- Humana (Tallahassee, FL)
- …independent determination of the appropriate courses of action. **Where you Come In** As a Claims Process Organization Project Manager II you will manage ... caring community and help us put health first** The Project Manager II manages all aspects of a ... + Communicate with other operational areas in the organization to secure specialized resources and contributions for the… more
- Humana (Tallahassee, FL)
- …career to the next level by driving real impact and shaping the future of claims management? As a Senior Pharmacy Claims Professional, you will play a pivotal ... in resolving outstanding balances related to claim reversals, all while leading process improvements and influencing departmental strategies. This is your chance to… more
- Kepro (Tallahassee, FL)
- …Conduct thorough investigations to address and rectify any issues arising during the claims entry process , ensuring accuracy and efficiency in documentation and ... composure and professionalism when handling challenging situations. + Experienced in managing claims through the review process and monitoring the status of… more
- Guardian Life (Tallahassee, FL)
- **Job Posting Title** **Team Leader, Absence Claims Management** **Job Description** The **Team Leader, Absence Claims Management** is responsible for leading a ... Managers to get results within their team and the organization . The Team Leader will serve as a primary...action plans for improvement. + Review processes/reports regularly for process improvement opportunities. + Own relationship with client and… more
- Norstella (Tallahassee, FL)
- …Now, Citeline is proud to be a part of Norstella, an organization that consists of market-leading pharmaceutical solutions providers united under one goal: ... to improve patient access to life-saving therapies. Within this organization , Citeline plays a key role in helping clients connect the dots from pipeline to patient.… more
- Emerson (Tallahassee, FL)
- …Engineer to oversee and manage projects related to feeding systems in our organization . The successful candidate will coordinate and lead projects from conception to ... proposal with the sales team, making adjustments as necessary. Overall Project Responsibility: + Assume end-to-end project responsibility, ensuring consistency… more
- Sedgwick (Tallahassee, FL)
- …their employees regain health and productivity, guide their consumers through the claims process , protect their brand and minimize business interruptions. Our ... all software developers and development initiatives managing timelines, resources and project plans + Analyze and translate business requirements and high level… more
- Deloitte (Tallahassee, FL)
- …the power of hybrid services and products, and unlocking the power of Process Bionics to deliver sustainable and impactful solutions to our clients. We advise, ... relevant processes and technologies for their industry-and apply them with a process and mindset that tailors transformational change to their specific … more
- Prime Therapeutics (Tallahassee, FL)
- …Description** + Performs exploratory data analysis and data mining of healthcare claims and authorizations data. + Designs, documents, develops and rolls out ... reports that give a detailed description of the current project 's progress and indicates time devoted to each task...in easily understandable format for varying levels of the organization . **Responsibilities** + 3+ years of transact-SQL (MS SQL… more
- Sunrun (Tallahassee, FL)
- …branch relationships including weekly/monthly reviews, utilization and workload management, process updates and identification and resolution of specific market and ... process issues + Work to pursue and achieve tactical...that require cross-functional engagement with key staff across the organization and external stakeholders + Launch initiatives that increase… more
- Takeda Pharmaceuticals (Tallahassee, FL)
- By clicking the "Apply" button, I understand that my employment application process with Takeda will commence and that the information I provide in my application ... **About the role:** At Takeda, we are a forward-looking, world-class R&D organization that unlocks innovation and delivers transformative therapies to patients. By… more
- Prime Therapeutics (Tallahassee, FL)
- …processes and plans to mitigate future risk. + Lead coordinated efforts across the organization to implement new program or process changes for the client. ... minimization of expense and reporting of performance measures including drug claims processing + Create and maintain strategic partnerships with customers through… more
- Wolters Kluwer (Tallahassee, FL)
- … project life cycle; contributing to and executing department process improvement initiatives; managing time and resources effectively; maintaining performance ... increase operational efficiency and reduce costs. Corporate legal and insurance claims departments trust our innovative technology and end-to-end customer experience… more
- Sedgwick (Tallahassee, FL)
- …their employees regain health and productivity, guide their consumers through the claims process , protect their brand and minimize business interruptions. Our ... SAP, assisting Sedgwick in improving business processes. + Defines project scope, estimates and project plans, incorporating...they demonstrate what it means to work for an organization committed to doing the right thing - one… more
- Wolters Kluwer (Tallahassee, FL)
- …and not afraid of the hunt. Someone that prefers to navigate the entire sales process , from start to finish, run their own demos, build a strong and lasting ... entity or claim management - Legisway covers end-to-end legal department needs (corporate, claims , IP, Data Privacy, and so much more!). Legisway is used by legal… more
- Humana (Tallahassee, FL)
- …projects and initiatives, partnering and collaborating with multiple areas across the organization . + Develops or has a deep understanding of physician networks, ... physician performance and rating metrics ( claims , measures, conditions, specialties, etc.), product offerings, and analytics-based approaches which produce… more
- Sunrun (Tallahassee, FL)
- …**ESSENTIAL DUTIES AND RESPONSIBILITIES** + **Represent the customer within the organization , collaborating with the technology team to align product developments ... + **Facilitate research and investigation into Sales ROE (Rules of Engagement) claims , working with customer care and compliance teams to ensure fair outcomes.**… more
- MyFlorida (Tallahassee, FL)
- …about the operations of the Medicaid fiscal agent, including Medicaid claims process , billing procedures, reimbursement methodologies, encounter submissions, and ... care. If you have a desire to use your talent and skills at an organization that provides critical services to millions of individuals and families across the state,… more
- Sumitomo Pharma (Tallahassee, FL)
- …the Medicaid rebate team in receiving, processing, validating, trouble-shooting Medicaid claims and dispute resolution with state agencies. This position requires a ... as it relates to Model N implementation and payment process . + Lead subject matter expert (SME) for shared...Proficient in MS Office (Word, Excel, Access, PowerPoint, MS Project , Visio, SharePoint). + Customer-focused ability to communicate across… more
- HUB International (Tallahassee, FL)
- …our people to make the best decisions for our customers and organization . We offer: + Competitive salaries and benefits offering + Medical/dental/vision insurance ... judgment to resolve. May also negotiate with underwriters and carriers. Troubleshoots claims and billing issues. + Responsible for overall retention of accounts in… more