- Molina Healthcare (Orlando, FL)
- …functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received ... support issues related to EDI transaction editing and custom claims processes to determine root cause of issue. Gains...claims to identify billing issues that will impact claims processing and payment. Monitor new solutions implemented to… more
- AdventHealth (Maitland, FL)
- …sources using knowledge of healthcare managed care contracts and healthcare administrative claims data + Employs existing complex models and implements them ... to the team:** + Research and analyzes managed care data from the various financial systems and...provider types + Applies detailed understanding of medical coding systems affecting the adjudication of claims to… more
- Molina Healthcare (Orlando, FL)
- … claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of ... business rules as they apply to each database. Validate data to be housed on databases and ensure adherence...information into the claim payment system and other applicable systems . + Participates in defect resolution for assigned component… more
- The Hartford (Lake Mary, FL)
- …our team as we help shape the future. The Hartford is seeking to hire a Senior Litigation Analyst to join our Legal team. We are looking for motivated attorneys to ... legal bill invoices and to conduct in office Legal Bill Review audits.As a Senior Litigation Analyst you will be expected to provide a breadth and depth… more
- Walgreens (Orlando, FL)
- …with Company policies and procedures. + Responsible for operating pharmacy systems to obtain patient and drug information and process prescriptions. Assists ... and coaches pharmacy technicians in the operation of pharmacy systems and cashiers in the operation of the pharmacy...those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a… more
- AdventHealth (Maitland, FL)
- …care issues by collecting and interpreting contract performance information (eg claims volumes, quality and efficiency reports, participation gap analysis, accounts ... receivable data , etc.) to preserve the integrity of those contracts....AdventHealth departmental leaders and making recommendations as needed. + SYSTEMS (5%) Accepts responsibility for the overall contracting process… more
- Walgreens (Deltona, FL)
- …by Pharmacy Manager, Staff Pharmacist and Store Manager including utilizing pharmacy systems to enter patient and drug information, ensuring information is entered ... the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and… more
- Kemper (Orlando, FL)
- …to achieve growth & profit objectives may include training on products, systems , service, and underwriting, book transfers, development of existing accounts, new ... + Operates as the point of contact for operations, systems and policy training for account products as well...Utilizes agency segmentation, reports and technology to manage account data and performance. + Documents all completed activities with… more
- AdventHealth (Altamonte Springs, FL)
- …skills to solving problems + Ability to use knowledge and understanding of data , data systems , and statistical software applications, clinical and ... to the Population Health team. The Health Plan Data Analyst engages clients (finance team, senior ...utilizing analytical software tools and applications + Health Plan claims data knowledge This facility is an… more
- AdventHealth (Maitland, FL)
- …various sources using knowledge of healthcare managed care contracts and healthcare administrative claims data + Works alongside Senior Medical Economics ... **A Medical Economics Analyst is responsible for supporting the Senior Medical Economics Analyst by applying technical, analytical, and...team:** + Assisting in Research and analyzes managed care data from the various financial systems and… more
- Synergy Healthcare Solutions (Maitland, FL)
- …to online learning 24/7:** Our Learning Management System offers over 1,500 courses for senior care, health and human services industry. Data base includes, MS ... + Generate timely billing of assigned payers + Ensure claims are received and processed by payers + Review...payments are received + Maintain current and accurate computer data including documentation of all account activity performed in… more