- Healthfirst (FL)
- …in 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 ... Assist in the setup of code sets and defining pre-authorization guidelines used in claims configuration to drive application of medical policy and accurate … more
- Healthfirst (FL)
- …products, claims editing, reference data and their enhancements including claims configuration improvements, compliance and systems enhancements. + Follow ... the annual product development processes to manage major claims configuration projects, including claims business rule set up outlier management. + Interpret… more
- Molina Healthcare (St. Petersburg, FL)
- …expected completion dates with Health Plans. + Must have experience with Benefits configuration , claims + The team is responsible for implementation and ... accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes… more
- Molina Healthcare (FL)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... for quality and financial accuracy and provides documented feedback. + Assists in configuration issues and loading of provider information, as needed. + Assists in… more
- Healthfirst (FL)
- **Duties & Responsibilities** : + Conducts routine assessments of current claims edits and ensures comprehensive and defensible editing across all Healthfirst ... edits. + Monitors and reports on performance of current claims editing packages + Supports claims editing...as AMA guidelines, and compare to current payment policy configuration in order to resolve the providers payment discrepancy.… more
- Molina Healthcare (Orlando, FL)
- …areas. **KNOWLEDGE/SKILLS/ABILITIES** + Provides research and analytics associated with medical claims processing requirements (1500 and UB04), provider and benefit ... configuration , and other claim reimbursement drivers + Recognizes, identifies and documents changes to existing business processes and identifies new opportunities… more
- University of Miami (Miami, FL)
- …programs. UHealth/SoLe Mia has an exciting opportunity for a Full-Time Epic Senior Analyst , Resolute Hospital Billing with a hire date of December 2024. The Epic ... Senior Analyst , Resolute Hospital Billing oversees and leads the Associate...end-users, and application team members to optimize the application's configuration , function, and access. The incumbent supports junior staff… more
- University of Miami (Miami, FL)
- …System IT Department has an opportunity for a full-time Epic Senior Analyst - Resolute Professional Billing. The Epic Senior Analyst , Resolute Professional ... Epic Analysts and Epic Analysts on the team. The Epic Senior Analyst , Resolute Professional Billing initiates the implementation, builds, and modifies of the… more
- University of Miami (Miami, FL)
- …Technology Department has an exciting opportunity for a full time Epic Senior Analyst - Resolute Professional Billing. The Epic Senior Analyst - Resolute ... Epic Analysts and Epic Analysts on the team. The Epic Senior Analyst initiates the implementation, builds, and modifies of the application, and collaborates… more
- Molina Healthcare (Miami, FL)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... and other business requirements. **KNOWLEDGE/SKILLS/ABILITIES** + Trains staff on configuration functionality, enhancements, and updates. + Works with internal and… more
- Centene Corporation (Tallahassee, FL)
- …Project management experience preferred. **Benefits and Payment Configuration :** **Compliance Coding/Prepay Compliance (Payment Integrity):** Bachelor's degree ... preferably healthcare (ie documenting business process, gathering requirements) or claims payment/analysis experience. Advanced knowledge of Microsoft Applications, including… more
- Elevance Health (Tampa, FL)
- …providing support, configuration , design, testing and implementation for ratings or claims systems. **How you will make an impact:** + Develops, implements, and ... of study and a minimum of 6 years systems analyst or business analyst experience; or any...field strongly preferred. + Strong understanding of data analysis, claims processing, and audit processes associated with healthcare payment… more