- Molina Healthcare (Orlando, FL)
- …root cause and resolve outstanding issues. Creates reports and analysis based on business needs and required or available data elements. Collaborates with Health ... remediation plans and fixes, overall progress, and status of impacted claims **JOB QUALIFICATIONS** ** Required Education** Associate's Degree or equivalent… more
- Molina Healthcare (Orlando, FL)
- **Job Description** Job Summary Serves as claims subject matter expert. Assist the business teams with reviewing claims to ensure regulatory requirements are ... appropriately applied. Manages and leads major claims projects of considerable complexity and volume that may be initiated through provider inquiries or complaints,… more
- Molina Healthcare (Orlando, FL)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...in research, review and audits for adjudication rates of claims + Must be able to work in cross… more
- The Hartford (Lake Mary, FL)
- …with Claim Centers and territories in furtherance of and execution on the Claims legal cost containment goals, objectives, and business plan. + Integrate ... The Hartford is seeking to hire a Senior Litigation Analyst to join our Legal team. We are looking...pending invoices for the assigned region and/or line of business through utilization of team resources as well as… more
- Molina Healthcare (Orlando, FL)
- …**Job Summary** A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the ... organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses… more
- MyFlorida (Orlando, FL)
- …Agency: Business and Professional Regulations Working Title: Systems Project Analyst - 79010063 Pay Plan: Career Service Position Number: 79010063 Salary: ... Systems Project Analyst - 79010063 Date: Jan 16, 2025 The...hold a current license through the Florida Department of Business & Professional Regulation, you may be required… more
- Molina Healthcare (Orlando, FL)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... business issues related to cost, utilization and revenue for...and manage information from large data sources. + Analyze claims and other data sources (eg authorization) to identify… more
- Molina Healthcare (Orlando, FL)
- …data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with ... Education** Bachelor's Degree or equivalent combination of education and experience ** Required Experience** + 5-7 years of business or experience system… more
- AdventHealth (Altamonte Springs, FL)
- …SQL **KNOWLEDGE AND SKILLS PREFERRED:** * Knowledge of SAS * Understanding of payer claims data **EDUCATION AND EXPERIENCE REQUIRED :** * Bachelor's degree in a ... - Onsite- Altamonte Springs, FL** **The role you'll contribute:** The Financial Analyst position is part of the Finance team and specifically will support… more
- AssistRx (Orlando, FL)
- The Data Quality Analyst is responsible for acquiring, managing and analyzing data that will be presented to internal teams, clients and partners. The Data ... Analyst leads the onboarding of electronic data trading partners...issues. Successful applicants will have experience with Excel Pharmacy Claims experience is a huge plus Requirements + Developing… more
- Sedgwick (Orlando, FL)
- …their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Financial Analyst **PRIMARY PURPOSE:** To assist in financial planning, analysis and reporting… more
- Molina Healthcare (Orlando, FL)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...Health Plans. + Must have experience with Benefits configuration, claims + The team is responsible for implementation and… more
- The Cigna Group (Maitland, FL)
- …the office or visit Providers 3 days per week** The **Provider Contracting Lead Analyst ** serves as an integral member of the Provider Contracting Team and reports ... of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales… more
- Molina Healthcare (Orlando, FL)
- …systems to support the departments goals. + SQL, Databricks, Python + Claims knowledge/QNXT **JOB QUALIFICATIONS** ** Required Education** Associate's Degree or ... used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables… more
- Molina Healthcare (Orlando, FL)
- …analyses on a variety of topics related to the overall support of business operations. + Creates and maintains reports to manage claim inventory, adjustment ... findings and may develop recommendations to solve problems and issues related to business operations. + Follows team coding standards for report design. Works to… 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 ... Analyzing Financial and Utilization Metrics of Healthcare. **JOB QUALIFICATIONS** ** Required Education** Bachelor's Degree in Finance, Economics, Computer Science **… 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 ... Analyzing Financial and Utilization Metrics of Healthcare. **JOB QUALIFICATIONS** ** Required Education** Bachelor's Degree in Finance, Economics, Math, Computer… more
- Molina Healthcare (Orlando, FL)
- …opportunities to support clinical savings initiatives. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze claims and authorization data to identify trends or other issues ... exhibits and data visualizations to illustrate key trend drivers + Work with business owners to track performance indicators of medical interventions + Extract and… more
- Abbott (Orlando, FL)
- …or Orlando, FL location in the Abbott Heart Failure, Acelis Connected Health business . Our Heart Failure solutions are helping address some of the World's greatest ... healthcare challenges. As the Analyst I, QA, you'll have the chance to analyze...QA, you'll have the chance to analyze and audit claims , including the billing, collections and insurance verification functions.… more
- Molina Healthcare (Orlando, FL)
- …meet data analysis and database development needs. + Reviews, evaluates, and improved business logic and data sources. + Resource to staff for mentoring, coaching, ... and analysis questions. + Reviews Medical Economics analyst work products to ensure accuracy and clarity. + Reviews regulatory reporting requirements and Health Plan… more