- Molina Healthcare (South Florida, FL)
- **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage ... amount and benefit interpretation. Monitors and controls backlog and workflow of claims . Ensures that claims are settled in a timely fashion and in accordance… more
- Elevance Health (Miami, FL)
- …and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant ... **Pharmacy Data Claims Analyst & Insights (Business Analyst II)** _Location:...Experience working in a health plan and/or pharmacy benefit manager (PBM) strongly preferred. + Strong proficiency in SQL,… more
- Elevance Health (Fort Lauderdale, FL)
- …and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant ... one of our Elevance Health PulsePoint locations. **Nurse Case Manager I** Responsible for performing care management within the...such as at hospitals for discharge planning. **Ideal candidate ** MUST ** reside and licensed in the state… more
- Elevance Health (Miami, FL)
- …and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant ... to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Miami, FL)
- …and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant ... Included are processes related to enrollment and billing and claims processing, as well as customer service written and...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Miami, FL)
- …and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant ... abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Miami, FL)
- …and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant ... a designated virtual-eligible role and specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least… more
- Elevance Health (Miami, FL)
- …and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant ... **Grievance/Appeals Analyst Lead** **Candidates must be located within 50 miles of Atlanta,...and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize… more
- Elevance Health (Hialeah, FL)
- …and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant ... medical directors in interpreting appropriateness of care and accurate claims payment. + May also manage appeals for services...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Miami, FL)
- …and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant ... of proposal activities and responses with other operating areas such as Claims , Underwriting, Sales, and Specialty companies assuring their actions come together as… more