- Molina Healthcare (FL)
- …conducts research to resolve customer initiated issues related to core systems processing , and coordinates and manages project teams in the development of large ... + SQL expertise + Excel expertise + Medicare, Medicaid, Marketplace claims expertise **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting… more
- Molina Healthcare (Orlando, FL)
- **Job Description** **Job Summary** Responsible for preparation, processing and maintenance of new members and re-enrollment. Processes and maintains health plan's ... rejections. Address a variety of enrollment questions or concerns received via claims , call tracking, or e-mail. Maintain records in the enrollment database.… more
- The Cigna Group (Tallahassee, FL)
- …+ Receive requests by email or telephone regarding insurance claims /policies while operating on multiple computer applications. Respond to inquiries ... route claim forms and supporting documentation to various units for final processing + Independently respond to inquiries, grievances, complaints or appeals ranging… more
- Molina Healthcare (Jacksonville, FL)
- …**Required Experience** + 3-5 Years of experience with healthcare-related data ( claims /encounters, provider, CMS/EDGE response files, etc. + 3-5 Years of experience ... of programming experience in python to support automated data validation / processing at scale (functions and objects) **PHYSICAL DEMANDS** Working environment is… more
- Molina Healthcare (St. Petersburg, FL)
- **Job Description** **Job Summary** Responsible for preparation, processing and maintenance of new members and re-enrollment. Processes and maintains health plan's ... rejections. Address a variety of enrollment questions or concerns received via claims , call tracking, or e-mail. Maintain records in the enrollment database.… more
- City of Jacksonville (Jacksonville, FL)
- …of workers' compensation laws, rules, and regulations and workers' compensation claims processing practices and procedures with substantial litigation experience ... rules, and regulations. + Knowledge of complex workers' compensation claims processing practices and procedures involving lost...is located in an office and is not a remote location. + I have read and understand the… more
- Humana (Tallahassee, FL)
- …2 opening available. The Payment Integrity Professional 2 utilizes vendor platforms, claims processing platforms, and data to collaborate with key internal ... and external business stakeholders, while supporting claims code editing pre and post-implementation and functionality. The...your skills to make an impact** **WORK STYLE** : Remote , work at home. Minimal travel possible: Approximately 1-2x/year… more
- Bristol Myers Squibb (Tampa, FL)
- …intake and loading requirements. Act as subject matter expert related to Model N claims & payment processing and reporting functionality and has a high level ... loading requirements + Acting as a Subject Matter Expert regarding Model N claims & payment processing and reporting functionality including: + Providing… more
- Mass Markets (FL)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... MBA or equivalent executive education strongly preferred + Experience managing both remote and on-site teams at scale + Exposure to public-sector, government, or… more
- Humana (Tallahassee, FL)
- …knowledge. + Claims knowledge and understanding of claims processing . **Additional Information** + **Workstyle:** Remote , work from home. + **Typical ... and experience at a time that is best for your schedule. Nationwide Remote - This is a remote nationwide position. Travel: While this is a remote position,… more