- …**Quality, Compliance, and Scalability** + Ensure analytics products support audit defensibility, regulatory compliance, and documentation traceability. + Design ... SDLC. + **Technical Acumen:** Comfortable working with large datasets, EHR data, claims data, and HCC-based analytics. Familiarity with query languages such as SQL,… more
- MyFlorida (Tallahassee, FL)
- …discrepancies, continuing education matters, and other informational inquires. + Assist audit leader with the administration of continuing eduation audits. + ... available for dental, vision, hospital supplement, cancer, etc. + Tax deferred medical and childcare reimbursement accounts are available. + Tuition waiver program… more
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