- Bank of America (Jacksonville, FL)
- …18 years of age.** Acknowledge (https://ghr.wd1.myworkdayjobs.com/Lateral-US/job/Pennington/Wealth-Management-Fraud Claims Sr -Fraud- Analyst \_25037888) **Job ... Wealth Management Fraud & Claims - Sr . Fraud Analyst...reports of suspected fraudulent activity with accurate recording of data captured during client interactions + Follows established processes… more
- Baylor Scott & White Health (Tallahassee, FL)
- + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position ... + Performs analysis and reporting activities related to risk score calculation, claims /encounters data submission, chart review programs and audits, and related… more
- University of Miami (Miami, FL)
- …MU + Familiarity with health plan concepts and workflows + Familiarity with outside claims data ingestion. + Ability to communicate effectively in both oral and ... of Miami Health System, "UHealth", IT Department has an exciting opportunity for a Full-time Epic Sr . Analyst - Quality and Population Health. The Epic Sr . … more
- Evolent (Tallahassee, FL)
- …data using industry-standard metrics. + Process and validate raw unadjudicated claims data . **Qualifications Required and Preferred:** + Bachelor's degree, ... candidates the opportunity to generate meaningful impact through translating disparate data points into tangible insights and actions. Our team values accuracy,… more
- Highmark Health (Tallahassee, FL)
- …medical terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information ... evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for… more
- Molina Healthcare (St. Petersburg, FL)
- …pertaining to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr . Analyst works with health plans and operations departments to ... ensure adherence to and compliance with State and Federal regulatory guidelines. The Sr . Analyst develops and performs audits and oversight functions involving… more
- Molina Healthcare (St. Petersburg, FL)
- **Job Description** **Job Summary** The Sr Analyst , Encounters is responsible for monitoring inbound and outbound encounter processes and ensuring timely, ... follow up, and performance monitoring. + Understands provider, member, and, inbound claims data compliance in relation to encounters submission requirements +… more
- Molina Healthcare (St. Petersburg, FL)
- …in data analysis. Performs research and deep-dive analysis of complex healthcare claims data , CMS return files, and financial cost, revenue, and vendor ... **JOB DESCRIPTION** **Job Summary** This Sr . Analyst , Healthcare Analytics role will...and Power BI, organizing and managing large and varied data sets, analyzing healthcare data for decision… more
- AdventHealth (Maitland, FL)
- …from various sources using knowledge of healthcare managed care contracts and administrative claims data . + Employs existing complex models and implements them ... Wednesday, Thursday) on-site **The role you will contribute:** A Senior Medical Economics analyst is responsible for...is responsible for analyzing and evaluating financial and economic data related to healthcare costs and managed care payer… more
- Molina Healthcare (Jacksonville, FL)
- …all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims ... systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and… more