- TEKsystems (Tampa, FL)
- …& Qualifications + Extensive understanding of the Revenue Cycle + Experience working as a Medical Claims Analyst + Experience and knowledge in Medical ... refund resolution. The ideal candidate will have strong analytical skills, medical claims experience, and the ability to navigate complex systems while… more
- Molina Healthcare (St. Petersburg, FL)
- … function efficiency. **Required Qualifications** * At least 3 years of medical claims processing experience, or equivalent combination of relevant education ... JOB DESCRIPTION **Job Summary** Provides analyst support for claims research activities...and experience. * Medical claims processing experience across multiple states,… more
- Deloitte (Tampa, FL)
- …work in a collaborative environment. As an experienced Epic Resolute Hospital Billing Analyst Project Delivery Specialist, you will have the ability to share new ... you'll do/Responsibilities + Support Epic enterprise implementation for a large academic medical center and health system in the Southeast region. + Conduct Epic… more
- Elevance Health (Tampa, FL)
- …not eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical ... into effective and accurate reimbursement criteria.** PRIMARY DUTIES: + Review medical record documentation in support of Evaluation and Management, CPT, HCPCS… more
- Sedgwick (Tampa, FL)
- …Work(R) Fortune Best Workplaces in Financial Services & Insurance SAP FICA Systems Analyst **PRIMARY PURPOSE OF THE ROLE:** To design and maintain robust, scalable ... INCLUDE** + Ensures software scalability and data integrity throughout all claims -related applications. + Ensures software compatibility and alignment with overall… 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
- 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...coding guidelines, and supporting the Office of the Chief Medical Officer in managing disputes related to clinical claim… 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
- Elevance Health (Tampa, FL)
- **Cost of Care/Provider Contracting Data Analyst Senior** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and ... is granted as required by law. The **Cost of Care/Provider Contracting Data Analyst Senior** is responsible for providing analytical support to the Cost of Care… more
- Elevance Health (Tampa, FL)
- **Cost of Care/Provider Contracting Data Analyst ** **Location** : This role requires associates to be in-office 1-2 days per week, fostering collaboration and ... is granted as required by law. The **Cost of Care/Provider Contracting Data Analyst ** is responsible for provides analytical support to the Cost of Care and/or… more
- Elevance Health (Tampa, FL)
- …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Business Analyst III** will be responsible ... **Business Analyst III - Payment Intergrity Datamining** **Location:** This...and Experiences:** + Comprehensive understanding of healthcare payer systems, claims processes, and coding practices preferred. + Demonstrated proficiency… more
- Sedgwick (Tampa, FL)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Data Analyst Manager **PRIMARY PURPOSE OF THE ROLE:** To manage a staff of data ... growth opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401k, PTO and more. \#IT \#informationtechnology Work… more
- Sedgwick (Tampa, FL)
- …in Financial Services & Insurance Workforce Analytics & Productivity Monitoring Analyst **PRIMARY PURPOSE OF THE ROLE:** To manage Sedgwick's Workforce Analytics ... growth opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401k, PTO and more. \#IT \#informationtechnology Work… 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)
- **Actuarial Analyst II** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing ... unless an accommodation is granted as required by law. The **Actuarial Analyst II** completes projects and performs complex actuarial studies. **How You Will… more
- Molina Healthcare (St. Petersburg, FL)
- …and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department ... **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will...rate tracking and supplemental data impact reporting. + Develop Medical Record Review project reporting to track progress and… more
- Molina Healthcare (St. Petersburg, FL)
- …more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data ( medical , pharmacy and ancillary) to deliver practical, ... **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and… more
- Molina Healthcare (St. Petersburg, FL)
- …more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data ( medical , pharmacy and ancillary) to deliver practical, ... **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and… more
- Molina Healthcare (St. Petersburg, FL)
- …recoveries in a managed care or payer environment. + In-depth knowledge of medical and hospital claims processing, including CPT/HCPCS, ICD, and modifier usage. ... for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). + Medical Coding certification. To all current Molina employees: If you are interested in… more
- Sedgwick (Tampa, FL)
- …best brands? + Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing ... years of related experience to include one (1) year as an Account Coordinator, analyst , associate or three (3) years adjuster experience. **TAKING CARE OF YOU** +… more