- Orlando Utilities Commission (Orlando, FL)
- **OUC - The** **_Reliable_** **One** **,** is presently seeking a ** Claims Analyst ** to join the Office of General Counsel division. At OUC, we don't just work - ... Florida statutes to review and analyze property and liability claims for OUC. In this role, you will investigate,...In this role, you will investigate, negotiate, and settle claims in a professional, equitable, and consistent manner. You… more
- Molina Healthcare (Orlando, FL)
- …**Job Summary** Analyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers. Identifies and ... interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and analysis based on business needs and… more
- Molina Healthcare (Orlando, FL)
- …**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 for process developments and improvements. + Reviews, researches, analyzes and evaluates all… more
- AdventHealth (Maitland, FL)
- …(Altamonte Springs,FL)** **The role you'll contribute:** A Senior Medical Economics analyst is responsible for analyzing and evaluating financial and economic data ... analyze fee schedules, and determine contract compliance. The Senior Medical Economics analyst must have attention to detail and competencies in decision support and… more
- AdventHealth (Altamonte Springs, FL)
- …identifying and sharing insights that improve operational, clinical, and financial performance. The Analyst will use healthcare data ( claims , labs, MMR data, EHR ... **Senior Medicare Data & Finance Analyst ** **Location:** Virtual **All the benefits and perks...role will include leveraging data from electronic health records, claims , and payer reports by means of SQL queries,… more
- Molina Healthcare (Orlando, 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
- MyFlorida (Orlando, FL)
- GOVERNMENT ANALYST I - 79011410 Date: Jan 14, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 844603 Agency: Business and Professional Regulations Working Title: GOVERNMENT ANALYST I - 79011410 Pay Plan: Career Service Position Number: 79011410… more
- Molina Healthcare (Orlando, FL)
- …organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses ... and existing health plans. + Completes analysis on retroactive claims reports + Pre and post validation of complex...Requires assistance with schema from Tech resource or Lead Analyst . + Writes Requirements for BRDs/FRDs and Reports. +… more
- Sedgwick (Orlando, FL)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer IT Systems Analyst Specialist **PRIMARY PURPOSE** : To review, analyze and document software ... combination of education and experience required. Experience in multi-line claims management processes and system requirements preferred. **Skills & Knowledge**… more
- AssistRx (Orlando, FL)
- The Data Quality Analyst is responsible for acquiring, managing and analyzing data that will be presented to internal teams, clients and partners. The Data ... Analyst leads the onboarding of electronic data trading partners...issues. Successful applicants will have experience with Excel Pharmacy Claims experience is a huge plus Requirements + Developing… more
- Molina Healthcare (Orlando, FL)
- …Description** Who you are : + You have proven experience as a QA Analyst within an Agile environment. + Experienced testing on-premise and cloud based ETL/BI ... You can prioritize. + You have experience with QNXT, claims processing , healthcare insurance and SQL + You...QA role within our Agile team is a Senior Analyst position dedicated to ensuring the highest quality standards… more
- Molina Healthcare (Orlando, FL)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... + Must have experience in system configuration. + Monitor claims , create , generate and analyze reports using Excel...make changes if needed. + Must have experience in claims , advanced excel for analyzing and presenting data. +… more
- Molina Healthcare (Orlando, FL)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... conversion of new and existing health plans. + Must have experience on claims processing system, benefit configuration. + SQL knowledge is preferred. + Healthcare… more
- Molina Healthcare (Orlando, FL)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... completion dates with Health Plans. + Must have experience with Benefits configuration, claims + The team is responsible for implementation and configuration of all… more
- Sedgwick (Orlando, FL)
- …Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workforce Planning Analyst **PRIMARY PURPOSE:** To provide workforce development strategies and ... their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more… more
- Molina Healthcare (Orlando, FL)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department with HEDIS… more
- Molina Healthcare (Orlando, FL)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings. **KNOWLEDGE/SKILLS/ABILITIES** + Develop ad-hoc reports using SQL programming, SQL Server… more
- Molina Healthcare (Orlando, FL)
- …to support the departments goals. + SQL, Databricks, Python + Claims knowledge/QNXT **JOB QUALIFICATIONS** **Required Education** Associate's Degree or equivalent ... combination of education and experience **Required Experience** 1-3 years **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 3-5 years To all current Molina employees: If you are interested… more
- Molina Healthcare (Orlando, FL)
- …operational processes including but not limited to Enrollment, UM, Claims & Care Management** **Preferred License, Certification, Association** Certified Business ... Analysis Professional (CBAP), Certification from International Institute of Business Analysis preferred To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare… 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