- Molina Healthcare (Miami, 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
- Molina Healthcare (Miami, FL)
- …Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business ... rules as they apply to each database. Validate data to be housed on provider databases and ensure...and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality. +… more
- Medtronic (Miami, FL)
- …for these individuals. We are hiring a passionate, fast-paced, and strategic ** Sr . Group Market Development Manager** to manage the healthcare professional (HCP) ... and provides strategic support to reimbursement, clinical, and sales teams. The Sr . Group Market Development Manager will focus on increasing healthcare professional… more
- Molina Healthcare (Miami, 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
- ChenMed (Miami, FL)
- …economics data such as hospital/physician /ASC claims , utilization data , and healthcare industry coding systems ICD-10, CPT/HCPCS, Revenue Codes, ... we need great people to join our team. The Senior Health Economics Analyst is responsible for identifying and...JOB DUTIES/RESPONSIBILITIES:** + Analyzes and interpret enrollment, revenue, and claims (utilization and unit cost) data to… more
- Molina Healthcare (Miami, 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
- Elevance Health (Miami, FL)
- … data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy ... **Investigator Senior ** **Supports the Payment Integrity line of business**...to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health… more
- Walgreens (Davie, 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
- Kemper (Miami, 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
- LogixHealth (Dania Beach, FL)
- Location: On-Site in Dania Beach, FL This Role: As a Senior Manager of the ED Billing department at LogixHealth, you will work with internal teams to identify ... training for new hires + Develop new processes as systems and job duties evolve + Update staff on...offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting dashboards… more
- Trinity Health (Fort Lauderdale, FL)
- …with THS Regional Managers and RHM stakeholders. Works with all levels of senior leadership and management teams at RHMs and within the region. Develops and ... Mission, Vision, and Values in behaviors, practices, supports and endorses senior leadership decisions, goals, objectives, and strategies. Oversees the day-to-day… more
- University of Miami (Miami, FL)
- …and testing the revised treatment matrix which will identify possible cancers from claims data . The RA1 will facilitate the process of preparing required ... information and research records for clinical trials within institution's electronic systems (eg, Velos, Complion) and appropriate drives, as applicable. +… more
- Monte Nido (Miami, FL)
- …of reasonable accommodations. + Oversee workers compensation program, by filing claims and communicating with vendor as employees/managers. + Reconcile annual ... compliance-related reports, including FMLA utilization, leave trends, and absence data . + Prepare and provide reports for internal audits,...+ **Skills and Abilities** : + Knowledge of HR systems and leave tracking software. (ADP Workforce Now a… more