- TEKsystems (Orlando, FL)
- Senior Medical Claims Analyst ( Remote ) Contract Duration: Through January 2026 (with potential for extension) Location: Remote (US based) Schedule: ... About the Role We're seeking a detail-oriented and analytical Senior Claims Analyst to join our team....strong technical skills and a background in pharmacy or medical claims . You'll play a key role… more
- Zelis (St. Petersburg, FL)
- …focused on supervising a team of Clinician's performing clinical reviews of facility claims , including UB's, Itemized Bills and medical records, to verify ... and operational support to the Manager, Clinical Chart Review, Sr . Level Clinicians and Operations Analysts as directed by...output and queues for timely and proper management of claims . + Ensure client turnaround times and specific processing… more
- CRC Insurance Services, Inc. (FL)
- …following job description:** Responsible for managing and resolving complex insurance claims involving litigation, coverage disputes, and high exposure. This role ... then hire attorney for coverage counsel for coverage analysis. 2. Settle claims within settlement authority, where applicable. 3. Work with adjusters, insureds,… more
- Sedgwick (Tallahassee, FL)
- …Services & Insurance Complex Claims Advisor | Commercial GL and Auto | Remote Are you looking for an opportunity to join a global industry leader where you ... background in insurance coverage analysis? We're seeking an experienced attorney or senior level examiner with a strong background in insurance coverage analysis to… more
- Zurich NA (Tallahassee, FL)
- Auto Claims Call Center Senior Represent 127692...Amazing PTO + 401K Match + Career mobility + Medical , Vision & Dental Required: + High School Diploma ... identify opportunities for customer care's improvements. + Handle first and third-party claims taking responsibility to resolve all enquiries from both customer and… more
- Molina Healthcare (FL)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical… more
- Molina Healthcare (Orlando, FL)
- **JOB DESCRIPTION** **Job Summary** This Sr . Analyst, Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities ... skills in data analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue, and vendor data.… more
- CVS Health (FL)
- …with heart, each and every day. **Position Summary** A Quality Assurance Senior Analyst reviews business requirements and translates them into clear, actionable test ... and hands-on experience. **Preferred Qualifications** + Background in healthcare or claims processing experience. + Experience with Aetna claims processing… more
- The Hartford (Lake Mary, FL)
- Sr Representative Claims - CH08BESr Representative Clms CA - CH08ANConsultant Claims CA - CH08BNConsultant Claims - CH08CE We're determined to make a ... team as we help shape the future. The General Liability Litigation Senior Claim Representative or Consultant is accountable for delivering superior customer service… more
- Molina Healthcare (Orlando, FL)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... Economics, Math, or Computer Science **Preferred Experience** Preferred experience in Medical Economics and Strong Knowledge of Performance Indicators: + Proactively… more
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