- AdventHealth (Altamonte Springs, FL)
- …payers to address issues and ensure accurate processing. Works closely with Managed Care contract administration to ensure accurate provider profiles. Maintains ... anti-discrimination laws, regulations and ordinances._ **Category:** Revenue Cycle & Managed Care **Organization:** AdventHealth Corporate **Schedule:** Full… more
- Insight Global (Maitland, FL)
- …responsible for analyzing and evaluating financial and economic data related to healthcare costs, managed care payer rates, and reimbursement . It focuses on ... Job Description Role overview: This role is focused on managed care within the payor space, commonly...negotiators who engage with BUCA payors to establish new reimbursement rates and build rate structures for future periods.… more
- Molina Healthcare (Miami, FL)
- …utilized in medical coding/billing (UB04/1500 form). * Demonstrated understanding of key managed care concepts and provider reimbursement principles such ... health care vendor, commercial health insurance, large physician practice, managed care organization, etc.) * Proficiency with retrieving specified… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …we're more than a pharmacy - we're a dedicated partner in care , transforming how patients experience long-term, post-acute, correctional, PACE, and specialty ... we're raising the bar for quality and coordination across all sites of care , ensuring every patient receives seamless, compassionate, and expert support. Founded in… more
- Evolent (Tallahassee, FL)
- …experience in claims-based healthcare analytics with a payer, provider, clinical vendor, managed care , or related healthcare consulting entity + Ability to ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
- Evolent (Tallahassee, FL)
- …experience in claims-based healthcare analytics with a payer, provider, clinical vendor, managed care , or related healthcare consulting entity + Ability to ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
- CVS Health (Miramar, FL)
- …fast-paced changing environment + Effective communication skills, both verbal and written Managed Care experience + Case management and discharge planning ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- AdventHealth (Maitland, FL)
- …MAITLAND **State:** Florida **Postal Code:** 32751 **Job Description:** Researches and analyzes managed care data from various financial systems and interface ... Interprets and analyzes data from various sources using knowledge of healthcare managed care contracts and administrative claims data. Employs existing complex… more
- Highmark Health (Tallahassee, FL)
- …various complex potential claims with emphasis on controlling losses through effective managed care . This includes following a departmental claim checklist to ... ensure eligibility is met, the payment reimbursement request is accurate by auditing the claim for...3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate… more
- Molina Healthcare (Miami, FL)
- …+ Proven experience handling provider disputes, appeals, and overpayment recoveries in a managed care or payer environment. + In-depth knowledge of medical and ... Qualifications** + At least 4 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent… more