- Molina Healthcare (Jacksonville, FL)
- …and opportunities. **Job Duties** + Extract and compile information from various systems to support executive decision-making + Mine and manage information from ... of healthcare financial terms (eg, PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500… more
- Molina Healthcare (FL)
- …and oversee the work of external vendors. Assigns, directs, and monitors system analysis and program staff. These positions' primary focus is project/program ... management, rather than the application of expertise in a specialized functional field of knowledge although they may have technical team members. Senior Program Management professional. Responsible for overall governance across all operational and strategic… more
- Highmark Health (Tallahassee, FL)
- …processes + Understanding of healthcare costs and the broader healthcare service delivery system + Proficiency in MS Excel and strong analytic skills with ability to ... interpret, evaluate and act on clinical and financial data, including analysis of statistical data + Excellent interpersonal/ consensus building skills as well as the ability to work with a variety of internal and external colleagues from all levels of an… more
- AdventHealth (Orlando, FL)
- …appropriate ICD-10-CM/PCS coding conventions and MS-DRG Medicare Prospective Payment System requirements. Actively participates in outstanding customer service and ... accepts responsibility for maintaining relationships that are equally respectful to all. The Senior Coder demonstrates experience and expertise, so coding quality review is not required before billing. The Senior Coder utilizes years of experience and… more
- Molina Healthcare (FL)
- …to all levels of leadership based on business requirements + Supports system integrity for Workforce Management software, Performance Manager and Cisco tools by ... communicating any known issues. **JOB QUALIFICATIONS** **Required Education** Associate degree or equivalent combination of education and experience **Required Experience** Requires at least 3-5 years relevant experience with Workforce Management methodologies… more
- Molina Healthcare (Orlando, FL)
- …and oversee the work of external vendors. Assigns, directs and monitors system analysis and program staff. These positions' primary focus is project/program ... management. **Job Duties** + Active collaborator with people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion.… more
- Molina Healthcare (Orlando, FL)
- …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 enrollment database. **Knowledge/Skills/Abilities** + Holds general oversight of enrollment and premium staff at each plan site within defined region. This may include employee reviews, coaching… more
- Sharecare (Tallahassee, FL)
- …from standard screens, scripts and procedures. CSRs use a computerized system for tracking calls, information gathering, and/or troubleshooting and may assess ... needs, explain programs and suggest/promote alternative products or services. **Start date:** September 22, 2025 (new hires must be able to start on this day) **Training:** Two weeks from 8am - 4:30pm CT. New hires are unable to miss any days of training (9/22… more
- Cognizant (Tallahassee, FL)
- …collaborate with stakeholders and other teams. **Primary Responsibilities** : + Review claim system data and verify against UB or HCFA paper or EDI information. + ... Evaluate medical records to determine if the service rendered was medically appropriate and criteria compliance. + Analyze claim and line-item edits, including warning messages, to determine payment eligibility. + Manage all tasks within designated timeline to… more
- Insight Global (Tampa, FL)
- …and user-friendly interfaces. Review and refactor all static text in the system , migrating it into dynamic resource files to support localization. Appropriately key ... and integrate resource strings within the codebase for maintainability and scalability. Systematically review every page and backend process in the application to: Identify and extract all static text. Translate static text into dynamic resource files to… more