- Molina Healthcare (St. Petersburg, FL)
- JOB DESCRIPTION **Job Summary** Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory ... inquiries and projects. * Interprets and presents in-depth analysis of claims research findings and results to leadership and respective operations teams. *… more
- TEKsystems (Tampa, FL)
- …Handle refund requests, including overpayment analysis and reimbursement facilitation. - Claims Research & Resolution: Investigate discrepancies, and resolve ... Reporting: Create and maintain reports, pivot tables, and document research findings. -Follow-Ups: Ensure timely receipt of bills (within...the Revenue Cycle + Experience working as a Medical Claims Analyst + Experience and knowledge in… more
- Zelis (St. Petersburg, FL)
- …that shape who you are. Position Overview At Zelis, the Clinical Dispute Analyst role is responsible for the resolution of facility and provider disputes as ... will be responsible for reviewing facility inpatient and outpatient claims for Health Plans and TPA's to ensure adherence...s and provide support where needed for inquiries and research requests. + Create and present education to Expert… more
- MetLife (Tampa, FL)
- …group (GTO) is a diverse team of engineers, developers, business analysts, claims analysts and project managers who collaborate to create innovative solutions to ... within MetLife. This role will conduct quality reviews of disability claims , collecting and analyzing quality opportunities, and delivering results and driving… more
- CVS Health (Largo, FL)
- …we do it all with heart, each and every day. **Position Summary** The Benefits Analyst , Account Manager at CVS Health, you will play a critical role in supporting ... in-person support across multiple worksites, handling complex benefit and claims inquiries, and providing education during open enrollment and health-related… more
- WTW (Tampa, FL)
- …**The Role** We are seeking an organized and detail-oriented Retirement Plan Compliance Analyst to join our team. As a compliance analyst you will ... **Other:** Keep abreast of laws and regulations impacting employee benefits, claims procedures, and notice requirements by using our legal database subscriptions… more
- Elevance Health (Tampa, FL)
- …Coordinates research and responds to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues and ... eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing… more
- Molina Healthcare (St. Petersburg, FL)
- … research , financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable financial ... **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the...basis using SQL, Excel, and other reporting software. * Research , develop, analyze and recommend cost savings opportunities in… more
- Molina Healthcare (St. Petersburg, FL)
- … research , financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable financial ... **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the...basis using SQL, Excel, and other reporting software. + Research , develop, analyze and recommend cost savings opportunities in… more
- Molina Healthcare (St. Petersburg, FL)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... and Identifying targeted Interventions and tracking outcome. Assist with research , development, and completion of special performance improvement projects.… more
- Air National Guard Units (Macdill AFB, FL)
- …in work such as computer operator or assistant, computer sales representative, program analyst , or other positions that required the use or adaptation of computer ... science, engineering, information science, information systems management, mathematics, operations research , statistics, or technology management or degree that provided… more