- CHS (Clearwater, FL)
- **Overview** ** Claims Manager ** **Servicing** **Health Insurance Policies or Benefits** **Summary:** Premier Administrative Solutions (PAS) is a Third-Party ... as the client's stated coverage. Join Premier Administrative Solutions as a Claims Manager and lead our Claims Department in delivering exceptional service… more
- Molina Healthcare (St. Petersburg, FL)
- **Job Summary** The Manager , Medical Economics provides support and consultation to the New York Health Plan and Finance team through analyzing key business issues ... executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other… more
- Walgreens (St. Petersburg, FL)
- …events that reflect the unique communities we serve as requested by Store Manager , Healthcare Supervisor, or District Manager . Operations + Counsels patients and ... that elements of Good Faith are present. + Collaborates with Store Manager to define and develop new strategic business opportunities. + Maintains information… more
- Walgreens (Pinellas Park, FL)
- …others accountable for efficient workflow. + At the direction of the Pharmacy Manager or pharmacist, prepares, and files reports and records required by the company ... maintenance of pharmacy department equipment. In collaboration with Pharmacy Manager , responsible for recordkeeping and ensuring security safeguards are in-place.… more
- Compass Group, North America (St. Petersburg, FL)
- …guests and partners is our number one priority. As Food Safety and Sanitation Manager , you are responsible for leading all areas of Food Safety and Sanitation ... team in responding to or managing any safety and claims issues + Working with operations and culinary teams...of team members, foodborne illness, liquor liability and guest claims + Work with local OSHA, sanitation or Everclean… more
- Avenue5 Residential, LLC (St. Petersburg, FL)
- Job Title: Property Manager Explore Promenade at Carillon Unlock your potential with Avenue5 Residential. Your ideas. Your development. Your experience. We take care ... program. And we're just getting started. About the property manager position: The senior property manager is...Manage the property and associate safety records, property loss claims , and risk management initiatives + Other duties as… more
- GE Vernova (Clearwater, FL)
- …and implement project specific contractual procedures, particularly regarding claims , insurance, variation orders, correspondence and notifications. + Support ... support and guidance to project team on general contractual issues and claims . Clarify contractual/legal enquiries, if necessary referring to Legal. + Provide… more
- Molina Healthcare (St. Petersburg, FL)
- …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of SQL ... 2005/2008 SSRS report development + Familiar with relational database concepts, and SDLC concepts **Preferred Education** Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field. **Preferred Experience** 3 - 5 years… more
- Molina Healthcare (St. Petersburg, 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...complex MRDT and other configuration update scripts * Assists manager in establishing standards, guidelines, and best practices for… more
- Molina Healthcare (St. Petersburg, FL)
- …Duties** + Facilitates clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases in which an appeal has been made, ... likely to be made, to ensure medical necessity and appropriate/accurate billing and claims processing. + Reevaluates medical claims and associated records by… more
- Walgreens (Seminole, FL)
- …records. Checks in and prices merchandise as required or as directed by store manager or communicated by the shift leader. + Performs duties as assigned by Pharmacy ... Manager , Staff Pharmacist and Store Manager including...those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a… more
- Walgreens (Seminole, FL)
- …Co. Pharmacy Code of Conduct. + Performs duties as assigned by Pharmacy Manager , Staff Pharmacist and Store Manager including utilizing pharmacy systems to ... pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient… more
- Walgreens (St. Petersburg, FL)
- …Co. Pharmacy Code of Conduct. + Performs duties as assigned by Pharmacy Manager , Staff Pharmacist and Store Manager including utilizing pharmacy systems to ... pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient… more
- Elevance Health (Clearwater, FL)
- …information as needed. + Copies incoming and outgoing correspondence. + Ensures rejected claims were denied correctly or determines if those claims should be ... matched to a member. + Manually matches or denies claims that are halted in our system because of...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Walgreens (St. Petersburg, FL)
- …Supports the efficient workflow of the pharmacy and assists the pharmacy manager in identifying ways to optimize pharmacy financials, inventory management and ... in accordance to regulations, company policies and standards. Assists pharmacy manager with establishing procedures that promotes the efficient workflow of the… more
- ABM Industries (Clearwater, FL)
- …operation and report all pertinent details of the operation to the Operations Manager and Assistant Operations Manager . Recommend measures to improve ... patterns and valet activity to prevent injuries and guest claims . . Promptly investigate claims , providing support...injuries and guest claims . . Promptly investigate claims , providing support whether denied or approved. . Investigate… more
- MyFlorida (Largo, FL)
- …and to other Accounts Receivable billing software systems. + Perform third party claims processing and collection activities for all payors of the State Veterans' ... assigned Homes. + Provide ongoing feedback to Billing Department Manager related to process improvement for billing unit practices...other related duties as directed by the Health Operations Manager and Billing Department Manager in an… more
- RTX Corporation (Largo, FL)
- …Secret Collins Aerospace is seeking a talented and driven Principal Specialist Material Program Manager (MPM) to join our Mission Systems team in either Largo, FL or ... customer communications and building a robust customer relationship + Supplier Claims /Request for Economical Adjustments (REA's) and mediation management + Conduct… more
- Molina Healthcare (St. Petersburg, FL)
- …focused reviews and recommends corrective actions. * Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. ... (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other… more
- Molina Healthcare (St. Petersburg, FL)
- …Responsible for analytics and reporting, acting as a Jr Project manager to oversee vendor implementations, coordinating data extractions, gathering requirements, ... SQL, PowerBI, databricks. + Experience on ETL , healthcare specifically claims is highly preferred. **JOB QUALIFICATIONS** **Required Education** Associate degree or… more