- ENFRA (Orlando, FL)
- …Managers, General Superintendents and Superintendents. + Allocating, coordinating and quality assurance of drafting resources within Business Units. + Implementing ... productivity improvements, assure project compliance and quality assurance. + Maintaining consistency in Project and Field Management processes throughout Business… more
- Highmark Health (Tallahassee, FL)
- …and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, ... areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in… 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 ... on utilization, outcomes, and cost drivers across the organization. + Ensure data quality , governance, and documentation standards are met in all analytics work. +… more
- Humana (Fort Lauderdale, FL)
- …safeguarding Humana's data and technology assets. The team manages cybersecurity, risk management, and regulatory compliance through advanced technologies and best ... core insurance operations by developing and maintaining systems for claims processing, underwriting, policy administration, and member enrollment. Projects often… more
- Centene Corporation (Tallahassee, FL)
- …and policy changes. + **Support strategic initiatives** related to value-based care, risk adjustment, and quality improvement by ensuring attribution integrity. ... business needs. + **Design and maintain** attribution models based on claims data, member selection, contractual arrangements, and regulatory requirements. +… more
- NextEra Energy (Juno Beach, FL)
- …hearings, and appeals across multiple jurisdictions + Oversee inverse condemnation claims and property damage disputes + Manage appeals and complex valuation ... internal teams on land acquisition strategies, easement negotiations, and risk mitigation. **_Stakeholder Relations_** + Build relationships with landowners,… more
- Trinity Health (Fort Lauderdale, FL)
- …and verbal communications, ongoing monitoring of work queues, productivity and quality measurements of staff members.** **What you will do:** **Supervises the ... and HCPCS level II coding guidelines, along with CCI edits and Medicare claims processing manual contents in a multi-facility, integrated health care delivery system… more
- CHS (Clearwater, FL)
- …3 calls per week for MPS Representative will be audited by the Enterprise Risk Management (ERM) with accuracy a critical measure. + Adhering to Company standards to ... or a written response to inbound mail or e-mail. Quality Level + A minimum of 10 calls per...graduate or equivalent. + Knowledge of medical terminology, billing, claims and the health insurance industry is STRONGLY preferred… more
- NextEra Energy (Juno Beach, FL)
- …that NextEra Energy, Inc. remains "Best in Class" by continuing to drive quality and efficiency of our income tax forecasting and reporting processes. **Tax ... tax technology tools and data management solutions to automate and reduce risk related to forecasting **Preferred Tax Qualifications** + The successful candidate… more
- 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 ... be in use in a Pharmacy Benefit Management setting ( Claims Processing, Prior Authorization, Telephony, Membership, etc.). + Consideration...new ideas and work collaboratively to provide the highest quality of care and service to our members. If… more