- Molina Healthcare (Miami, FL)
- …functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received ... support issues related to EDI transaction editing and custom claims processes to determine root cause of issue. Gains...claims to identify billing issues that will impact claims processing and payment. Monitor new solutions implemented to… more
- Canon USA & Affiliates (Tallahassee, FL)
- **Mgr Medical Affairs - Clinical Development Sr - HIT - req1494** **OVERVIEW** Works independently and as part of a dynamic and fast-paced team of clinical and ... and review of collaterals for clinical accuracy and adherence to clinical claims . Effectively interacts with multiple teams including R&D, global and local business,… more
- AdventHealth (Maitland, FL)
- …sources using knowledge of healthcare managed care contracts and healthcare administrative claims data + Employs existing complex models and implements them ... to the team:** + Research and analyzes managed care data from the various financial systems and...provider types + Applies detailed understanding of medical coding systems affecting the adjudication of claims to… more
- Cushman & Wakefield (Clearwater, FL)
- **Job Title** Sr . Facilities Manager **Job Description Summary** This position has managerial oversight of multiple facilities, an entire campus, or a portfolio of ... Facilities Manager and/or Assistant Facilities Manager reporting into it. The Senior Facilities Manager has the overall responsibility for overseeing the… more
- Publix (Lakeland, FL)
- …and ad-hoc reporting identifying operational fluctuations in account balances and/or transactional data within the various Pharmacy systems to ensure accuracy ... **33247BR** **Position Title:** Sr . Collections Specialist - Pharmacy - Lakeland **Department:** Finance **Location:** Lakeland, FL **Description:** The Senior … more
- Sumitomo Pharma (Tallahassee, FL)
- …computer systems . + Identifies and resolves discrepancies in submitted data invoices to ensure legitimacy of contract discounts. + Ensures detailed accuracy ... highly motivated, and experienced individual for the position of Sr . Manager, Medicaid Contract Administration. This position is responsible...of correct data input into company systems . + Maintains… more
- Evolent (Tallahassee, FL)
- …mission. Stay for the culture. **What You'll Be Doing:** Evolent Health is looking for a Sr . Product Owner within our Common Data portfolio to be a key member of ... a technical field or relevant related field + Understanding of healthcare data formats (eg, eligibility, claims , configuration, authorizations, clinical data… more
- Gilead Sciences, Inc. (Tampa, FL)
- …Join Gilead and help create possible, together. **Job Description** As a ** Sr ** **Therapeutic Specialist** you are responsible for representing Gilead's products and ... other team members, and acts as a mentor for junior staff. + Initiates systems to regularly measure sales progress and action plans. Documents and provides feedback… more
- Evolent (Tallahassee, FL)
- …data using industry-standard metrics. + Process and validate raw unadjudicated claims data . **Qualifications Required and Preferred:** + Bachelor's degree, ... Familiarity with value-based care and utilization management is preferred + Understanding of data systems and the critical thinking skills to solve new problems… more
- Evolent (Tallahassee, FL)
- …Familiarity with value-based care and utilization management is preferred + Understanding of data systems and the critical thinking skills to solve new problems ... interactions fostering expertise and cooperation. + Extract, manage, and analyze claims and operational data using industry-standard metrics. **Qualifications… more
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