- Prime Therapeutics (Tallahassee, FL)
- …the best technologies to use for our environment considering future direction, risk , consistency and return on investment. + Takes into account the technology ... that may be in use in a Pharmacy Benefit Management setting ( Claims Processing, Prior Authorization, Telephony, Membership, etc.). + Consideration will be given… more
- Highmark Health (Tallahassee, FL)
- …areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in ... and communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong education/training background… more
- GE Vernova (Pensacola, FL)
- …thinking and flexibility to manage and solve these issues and ensure risk mitigation efforts. + Support research and preparation of Customs rulings, post-summary ... & Partners in Protection (PIP), foreign trade zones, bonded warehouses, duty recovery claims , etc. + Support of import and export permits & licensing and other… more
- Bank of America (Miami, FL)
- …Self-motivated and results-oriented with excellent organizational skills **Skills:** + Claims Management + Controls Management + Monitoring, Surveillance, and ... Assurance + Attention to Detail + Investigation Management + Problem Solving + Risk Management + Written Communications + Adaptability + Process Management + Process… more
- Molina Healthcare (FL)
- …& ABILITIES** : * 2 - 3 years customer service, provider service, or claims experience in a managed care setting. * Working familiarity with various managed ... including but not limited to, fee-for service, capitation and various forms of risk , ASO, etc. **PREFERRED EDUCATION** : Bachelor's Degree in a related field or… more
- Meta (Tallahassee, FL)
- …4. Respond to counterparty inquires and manage contract amendments, collateral, force majeure claims , and other issues as needed 5. Surface and resolve issues in ... 8. Track project progress through development and construction milestones and lead risk reporting against schedule and forecast 9. Manage approval and signature… more
- Molina Healthcare (Orlando, FL)
- …advanced SQL queries to extract, validate, and analyze healthcare data, including claims , pharmacy, and lab datasets. + Build and maintain efficient ETL pipelines ... with **clinicians, nurses, or case management teams** + Familiarity with risk adjustment, value-based care models, or healthcare performance metrics + Understanding… more
- Kyndryl (Tallahassee, FL)
- …on engagements, while enduring profitability and understanding and containing risk **Client Engagement:** + Lead C-level client engagements and consultative ... Partner with CCaaS architects to build future-proof architectures with EHR, CRM, and claims system integrations. The compensation range for the position in the US is… more
- NBC Universal (Orlando, FL)
- …applicable employment laws and regulations while promoting consistency, efficiency and risk management + Lead and collaborate with multiple stakeholders to drive ... investigations of employment-related and other types of complaints, ensuring that claims are promptly and thoroughly investigated and documented appropriately +… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
- …CAPAs, Nutritional Documents, COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety & Product Quality audits at ... Manufacturing, and Food Distribution outlets, etc.). + Conducts ongoing risk assessments, develops corrective actions and monitors implementation, efficacy, and… more