- AdventHealth (Maitland, FL)
- …**Responsible for ensuring the providers are loaded timely and accurately with Managed Care contracted payers. Responsible for evaluating professional fee ... the Physician Enterprise (PE) and works closely with practice office operations staff, Managed Care (MC) contracting, MC Credentialing and Enrollment and billing… more
- AdventHealth (Maitland, FL)
- …(Medicare, Medicaid, Tricare) payer reimbursement language and methodologies. The Senior Compliance Analyst works with Managed Care staff in all AH ... policies, laws, and guidelines that impact healthcare billing. + ** Reimbursement ** * Supports Managed Care ...Compliance Analyst role requires extensive knowledge in Managed Care contract interpretation and payment methodologies,… more
- AdventHealth (Maitland, FL)
- …for analyzing and evaluating financial and economic data related to healthcare costs and managed care payer rates and reimbursement . The role focuses on ... ethic, trainability, communicative, team player, and strong analytical skills The Senior Medical Economics Analyst will work with managed care staff for both… more
- MyFlorida (Tallahassee, FL)
- …1115 waivers and home and community-based waivers), administrative rules, coverage policies, managed care plan contracts, bill analyses, drug utilization review ... 68064851 - MEDICAL/HEALTH CARE PROGRAM ANALYST Date: May 8,...in the development of policy language for: the Medicaid managed care report guide, Medicaid contracts and… more
- BayCare Health System (Clearwater, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **Responsibilities:** + The Managed Care Financial Analyst Sr. performs financial ... Excel during the contract negotiation process. + Serves as Primary Contact for contract/ managed care payer claims and operational issues resolution for assigned… more
- Molina Healthcare (St. Petersburg, FL)
- …utilized in medical coding/billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts and provider reimbursement principles such ... facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.) + Proficiency with Microsoft… more
- Molina Healthcare (FL)
- …utilized in medical coding/billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts and provider reimbursement principles such ... facilities, healthcare vendor, commercial health insurance company, large physician practices, managed care organization, etc.) + Proficiency with Microsoft… more
- Evolent (Tallahassee, FL)
- …in claims-based healthcare analytics with a payer, provider, clinical vendor, managed care , or related healthcare consulting entity- Required.** **Ability ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
- CVS Health (Miami, FL)
- …changing environment + Effective communication skills, both verbal and written + Managed care experience + Case management and discharge planning experience ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- RTX Corporation (Largo, FL)
- …for a security clearance **Security Clearance:** DoD Clearance: Secret Raytheon Company, Managed by Collins Aerospace Collins Aerospace is looking for an entry-level ... Logistics Analyst to support the Largo, FL Logistics Shipping Operation...contribution, including a Lifetime Income Strategy option + Tuition reimbursement program + Student Loan Repayment Program + Life… more
- Highmark Health (Tallahassee, FL)
- …various complex potential claims with emphasis on controlling losses through effective managed care . This includes following a departmental claim checklist to ... ensure eligibility is met, the payment reimbursement request is accurate by auditing the claim for...3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate… more
- Evolent (Tallahassee, FL)
- …experience in claims-based healthcare analytics with a payer, provider, clinical vendor, managed care , or related healthcare consulting entity + Ability to ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
- Centene Corporation (Tallahassee, FL)
- …business process, gathering requirements) or claims payment/analysis experience. Knowledge of managed care information systems and experience in benefits, ... pricing, contracting or claims preferred. Knowledge of provider reimbursement methodologies preferred. Previous structured testing experience preferred. Experience… more
- Community Health Systems (Sarasota, FL)
- …guidelines, and payor medical policies + Demonstrates knowledge of governmental, managed care , and commercial denial/appeal policies + Appropriately reviews ... (Full-Time, Remote) The Clinical Review Analyst is a professionally licensed nurse/LPN who is...defensible appeals (according to payer guidelines) to obtain appropriate reimbursement for care delivered to patients. As… more
- RTX Corporation (Largo, FL)
- …under this program/contract. **Security Clearance:** None/Not Required **Raytheon Program Managed by Collins Aerospace** Collins Aerospace has an exciting ... and Cost Estimating organization supporting our Largo, FL facility. The Cost Estimating Analyst is responsible for bidding the labor costs for all of Mission… more