- Healthfirst (FL)
- …disputes/appeals and provides guidance across all areas of the company with regards to claims editing and proper coding , billing, and payment. + Researches and ... **Duties & Responsibilities** : + Conducts routine assessments of current claims edits and ensures comprehensive and defensible editing across all Healthfirst… more
- Healthfirst (FL)
- …a simple and easy to understand manner to other staff. As the SME, the Claims Configuration Analyst will need to effectively communicate with all levels of the ... + Assist in the on-going evaluation of configuration for new and existing claims business rules including member benefits, claims editing, reference data and… more
- Healthfirst (FL)
- …the development and configuration of new business, member benefits and products, claims editing, reference data and their enhancements including claims ... enhancements. + Follow the annual product development processes to manage major claims configuration projects, including claims business rule set up outlier… more
- Centene Corporation (Tallahassee, FL)
- …management experience preferred. **Benefits and Payment Configuration:** **Compliance Coding /Prepay Compliance (Payment Integrity):** Bachelor's degree in related ... preferably healthcare (ie documenting business process, gathering requirements) or claims payment/analysis experience. Advanced knowledge of Microsoft Applications, including… more
- Elevance Health (Tampa, FL)
- …and/or claims editing software vendors, strongly preferred. + Billing, coding , revenue cycle, and claims editing software experience strongly preferred. ... **Clinical Content Analyst ** **Location:** This position will work a hybrid...and other major payer policies based on healthcare correct coding and regulatory requirements. **How you will make an… more
- AdventHealth (Maitland, FL)
- …the full spectrum of app provider types + Applies detailed understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10 CPT, ... (Altamonte Springs,FL)** **The role you'll contribute:** A Senior Medical Economics analyst is responsible for analyzing and evaluating financial and economic data… more
- ChenMed (Miami, FL)
- …Extensive knowledge of healthcare/medical economics data such as hospital/physician /ASC claims , utilization data, and healthcare industry coding systems ICD-10, ... we need great people to join our team. The Senior Health Economics Analyst is responsible for identifying and delivering data-driven insights and analytical support… more
- Molina Healthcare (FL)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources (eg authorization) to identify early signs of trends… more
- The Walt Disney Company (Celebration, FL)
- …for the entire family. The Disney Cruise Line Risk Management's Business Systems Analyst role supervises the ongoing needs related to the successful operation of ... the Disney Cruise Line Incident Management System (DCLIMS), SeaCare, and the Claims Administration Reporting System (CARS). We are seeking a candidate who can… more
- Prime Therapeutics (Tallahassee, FL)
- …decision we make. **Job Posting Title** Sr. Applied Stars and Quality Analytics Analyst **Job Description** The Senior Health Data Analyst provides information, ... Experience conducting complex analysis on large sets of pharmacy, claims , medical, and/or financial data + Basic to intermediate...medical, and/or financial data + Basic to intermediate SAS coding skills + Previous experience in a client facing… more
- Abbott (Orlando, FL)
- …solutions are helping address some of the World's greatest healthcare challenges. As the Analyst I, QA, you'll have the chance to analyze and audit claims , ... auditing Insurance Verification, Billing, Collections, and Payment posting functions. + Review claims for insurance carriers and tracking the status of payments. +… more