- 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
- Molina Healthcare (Orlando, FL)
- … systems to support executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation...evaluate the impact of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical… 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
- Walgreens (Orlando, FL)
- …accordance with Company policies and procedures. Responsible for operating pharmacy systems to obtain patient and drug information and process prescriptions. Assists ... coaches pharmacy technicians and Fulfillment Specialists in the operation of pharmacy systems . Models and delivers a positive customer experience. While this is… 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 ...Tableau, Business Objects + working with healthcare, insurance or claims data + Six Sigma certified This… more
- Molina Healthcare (Orlando, FL)
- …that internal teams and delegated vendors must follow, and you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and ... gains, audit readiness, and measurable member-experience improvements. You'll begin as a senior individual contributor with the charter to build a focused CTM… more
- Kiewit (Orlando, FL)
- **Requisition ID:** 176933 **Job Level:** Senior Level **Home District/Group:** Southeast District **Department:** Operational Finance **Market:** Transportation ... developing procedures and controls to ensure the integrity of all financial data . This role supports multiple infrastructure projects ranging from **$1 million to… more