- Molina Healthcare (Miami, FL)
- **Job Description** **Job Summary** The Senior Claims Research Analyst provides senior-level support for claims processing and claims research . ... The Sr. Analyst , Claims Research serves as a senior-level subject matter expert in...regulatory and contractual requirements. + Leads and manages major claims research projects of considerable complexity, initiated… more
- Molina Healthcare (Miami, FL)
- JOB DESCRIPTION **Job Summary** Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory ... inquiries and projects. * Interprets and presents in-depth analysis of claims research findings and results to leadership and respective operations teams. *… more
- University of Miami (Miami, FL)
- …of Miami Health System IT Department has an opportunity for a full-time Epic Analyst 2. The Epic Analyst 2 assists Associate Epic Analysts on the ... to optimize the application's configuration, function, and access. The Epic Analyst 2 facilitates day-to-day application support and resolving application issues and… more
- Elevance Health (Miami, FL)
- **Title: Grievance/Appeals Analyst I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... by law._ Shift hours: Tuesday - Saturday 8:30am - 5:00pm EST** The **Grievance/Appeals Analyst I** is an entry level position in the Enterprise Grievance & Appeals… more
- University of Miami (Miami, FL)
- …of Miami Health System IT Department has an opportunity for a full-time Business Systems Analyst 3 - Revenue Integrity. The Business Systems Analyst 3 - Central ... overall performance, reduce costs, and increase efficiencies. The Business Systems Analyst 3 - Central (H) analyzes established operations, systems, methods,… more
- University of Miami (Miami, FL)
- …of Miami/UHealth Department of SCCC has an exciting opportunity for a Full Time Regulatory Analyst 1 to work remotely. CORE JOB SUMMARY The Regulatory Analyst 1 ... tests the revised treatment matrix to identify possible cancers from claims data. CORE JOB FUNCTIONS Analyzes regulatory requirements, identifies potential… more
- Bombardier (Opa Locka, FL)
- …process and administrative activities: electronic filing of invoice with OEM's for claims , complete work order tracking system updates and close the work order ... + Manage OEM invoice disputes and claims (from claim filing to resolving disputes and securing...to resolving disputes and securing payments) + Support the research for end Customer disputed invoices including issue credits… more
- WTW (Miami, 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
- Molina Healthcare (Miami, FL)
- …Responsible for accurate and timely auditing of critical information on claims databases. Maintains critical auditing and outcome information. Synchronizes data ... among operational and claims systems and application of business rules as they...review standards and methodology * Leads peer reviews * Research and review new audit tools and techniques and… more
- ChenMed (Miami, FL)
- …expanding and we need great people to join our team. The Actuarial Services Analyst is responsible for managing and tracking the risk positions within ChenMed as ... business planning, process improvement, solution assessment, etc. + Analyzesand validatespayer claims data.Assistsmarkets to identify factors driving claims cost… more
- ChenMed (Miami, FL)
- …great people to join our team. Working with limited guidance, the Senior Analyst VBC (Value Based Care) Performance is responsible for proactively tracking the risk ... planning, process improvement, solution assessment, etc. + Analyzes and validates payer claims data. Assists markets to identify factors driving claims cost… more
- Elevance Health (Miami, FL)
- …Coordinates research and responds to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues and ... eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing… more
- Molina Healthcare (Miami, FL)
- … research , financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable financial ... **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the...basis using SQL, Excel, and other reporting software. * Research , develop, analyze and recommend cost savings opportunities in… more
- Molina Healthcare (Miami, FL)
- … research , financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable financial ... **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the...basis using SQL, Excel, and other reporting software. + Research , develop, analyze and recommend cost savings opportunities in… more
- Molina Healthcare (Miami, FL)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... and Identifying targeted Interventions and tracking outcome. Assist with research , development, and completion of special performance improvement projects.… more
- Molina Healthcare (Miami, FL)
- …emerging technologies. **KNOWLEDGE/SKILLS/ABILITIES** + With limited supervision, the Sr. Analyst , Data is responsible for data compilation, data management, data ... trends + Works with internal, external and enterprise individuals as needed to research , develop, and document new standard reports or processes + Consolidates data… more
- Molina Healthcare (Miami, FL)
- …Procedures, Standard Operating Procedures and other internal guidelines. + Review, research , analyze and evaluate information to assess compliancy between a process ... compliance related. + Coordinate, facilitate and document audit walkthroughs. + Research , collect or generate requested documentation. Provide timely and accurate… more
- World Insurance Associates, LLC. (Miami, FL)
- …cases + Create monthly financial reporting packages including detailed premium, claims , membership, commission, and cash reconciliation information + Create weekly, ... + Provide timely, courteous and accurate response to all inquiries, conducting research when necessary and communicating results + Process all necessary paperwork by… more